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May I Get Your Opinion On My Cross Taper Strategy?


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#1 juli

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Posted 17 April 2018 - 04:47 PM

Hi there!  I received a script from my doc today for Lexapro 10mg in order to help with my Cymbalta taper.  I was kind of hoping that she would give me a cross taper stragedy but she would like me to go from 40mg to 30mg for 2 weeks then to 20 for 2 weeks then 10 for 2 weeks then off.  She advised my to take the Lexapro when I start getting withdrawls.

 

I had cold turkey withdrawls about 2 months ago and of course it was horrific so based on everything I have read on here I have developed my own cross taper.  Would you be willing to take a peak and let me know if I am off base?

 

I am also on a mood stabilizer but will be keeping that the same.

 

I was thinking:

Week 1 - Lexapro 5mg - Cymbalta 40mg

Week 2 - Lexapro 10mg - Cymbalta 30mg

Week 3 - Lexapro 10 mg - Cymbalta 20mg

Week 4 - Lexapro 20mg - Cymbalta 10mg

Week 5 - Lexapro 20mg - Cymbalta 5mg

Week 6 - Lexapro 20mg - Cybalta 0mg

 

Any thoughts or suggestions would be greatly appreciated.

 

Juli

 


#2 sk8rmama24

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Posted 17 April 2018 - 04:59 PM

It really all depends on your metabolism, some people need to go slower than others from what I have learned.  I take citalopram (Celexa) as well as duloxetine (Cymbalta), so my doctor didn't believe I would have significant withdrawal because I still had an SSRI working in my system.  Went from 120mg to 60mg ok, but when I did 60mg to 30mg the trouble started.  It seems like the larger the percentage drop in the dose, the worse the withdrawal symptoms can become.  I had to go down at about 3-5mg increments from 60 to 30mg and it took months and not weeks, but will likely need to reduce that drop to 1-2mg until my next symptom explosion, then stabilize again.

Hi there!  I received a script from my doc today for Lexapro 10mg in order to help with my Cymbalta taper.  I was kind of hoping that she would give me a cross taper stragedy but she would like me to go from 40mg to 30mg for 2 weeks then to 20 for 2 weeks then 10 for 2 weeks then off.  She advised my to take the Lexapro when I start getting withdrawls.

 

I had cold turkey withdrawls about 2 months ago and of course it was horrific so based on everything I have read on here I have developed my own cross taper.  Would you be willing to take a peak and let me know if I am off base?

 

I am also on a mood stabilizer but will be keeping that the same.

 

I was thinking:

Week 1 - Lexapro 5mg - Cymbalta 40mg

Week 2 - Lexapro 10mg - Cymbalta 30mg

Week 3 - Lexapro 10 mg - Cymbalta 20mg

Week 4 - Lexapro 20mg - Cymbalta 10mg

Week 5 - Lexapro 20mg - Cymbalta 5mg

Week 6 - Lexapro 20mg - Cybalta 0mg

 

Any thoughts or suggestions would be greatly appreciated.

 

Juli


#3 fishinghat

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Posted 17 April 2018 - 05:02 PM

It looks pretty good to me. The only concern anytime you cross taper is serotonin syndrome but it can easily be recognized by a high fever. At those doses it normally wouldn't be a problem though.


#4 juli

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Posted 17 April 2018 - 05:14 PM

I do worry about seratonin sydrome which is probably why she doesn't want me to start the lexapro until the symptoms start.  


#5 fishinghat

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Posted 17 April 2018 - 05:55 PM

I understand but Lexapro takes 4 weeks to kick in. That is why a cross taper still has some withdrawal symptoms even though you are going on another AD at the same time cutting back the first one.


#6 juli

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Posted 17 April 2018 - 06:18 PM

I am hoping that my doses are low enough that seratonin syndrome will not be an issue.  No way can I deal with the horrible withdrawls without a cross taper.  Now I just need to pray the Lexapro will work.


#7 gail

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Posted 18 April 2018 - 09:19 AM

Hi Juli,

Welcome to the right place. I would feel better if at week four, you would bead count the 10 mgs left.

I see it as a safer way to minimize the cymbalta withdrawal.

Fishinghat, what do you think about this?

#8 fishinghat

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Posted 18 April 2018 - 05:24 PM

It just sort of depends on how well she handles the rest of her drop. Her body will let her know if she needs to slow down. But on the other hand the slower the better.

