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Insomnia With Cymbalta Withdrawal...help Please!


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#1 Robbie

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Posted 10 February 2018 - 06:32 PM

​Hi everyone, I just joined this forum this morning as I have just had my third night in a row of insomnia. I didn't do much research on Cymbalta withdrawal, just asked my doctor and she advised one 60mg capsule one day then one 30mg capsule next day, alternating for eight weeks. I am one week in and haven't been able to sleep properly for the last three nights, not getting to sleep until 2am-3am. This is bad news for me as I also have Multiple Sclerosis and badly need plenty of sleep! It looks like I may need to try the 'bead counting' thing, but will stick with current plan for now. What a terrible drug! It hasn't been helping me and now the battle to get off it begins. Have had some mild 'brain zaps' but not unbearable. I don't have any support around me, so am glad I found this forum. Thanks in advance.


#2 fishinghat

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Posted 10 February 2018 - 07:22 PM

Hi Robbie, Welcome

 

Many people handle the drop to 30 with few problems but as you drop below that it can get nasty. After your 8 weeks of alternating you should stay on 30 until settled. Once you feel comfortable then you can start your bead counting. In the meantime if things get to bad you can always take a few extra beads to help take the edge off or try a little Benadryl, it  ight make you a little sleepy/

 

You might look through the thread "and the answer to your question is...." in the medical support section. It is sort of a summary of what people have tried that worked and did.t work. You can probably get some direction from that too.

 

Keep us posted on how you are doing.

 

Hang in there.


#3 Robbie

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Posted 11 February 2018 - 04:59 AM

Thanks, really appreciate the advice...I no longer trust Doctors very much!


#4 gail

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    5 months on cymbalta, scary side effects, never felt good.
    Needed understanding and support, and a place where I was not alone. To read others stories and realizing that I was not the only one going through all that crap.
    In hope that one day, I can return the favors in some kind of way.

Posted 11 February 2018 - 10:00 AM

Hello Robbie and welcome,

I just want to add that if you find this regimen to harsh, you can go back to 60mg and bead count from there. I understand that sleep is real important to live a better life, and in your situation, it is imperative that you get it.

Fishinghat, I have never heard about this method, have you? Aren't we playing yo yo here?
Thank you sir!

#5 fishinghat

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Posted 11 February 2018 - 10:27 AM

Your right Gail. This jerks the Cymbalta level up and down as it has a short half life of 12 hours. Robbie would be better just going to 45 mg and bead counting but so many do not have any trouble going from 60 to 30 with little issue that I though he might come out at 30 Ok. Just an opinion.


#6 Robbie

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Posted 11 February 2018 - 06:44 PM

​So, just trying to take in all this information. I am on a generic brand of Cymbalta and I opened a capsule and counted 361 beads (never done that before, mind boggling to look inside!) Should I stay on that brand and start bead counting? I have, of course decided to now ignore my doctor's advice and stop alternating between 60mg and 30mg...should I stay on 60mg or 30mg to restabilise? Also, approx. how many beads would I drop for the first tapering? Thanks in advance everyone, I am doing this solo, except for this group. Quite frightening really. By the way, I am a 62 year old female..Robbie is short for Robyn.


#7 fishinghat

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Posted 12 February 2018 - 10:20 AM

I would stay with that brand. 360 is a good number to work with. I would try to stabilize at 30 mg and see if you can handle it. It not you could go up to 45 mg and see if you can stabilize at that point. When you get ready to bead count we usually recommend starting at around 1% (say 3 beads). So the first day you remove 3 beads, the second day you remove 5 beads, etc.

 

Take your time, this is usually easier on a person if they go slowly.


#8 Robbie

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Posted 12 February 2018 - 06:55 PM

​Thanks for your help Fishinghat. As the capsules only come in 60mg and 30mg how do you take 45mg? I am in Australia, so dosage may be different? I spoke to two chemists yesterday and they were very disinterested, I felt quite humiliated actually. Both said not to bother with 'bead counting' as there was no need! Easy for them to say! Anyway, I have found a compounding chemist who advertises assistance with weaning off drugs, so will chat with them today. I have been on many different anti-depressants and it seems they saved the worst for last...none of them have helped and now I am faced with this battle. At least I am getting some sleep...thanks again. 


