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Cross Tapered From Cymbalta To Zoloft - When Does Withdrawal Usually End?


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#1 bruinsfan617

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Posted 29 January 2018 - 11:01 AM

Hello,

 

I was taking Cymbalta for 5 years, beginning when I was 21 and in college for anxiety.
 

I am now 26, and beginning my life engaged, happily employed, and comfortable - and I don't want to lose that.  Something triggered my anxiety back, and around July 1st, 2017 - my anxiety symptoms of constant overthinking, fatigue & fear took over.  I was told by my GP to increase to 90mg before trying something else.  That seemed to do the trick for 2 months, along with consistent exercise.  However ,it just wans't enough due to other stressful events.

 

Eventually I went to a Psych doc, who recommended trying to max out at 120 mg of cymbalta before trying something else.  Needless to say, this did not help - it made it worse.

By November 2017, I began tapering off Cymbalta 120mg, and starting zoloft.  The process was absolute hell - constant anxiety/fear/faitige of losing my job due to feeling this way, losing my fiance, etc.  I worked on myself with more relaxation techniques like meditation & yoga, which seemed to help from time to time.

Ultimately, the anxiety became so bad, I started using my prescribed ativan periodically to help - .5 mg.  To date, I have not taken it for more than 5 days straight - at most twice a day during the tough stretch of withdrawals at the end of the year past Christmas.

Well, on Jnauary 12th, I officially stopped taking cymbalta.  I had gradually reduced cymbalta from 120 mg to 90 mg, to 60 to 30 to 20 - to zero between November 15th - January 12th.  Subsequently, I creased my zoloft from 50 to 100, to 125 to 150 along that same time frame.  Specifically, I began to see marked improvement when I began 150 mg of Zoloft around the time I dropped from 30mg to 20 mg.  Still had withdrawals of anxiety, but they began to fade away slowly.

Well after January 12th happened, that was a Friday, I simply kept going and feeling anxiety free for days!

 

I had nausea and weird bowel movements beginning 2 days later, but I thought it was just a stomach bug.  4-5 days later my skin developed weird hive-like rashes, which I just attributed to the cold, dry air + hot showers.

 

Fast forward to Friday, January 26th - my anxiety triggers from something at work, the same boss and a similar line written that just set me off.  It bothered me all night, but mostly anger & frustration.  I deiced to drink my problem away with some beers- bad idea.  I woke up the next morning, and I was still bothered by it.  It triggered anxiety, and wanting to just run & hide - eventually crying.  I couldn't believe it - it had been WEEKS since I was that bad.  This same effect continued on Sunday to a bit lesser of an extent - both both days I resorted to ativan to get through the day.  On the plus side, i confronted my boss on Sunday about it - and he was incredibly understanding (and has been throughout this process), and we reconciled.
 

 

Here I am Monday morning, still waking up with the same physical symptoms of anxiety.  My question is - is it cymbalta withdrawal lingering, or is it just me?  I typically feel anxiety kick in every time I drop form cymbalta, but honestly didnt feel that way for 2 weeks.  I presumed the stomach & skin issues were unrelated- could they be related?

I really appreciate everyone's years of expertise on this matter for guidance.  Thank you.

 


#2 fishinghat

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Posted 29 January 2018 - 11:58 AM

Welcome BF, sorry to hear about your issues. You were doing so well also.

"I had nausea and weird bowel movements beginning 2 days later, but I thought it was just a stomach bug. 4-5 days later my skin developed weird hive-like rashes, which I just attributed to the cold, dry air + hot showers."

I have a concern here. While the stomach issues with Zoloft is not unusual the it seems like the rash is an allergic reaction. I will check on that and ne back in a moment.


#3 fishinghat

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Posted 29 January 2018 - 12:06 PM

Yes this happened to one of our members about 6 mongths ago and she spent time in the hospital over it because it turned out to be Stevens-Johnson Syndrome which normally (but not always develops around the mouth. This can be serious so call your dr right away. Her dr wasn't even aware of this threat so you may want to go to this site and copy the sheet. It is the drug insert from the manufacturer that comes with the medicine.

 

Call right away.

https://dailymed.nlm...aa-3ebd79a046b5

Allergic Reactions
Advise patients to notify their healthcare provider if they develop an allergic reaction such as rash, hives, swelling, or difficulty breathing.
Skin and subcutaneous tissue disorders - photosensitivity skin reaction and other severe cutaneous reactions, which potentially can be fatal, such as Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN)


#4 bruinsfan617

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Posted 29 January 2018 - 12:38 PM

I honestly think I'm overreacting, because while zoloft did cause bowl issues after taking a new dose - it went away in 5 days.  Otherwise, I've had little to no issues.  Anything else is questionable between zoloft side effects or cymbalta withdrawal symptoms.