#9 fishinghat

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Posted 12 February 2018 - 07:16 PM

360 beads in a 60 mg capsule so if you take out 90 beads (1/4) that will leave 45 mg. Just that easy!  There are so many drs who aren't aware that there is a withdrawal from ssri/snri.  I guess they don't read the literature that comes with the meds.  lol


#10 gardenlady

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Posted 12 February 2018 - 10:09 PM

Chiming in here about generic duloxetine.  The capsules vary in the number of beads they have, so you have to count the beads in several capsules and then take an average.  That's the hard thing about removing beads....you're left with varying numbers in the capsules because the bead counts are not the same across capsules.

 

My Teva brand generic capsules have an average of 315 beads in a 60 mg capsule.  No two capsules I counted had the same number of beads.  Just throwing this out in the event it helps.  

 

I have found that weighing beads on a gram scale is much easier and faster than counting beads, especially when working with 60 mg capsules.  I'm 65 and find that it's very difficult on the eyes to count beads.  I ordered an American Weigh Gemini 20 scale from Amazon for about $20 and it works great for this purpose. 


#11 gail

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    5 months on cymbalta, scary side effects, never felt good.
    Needed understanding and support, and a place where I was not alone. To read others stories and realizing that I was not the only one going through all that crap.
    In hope that one day, I can return the favors in some kind of way.

Posted 13 February 2018 - 09:40 AM

Gardenlady,

So nice to hear from you. Good point with the scale. Thank you! How is it going with your process?

We missed you and I had to come by and say a big Hello and give you a big hug!

#12 gardenlady

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Posted 13 February 2018 - 01:57 PM

Gardenlady,

So nice to hear from you. Good point with the scale. Thank you! How is it going with your process?

We missed you and I had to come by and say a big Hello and give you a big hug!

Thanks for the kind greeting, Gail!  I think of you and fishinghat often and wonder how you both are.  I just entered my second month off of the benzo and it's gotten rather difficult.  Things started deteriorating after the second week and really got bad after I'd been off a month.

 

My symptoms are mostly spiritual and mental....the only physical ones I have are insomnia and tinnitus.  The depression, fear, terror are 24/7 and too horrifying to describe.  Honestly, I think the Cymbalta is making it worse as I've been agitated ever since starting it.  However, I'm in benzo withdrawal and very unstable.  I'm not sure how to handle this.  The Cymbalta is making me sick, but I'm too sick from the benzo taper to do anything about it.  Quite a quandry.  I'm praying about it and asking God what He would have me do.  Any suggestions?  Sorry to hijack Robbie's thread!


#13 gail

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    5 months on cymbalta, scary side effects, never felt good.
    Needed understanding and support, and a place where I was not alone. To read others stories and realizing that I was not the only one going through all that crap.
    In hope that one day, I can return the favors in some kind of way.

Posted 13 February 2018 - 02:39 PM

Gardenlady,

You got me thinking here and mostly reflecting. Where are you at with this disabiliting and so crazy Cymbalta?

At this moment, you have absolutely no quality of life. We're 65, we don't have that much left. And it gets to me that at this age we go on suffering, which is real sad. My advice is different from what you usually hear on the forum, I think.

Go back on a different benzo, I would say that to my mom, even though you and I are the same age...don't keep suffering like this, it breaks my heart to see you suffer with terror and fear. I do understand that it's spiritual and mental, I sure do.

I don't think that the Creator enjoys seeing you this way at all. Ease your mouse in your head and give it food for it to calm down.

We are not here to say Suffer and Suffer. That would be insane from our part.

So, Gardenlady, be kind to your mouse and give it what it needs. It has to be a different benzo. Fishinghat, correct me here if I'm wrong about having to switch to a different benzo. Or can it be the same? Thank you sir!

#14 gail

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    5 months on cymbalta, scary side effects, never felt good.
    Needed understanding and support, and a place where I was not alone. To read others stories and realizing that I was not the only one going through all that crap.
    In hope that one day, I can return the favors in some kind of way.

Posted 13 February 2018 - 03:18 PM

PS not necessarily a benzo, perhaps something else. Your doctor has to know how you are feeling Gardenlady for him to pinpoint the right med. That is, if you have a good doctor!

Something is needed here.

#15 fishinghat

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Posted 13 February 2018 - 07:20 PM

If you were still on the benzo I would say to switch to valium before weaning (longer half-life). Hydroxyzine is a standard treatment for benzo withdrawal. Going on another benzo is usually only successful about half the time when you are already in withdrawal. Once you cut your dose it is not often beneficial to go back up. These days there is no reason for significant benzo withdrawal. Did you do water titration? How long did it take you to taper?  Did your dr not offer to give you something for the withdrawal?


#16 gardenlady

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Posted 13 February 2018 - 09:51 PM

Thanks, Gail & fishinghat.  I tapered valium for about 14 months and did a daily liquid micro taper for the last 5 mg.  And that was my second benzo taper...I reinstated after unrelenting terror and akathisia 2 years after my first taper.  I had been doing ok...healing after about 18 months.  But, then I had a terrible emotional trauma that threw me back into benzo withdrawal.  When the terror and akathisia didn't let up for 6 months, I reinstated the benzo but found that it didn't help.....it only made me feel sick and poisoned.  I started to taper immediately and that's when my doctor cross tapered me from Lexapro to Cymbalta.  I felt even more agitated and poisoned after that.  I have found that I don't tolerate psych drugs well at all....they make me feel worse. The only thing for me to do is to get off all of them.

 

I stopped seeing a psychiatrist when I finally realized that it was the drugs making me sick.  I do have hydroxyzine, but it doesn't really help very much.  It takes the edge off, but I have to be careful not to take it too often so it won't lose its effectiveness.  I do use it for insomnia, but again, it doesn't have much of an effect on me.

 

There's really no pill that helps psych drug withdrawal that I've found....only the passage of time so that the brain can heal.  

 

If I could just get off the Cymbalta and heal, I think I'd be a lot better.  But, I'm still very unstable from the benzo taper, so don't know what to do. 


#17 gail

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Posted 14 February 2018 - 09:49 AM

Hello Gardenlady,

How I wish that I could help! I feel so unpowered.

Do stick with us, if only to chat or whatever you feel like. You are in my thoughts and I am praying for everyone that suffer from mental problems, including myself. With love, Gail xxx

#18 fishinghat

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Posted 14 February 2018 - 09:49 AM

First of all I would like to apologize GL. I read my last post to you and it sounded very rude. I did not mean it that way. Sorry.

 

It sounds like you did well with the second taper. The problem is going back on it again after the trauma. Seldom does that work out well. Some of the research indicates that once off a benzo a person should wait at least 2 years to try a benzo again. Going back on right away can lead to poor results, immediate dependence and lack of effect.

 

May I ask what dose of hydroxyzine you are on and are you currently taking clonidine as well? Right now the main problem is probably the toxic effect of the benzo you are having (and maybe the Cymbalta). The problem is if you start tapering either of these you will also be battling the withdrawal.

 

By the way, hydroxyzine is said to not buildup tolerance. Have you had that experience? I have been on it for several years and have had no issue with tolerance.


#19 gardenlady

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Posted 14 February 2018 - 02:06 PM

fh, Please  don't be concerned about your response.....I didn't take it as rude at all!  Just so you'll have it, here is my history:

 

May 2014-Tapered off 2mgs K via 4 wk rapid taper

Acute w/d 7 mos 
10 mo window
Acute w/d reappeared as PTSD w/ akathisia: personal trauma March 2016. 
8/29/16 - Reinstated 2 mg Ativan & 10 mg Ambien due to unrelenting akathisia  
10/5/16-Tapered Ativan to 1.75 mg
Oct 2016 - c/o from 20 mg Lexapro to 60 mg Cymbalta  
Nov-Dec 2016-Tapered off 10 mg Ambien
Jan-Feb 2017-c/o from 1.75 mg Ativan to 13 mg Valium
5/12-54 mg Cymbalta (10% cut)
5/22-48 mg Cymbalta - Bad sxs. Hold
10/24-Start DLMT 2.48V
1/11/18-Jump - 65 yrs old
Other meds: Cymbalta 48 mg, Progesterone 100 mg, Estradiol .5 mg, Synthroid 112 mcg
 
It's too long to fit in the signature space which is why it isn't there.  
 
I'm taking 50 mg hydroxyzine.  Sometimes it helps with sleep, but not much.  I still lie awake for hours and then wake up often getting little sleep and what I get is very broken.  A previous psychiatrist warned me about reaching tolerance with it...she said if I took it too often, it would quit working.   My internist won't prescribe clonidine because of side effects which he didn't specify.  
 
I've been off benzos for 1 month, 3 days.  How long do you think I should wait before trying a micro taper of Cymbalta?  I'm still very depressed and anxious.  I also have insomnia and tinnitus along with the fear, terror and agoraphobia. 

#20 fishinghat

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Posted 14 February 2018 - 04:03 PM

Where to begin.