My question is: how long can I realistically expect cymbalta withdrawals to continue after the last dose?  no stomach issues anymore, and the rashes are subsiding, with occasional itching.  That's the trouble with this darn drugs - you get paranoid too easily.


#5 fishinghat

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Posted 29 January 2018 - 02:03 PM

I understand the paranoia, been there done that.

 

Symptoms usually last 6 to 8 months with some breaks after 2 to 3 months. A few have had NO withdrawal symptoms and some it lasted 1 or 2 years before it was gone. You might read the thread "and the answer to your question is..." in the Medical Support section. It is sort of a compilation of the things members have tried that worked and some that didn't. You should find some useful info in there.


#6 bruinsfan617

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Posted 29 January 2018 - 03:11 PM

I understand the paranoia, been there done that.

 

Symptoms usually last 6 to 8 months with some breaks after 2 to 3 months. A few have had NO withdrawal symptoms and some it lasted 1 or 2 years before it was gone. You might read the thread "and the answer to your question is..." in the Medical Support section. It is sort of a compilation of the things members have tried that worked and some that didn't. You should find some useful info in there.

 

Gotcha.  While that's unfortunate to know how long they can last, it is comforting to know why....I would venture to guess these flare-ups of cymbalta withdrawal symptoms can be treated with lifestyle changes, and will eventually dissipate.  

Thank you for the information & resources FH.  It's nice to know I'm not alone out there.


#7 fishinghat

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Posted 29 January 2018 - 03:31 PM

Never alone here BF. Stop by any time, even if just to complain.  lol


#8 bruinsfan617

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Posted 29 January 2018 - 05:00 PM

thank you!

In the spirit of complaining, I'll add this:

 

If I had tracked my withdrawal symptoms better, I may have suspected 2 weeks before they hit again....The fact I felt no immediate issues the first few days off Cymbalta entirely was a trap of sorts.

So is it typical for people to experience delayed withdrawals once they finally stop taking Cymbalta?  Any research on why the symptoms of withdrawal can persist for months after the last dose taken?  Just curious.


#9 fishinghat

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Posted 29 January 2018 - 06:07 PM

No research on the delayed withdrawal. It is interesting that some people who are on it will start having withdrawal within 2 or 3 hours of the first drop and others may not experience withdrawal until they get down to just one or 2 grams left.

 

There is no actual research on specifically what Cymbalta does to the synapses in the brain but research on benzos and a few ssri show that the medicine does not "fit" perfectly into the synapse receptor site and with time those sites will change in shape to better fit the medicine. This is why it takes some ssri/snri a long time to kick in. Research also shows that after stopping these meds it can take as long as two years for the receptor sites to return to normal after the last dose.


#10 bruinsfan617

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Posted 31 January 2018 - 10:15 AM

FH - So as far as withdrawal symptoms go - even though i'm on 150mg of Zoloft, I can still expect to feel residual withdrawals for 6-8 months?  Is that consistent or more on-and-off?  I can only guess  the latter, as it would make sense my body is adapting to not having cymbalta running through my blood after 5 years.  

I just hoped maybe the Zoloft would do a better job of muting it....but on the plus side, I am functioning decently!  I just need to drink alot of water, and stay mentally occupied.  But after 7 months of trying to change meds, I just feel fatigued from these feelings....like they'll never end.

 

I do have .5 mg of ativan, but I try to save that for sleeping.  I don't want to make ativan another drug I have to ween off of.


#11 fishinghat

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Posted 31 January 2018 - 11:31 AM

I am sorry BF. Those figures were for Cymbalta withdrawal in general. On the 150 mg Zoloft you should only have light  withdrawal symptoms if any. It would not surprise me if you would be able to stop taking the Ativan in a couple weeks. Things should be much easier for you as you go on. If at some time you feel you want to come off the Zoloft let me know. I have some info withdrawing from it.


#12 bruinsfan617

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Posted 31 January 2018 - 12:03 PM

Ok good to know.  I'm diagnosed GAD, so overthinking and reactions to things tend to make them worse than they actually are haha.