"8/29/16 - Reinstated 2 mg Ativan & 10 mg Ambien due to unrelenting akathisia"

First of all Ambien(one of the Z drugs) is not to be used with benzos, especially Ativan as it can cause the benzo to be almost immediately addictive and make withdrawal worse.

https://dailymed.nlm...96-8702a28e6e76

Ambien drug insert

Additive effects occur with concomitant use of other CNS depressants (e.g. benzodiazepines, opioids, tricyclic antidepressants, alcohol), including daytime use. Downward dose adjustment of AMBIEN CR and concomitant CNS depressants should be considered.
Zolpidem (Ambien), the active moiety of zolpidem tartrate, is a hypnotic agent with a chemical structure unrelated to benzodiazepines, barbiturates, or other drugs with known hypnotic properties. It interacts with a GABA-BZ receptor complex and shares some of the pharmacological properties of the benzodiazepines.

https://www.ncbi.nlm...pubmed/24531568
We found that subchronic zolpidem and diazepam administration produced ...increased anxiety-like behaviors 1 day after drug termination.

https://www.ncbi.nlm...pubmed/22444504
Drug related deaths - In 83.5% of cases, psychoactive substances other than zolpidem were detected, most commonly antidepressants (46.2%), benzodiazepines (35.2%), opioids (26.4%), and alcohol (39.6%). In summary, zolpidem was a factor contributing to death in a large proportion of cases, predominately involving drug toxicity and suicide.
And see below as well.
---------------------------------------------------------------------------------------------------------
10/24-Start DLMT 2.48V
Sorry the only DMLT I am familiar with is the band and the short hand for dolomite (a limestone). A little help please.
---------------------------------------------------------------------------------------------------------
"A previous psychiatrist warned me about reaching tolerance with it...she said if I took it too often, it would quit working. My internist won't prescribe clonidine because of side effects which he didn't specify."

https://www.ncbi.nlm...les/PMC4956432/
There is no evidence for tolerance with antihistaminergic medications, and they are economical compared to other hypnotics.
The benzodiazepine receptor agonists or Z-drugs (eg, zolpidem, zaleplon, eszopiclone) are approved for the treatment of insomnia. They also might be able to induce dependence, tolerance, and withdrawal, although abuse is uncommon.

https://journals.lww...ects_of.14.aspx
No tolerance or sensitization was seen when comparing acute and repetitive assessments.

https://mentalhealth...reactions-list/
Due to the fact that hydroxyzine has a low potential for abuse, addiction, dependence, and a slow tolerance onset – many believe it is advantageous over other anxiolytics such as benzodiazepines.

 

The only main side effect of Clonidine is to lower the bp but maybe he knows something I don't.

---------------------------------------------------------------------------------------------------------

"I'm taking 50 mg hydroxyzine."

The dose of 50 mg is common for use at bedtime due to insomnia BUT when going through withdrawal that dose has proven to be ineffective. Normal dosage would start at 25 mg every 6 hours and with 50 mg at bedtime.

References available if you need them.
----------------------------------------------------------------------------------------------------------
"I've been off benzos for 1 month, 3 days. How long do you think I should wait before trying a micro taper of Cymbalta? I'm still very depressed and anxious. I also have insomnia and tinnitus along with the fear, terror and agoraphobia."
Research recommends being off benzos for 2 years prior to attempting another withdrawal. My experience has shown me that I need to wait at least one year. Healing of the benzo receptors have been shown to take 2 years to fully recover. I would suggest at least one year.

 


#21 gardenlady

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Posted 14 February 2018 - 04:49 PM

Thanks, fh, for the info.  Yes, the psychiatrist was clueless to prescribe Ambien with a benzo, but she did, I tapered and am off both.  So, that's water under the bridge.  

 

DLMT is Benzo Buddy lingo for daily liquid micro taper.  I'm finished with that taper, so that's water under the bridge, too.

 

My concern is the agitation I experienced when starting Cymbalta.  I'm still having it and can't imagine living with it for another year.  But, it's a dilemma because I'm also in benzo withdrawal.  I wonder if crossing over to another AD I've taken sucessfully before might be an option.  I've taken Prozac, Paxil, Lexapro, Zoloft and Pristiq with no problem...either in bridging or tolerating.  The only one I couldn't tolerate is Remeron as it gave me restless leg syndrome. 

 

I'm going to see my internist next week so will ask him why he dislikes clonidine.  

 

I wish hydroxyzine helped me as it does you, but I guess I'm not that fortunate.  Oh, well....