I think my P-Doc has done a great job at managing this transition, even though it has been extremely difficult.  I never took time off work through all of this, and my job is quite stressful half of the time. 

I'm also going to therapy doing CBT work & general talk therapy - it's been a great help.  

 

Based on my medicine journal I keep, I went from 125 mg of Zoloft to 150 mg on 12/29 - so we're at the 1 month mark on the same level, and only 2 and 1/2 months on zoloft period while tapering off cymbalta.  I guess that's not alot of time in retrospect - but the time getting off cymbalta & on zoloft was still awful.

Seems like I'm past the halfway point, and into the 7th inning stretch.  I thought when I didnt feel any side effects within the first week after coming off Cymbalta entirely I was scott-free.....but apparently not after something stressful triggered my anixety.

Praying for some relief from the last stretch of this cymbalta withdrawal effects!


#13 fishinghat

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Posted 31 January 2018 - 02:14 PM

I am impressed by your grasp of the situation BF. Also that you are doing CBT and keeping a journal. They are important steps to getting better.  Good job.


#14 bruinsfan617

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Posted 01 February 2018 - 12:03 PM

thanks FH.  Its been a tough road, but I'm figuring it out as it goes.

 

Good news is the anxiety is less mental than it was over the weekend - which to me seems like my CBT and Zoloft are working.  The symptoms are more physical (i.e rapid heart beat, headache, throbbing vagus nerve in the throat) - and I'm just frustrated its even occurring at all, after so many months of feeling this way.

What's possibly more frustrating is not knowing whether it is indeed cymbalta withdrawal, or breakthrough anxiety from a stressor.  That seems to be an issue universally with former cymbalta users, huh?


#15 fishinghat

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Posted 01 February 2018 - 02:00 PM

Absolutely!!


#16 bruinsfan617

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Posted 01 February 2018 - 04:19 PM

Whats amazing to me is - those with anxiety disorders tend to make the symptoms of withdrawal or the side effects of the drug far worse than they actually are.  Would that be a fair assessment?


#17 fishinghat

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Posted 01 February 2018 - 04:48 PM

Absolutely. Serotonin, Norepinephrine and Epinephrine all affect our emotions and can result in the development of anxiety by there actions in the hippocampus and amygdala in  the brain. Those two areas are also the centers of fear, phobias and panic. During my Cymbalta withdrawal I was in absolute fear of immediate death for 275 days until I finally got straightened out. If you have ever ridden in someone's car and woke to see a car apparently coming at you then you know what I mean. Fear!!! You freak out even though it may just be a car being towed on the back of a tow truck. I felt like I was going to die any instant. Even though my education told me what was happening in my brain the chemical reactions determined my feelings. Once the withdrawal was over you think both that was silly and then the next time you go through a withdrawal the same thing will happen again despite your best efforts.


#18 bruinsfan617

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Posted 02 February 2018 - 03:51 PM

Right now I just feel a dull, but persistent headache, and my heart pound harder than it usually does - especially that feeling in my neck where I check my pulse.  I try to stay busy to avoid feeling worse.....but it seems persistent this week no matter what I do.

 

Is this something an increase in the dosage of Zoloft would help? 


#19 fishinghat

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Posted 02 February 2018 - 05:53 PM

It is possible that an increase in dose of Zoloft would help. It usually would.


#20 gail

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    5 months on cymbalta, scary side effects, to get help and to return the favor if I can.

Posted 03 February 2018 - 08:40 AM

Hi BF,

Before upping the Zoloft, I would try Benadryl Total. One and a half caplets, GAD sufferers usually benefit (temporarily) relief from this. There is 500mg of acetaminophen in each caplets. This will quiet you down. Heart pounding and all. Only my two cents worth.

I am following your posts, not talking much but you are in good hands with our beloved Fishinghat.

#21 bruinsfan617

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Posted 04 February 2018 - 11:44 AM

Hi Gail,

Thanks for the tip! Fortunately I have Ativan when needed...I'm just trying to use sparingly.

FH - is it common for Cymbalta withdrawals to be delayed 2 weeks after the final dose? I just can't believe I had 2 good weeks with almost no anxiety symptoms and suddenly I'm back to how I was during each tapering adjustment.

What's killing me this week are nasty headaches, fatigue, and less-than-satisfying sleep.

I'm just scared if it is not Cymbalta, than I just wasted months going on zoloft for nothing - even though I've felt days where the Zoloft really really worked.