#22 fishinghat

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Posted 14 February 2018 - 06:13 PM

"DLMT is Benzo Buddy lingo for daily liquid micro taper. I'm finished with that taper, so that's water under the bridge, too"

WOW, when I was with Benzobuddies they just called it water titration )even if they used milk or PEG 80) lol You mentioned that you started the DLMT on 10/24/17. You must still be having significant benzo withdrawal if you have only been off 1 month. That was a quick wean. I am surprised you aren't a basket case. lol

"My concern is the agitation I experienced when starting Cymbalta."

You went on the Cymbalta in Oct of 2016 and the agitation began right away? That's not good. But according to your notes you began tapering Ativan at that same time. Could the irritation be from that and continued withdrawal since? Crossing over from Cymbalta to a different AD is an option but will the other AD work this time even though it helped before? Sometimes yes and sometimes no. That is just a matter of how lucky you feel. If you pick either the Prozac, Lexapro or Zoloft they should be easier to wean off of than Cymbalta. That would be one thought.

"I'm going to see my internist next week so will ask him why he dislikes clonidine. "

I am really interested in what he says.

Actually it might help you a lot more if you were taking around 125 to 150 mf/day but your current dose is just too small for benzo withdrawal.

 

Looking forward to hearing what the internist says.


#23 gardenlady

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Posted 14 February 2018 - 08:37 PM

Yes, I switched to Cymbalta and started tapering the benzo at the same time, so have felt agitated ever since. Not sure if it's the taper or the Cymbalta or both.  How could I know?  Cymbalta makes many people feel agitated, so that's why I suspected it.

 

What medication were you referring to when you wrote, "Actually it might help you a lot more if you were taking around 125 to 150 mf/day but your current dose is just too small for benzo withdrawal."?    Guess you meant hydroxyzine.  Do you recommend 25 mg hydroxyzine every 6 hrs with 50 mg at bedtime?  Would 25 mg be enough to have an effect?  Seems like a very small dose.  Thanks, fh,!


#24 fishinghat

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Posted 15 February 2018 - 10:48 AM

About the only way you could find out is to take a little extra Cymbalta (5 mg?) and see if that brings relief. If it does then it is probably from Cymbalta withdrawal. Don't try that with the benzos though as it can make the withdrawal worse in the long run.

 

You hit the nail on the head with the Hydroxyzine. That is what I am recommending at a minimum. Hydroxyzine has a 11 hr half-life so even though the 25 mg is a minimum dose there is overlap in dosages. For example if you take 25 mg at 8:00 AM there will still be about 1/2 of it in your system when you get to the next dose  at 2 PM. This overlap allows the hydroxyzine to build up in your body over a 4 or 5 day period before stabilizing.

 

For most drs around here that is the minimum dose for benzo withdrawal. What many of our drs do is supply a 2 month prescription at full dosage (400 mg/day) and tell you to build slowly until you find what dose works for you. Building slowly also allows your body to adapt to the drowsiness that can happen when you first start the medicine.

 

Hang in there. It will get better.


#25 KathyInFL

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Posted 15 February 2018 - 12:01 PM

Fh, you could never sound rude, don't even think that!! You are awesome and a very big help to all of us here!  :hug:

 

 

First of all I would like to apologize GL. I read my last post to you and it sounded very rude. I did not mean it that way. Sorry.

 

 


#26 gail

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    5 months on cymbalta, scary side effects, never felt good.
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    In hope that one day, I can return the favors in some kind of way.

Posted 16 February 2018 - 06:19 PM

Hi Kathy,

How are things for you and where are you at with the Cymbalta?

It's nice to see you back, looking forward for an update sweet pea.

#27 KathyInFL

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Posted 17 February 2018 - 12:06 AM

Gail, How are you feeling and doing?

  ;)                                                                   

I'm on to about 8mg, down from 60mg!                                                                         


#28 gail

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    5 months on cymbalta, scary side effects, never felt good.
    Needed understanding and support, and a place where I was not alone. To read others stories and realizing that I was not the only one going through all that crap.
    In hope that one day, I can return the favors in some kind of way.

Posted 17 February 2018 - 09:02 AM

Kathy,

I'm ok considering the circumstances. Still anxiety and depression free 90% of the time.

Keeping occupied with simple things,not going out much. But happy by this so simple way of living. I will never be that outgoing person that I used to be 12 years back, that's ok.

Like cymbalta, anxiety and depression marked me for life. A twelve year battle day after day changes you in every way. I'm quite happy about that huge change in my life. A miracle for me!

How do you feel on 8 mg? So nice to talk with you Kathy!



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