#22 fishinghat

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Posted 04 February 2018 - 01:00 PM

A delayed withdrawal like you described is very unusual. Normally the withdrawal continues or gets worse when you get to a low dosage and continues uninterrupted until you start recovering weeks later.


#23 bruinsfan617

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Posted 04 February 2018 - 02:41 PM

Well, I will say the two weeks I felt "good" weren't perfect - as I mentioned, I had strange stomach issues I presumed was the stomach bug. I pretty much got through that by staying busy and focused.

Needless to say I could not do that today, and got overwhelmed - so I took an Ativan and now feel much better.

My last change in zoloft was from 125 to 150 back on December 29th. That was the same day I dropped from 30mg of Cymbalta to 20mg. Needless to say, this has all been a roller coaster - but I felt like the 150 WAS working most days, and especially during the first 2 weeks off Cymbalta, given that my GAD is rooted in some form of hypochondria - so surviving a possible stomach bug is a big deal mentally.

Per my medication journal, the worst drops for Cymbalta were from 90 mg to 60mg, and 60 to 30mg. The 30-20mg drop was not nearly as bad, as I went up to 150 from 125 of Zoloft. Truth be told - my January was the best month in awhile in terms of anxiety management.

So why am I not "level"? Is it really just my anxiety making me crazier than I am? It just feels like work stress/triggering on last Friday broke through the zoloft barrier after 2 weeks of strong defenses from stomach bug related stuff. The headaches are new to me, as I have only had headaches like these from bad colds or a flu - but alas, neither cold nor flu symptoms.

Perhaps I haven't given Zoloft enough time to be fully kicked in? It's only been 4 weeks off of it, and now 3 weeks off Cymbalta. Could it also be Cymbalta symptoms still haven't left my body?

Thanks thus far for all the insight and support

#24 fishinghat

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Posted 04 February 2018 - 04:14 PM

The Zoloft is just now at the point where it is really kicking in. It has been 5 weeks and 2 days since you went to 150 on the Zoloft. A 6 weeks it will be fully kicked in. Your body is still adapting and that takes time. Most of us had a rollercoaster during our withdrawal.

 

Hang in there it will get better.


#25 bruinsfan617

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Posted 04 February 2018 - 05:53 PM

So you think it's just Cymbalta withdrawals breaking through, and I should ride it out?

#26 fishinghat

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Posted 04 February 2018 - 06:38 PM

Just my gut feelings, yes. Like I say, it is unusual but possible. I was just thinking  a few minutes ago that part of the Cymbalta withdrawal is digestive issues. Especially nausea, Maybe that is what that 'stomach bug' was.


#27 bruinsfan617

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Posted 05 February 2018 - 03:22 PM

yeah, I think you're right.    I'm guessing that stress from work/life just exacerbated the withdrawals.  I'm kind of surprised I wasn't as anxious when I had the stomach issues - anxiety to stomach issues are what caused me to go on in the first place!

 


#28 bruinsfan617

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Posted 07 February 2018 - 09:53 AM

So i talked to my p-doc - not sure if its continued Cymbalta withdrawal, or more likely just brain chemistry adjustments from the SNRI of Cymbalta to the SSRI or Zoloft.

I decided to go up to 175 mg on Zoloft for now.  My fiance was pissed about it, thinking I'm just trying to medicate my problem away rather than give it time.....I guess that bothers me more than it should, but it hits a real strong fear: will there be a day I need anti-depressants and they will no longer work?

 

Otherwise, i took the extra 25 mg this morning (totaling 175) - and as usual, the Zoloft immediately kicks in with that feeling I expect from the anti-depressants I've taken for the last 5-6 years.

Any thoughts on this?  Are my fears overblown, as most of them are?


#29 fishinghat

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Posted 07 February 2018 - 10:43 AM

Maybe not overblown. There is a theory among research drs now that the stress of taking AD which then stop working, give bad side effects and then you have to go back through a serious withdrawal may cause there own version of PSSD for the patient which in turn makes them more dependent on some kind of psych med in their future. That is why the American Psychological organizations now recommend NOT leaving a patient on a AD more than 6 months unless the patient has a history of severe stress/trauma from multiple events.


#30 bruinsfan617

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Posted 07 February 2018 - 11:49 AM

Makes sense.

Side note - wouldn't my brain need to adjust to the lack of Cymbalta after 5 years, then add a new drug into the mix?  In other words, rather than the anxiety symptoms being Cymbalta withdrawal per se, its likely just my body/mind adapting?





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