#9 juli

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Posted 18 April 2018 - 05:45 PM

I am having panic attacks today thinking about it. I am so scared because it was so bad last time.  I feel like have PTSD.


#10 gail

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Posted 19 April 2018 - 07:48 AM

Juli,

As you read, the slower the better. We are with you all the way.

The last time might have been too fast, I understand that that makes you scared.

Now, we are using a new method, real different one. Most people say that if it was to be done again, they would take one year to do it. Slow, you will hear this magic word real often. And your body will speak to you, if you feel unstable, just reinstate at the previous dosage.

You will be fine Juli, come back as many times you wish, we will be happy to guide you. Lovexx

#11 juli

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Posted 19 April 2018 - 08:24 AM

Gail does that mean that the year taper is better than the cross taper?


#12 juli

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Posted 19 April 2018 - 09:00 AM

My generic Teva is not available anymore so I am trying to avoid the generic switch since I have heard so many people having trouble.  I don't mind being on the lexapro for an extended period since it is easier to get off of.  I have gotten myself off of xanax and other antidepressants but nothing has been this scary.


#13 fishinghat

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Posted 19 April 2018 - 09:14 AM

If Lexapro is easier to get off of for you (it usually is) then you probably made the right decision. It will be a little rough until the Lexapro finally kicks in but once you settle down you can come of the Lexapro nice and slow.


#14 juli

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Posted 19 April 2018 - 03:04 PM

great thank you :)


#15 sk8rmama24

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Posted 19 April 2018 - 08:42 PM

I was worried about serotonin syndrome, and I was on some high doses.  I was taking 120mg duloxetine, 30mg citalopram, 72mg methylphenidate, half a tablet of cytomel (I think that is 12.5mg?) and seroquel (for like a month then switched), and Latuda (for maybe 2 months then stopped).  I've cross-tapered, swapped out, augmented, and off-labeled for years (the SACO protocol doctors follow when prescribing or changing medications).  This was pretty much where I decided I was done and told my doctor I want to come off the meds.  Nothing had worked, was working, or had any benefit ever, and I was on doses so high that it should tranquilize an elephant.  But of all the side effects (rare or common), I never had serotonin syndrome.  Honestly, that surprised me, because I have had some pretty rare adverse reactions to meds over the years.

I am hoping that my doses are low enough that seratonin syndrome will not be an issue.  No way can I deal with the horrible withdrawls without a cross taper.  Now I just need to pray the Lexapro will work.


#16 juli

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Posted 19 April 2018 - 08:49 PM

Thank you. Thank is comforting to know because I would like to drop a lot slower but I was worried about seratonin syndrome kicking in.


#17 juli

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Posted 27 April 2018 - 10:32 AM

I have read that there are different strategies to the cross taper and just curious what you think.  Some thinks its better to make the first drop of the current drug along with the first dose of the new drug. I think they say its best for avoiding seratonin syndrome and to benefit from the initial shock of the new drug.

Others say its best to start the new drug for a week before the first drop of the current drug.

 

I am on 40mg currently.

 

Any thoughts?  Can you tell that I am overthinking this?


#18 fishinghat

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Posted 27 April 2018 - 11:57 AM

You are not over thinking. It is a good question.

By beginning to drop the first drug while starting the second drug gets the second drug in your system faster thus you will only have 4 or 5 weeks of moderate withdrawal symptoms before the second drug kicks in fully. However, by being on two ADs at the same time it increases your chance of serotonin syndrome. Many drs, because of liability, choose to come fully off the first AD over a period of 4 to 6 weeks and then start up the new AD. This nearly eliminates the risk of Serotonin syndrome but it also causes the patient to suffer worse withdrawal symptoms over a 8 to 10 week period until the new AD fully kicks in. Obviously there are cross tapers that are somewhere in the middle of these two extremes.

#19 juli

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Posted 27 April 2018 - 01:23 PM

Thanks.  That makes sense.   I think I am going to start the process in a week or two.


#20 juli

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Posted 07 May 2018 - 01:05 PM

I made my first drop last night.  Dropped Duloxetine from 40mg to 30mg and added 5mg Lexapro.  This morning I have some nausea and head fog.  I can feel the withdrawl coming on.

 

Thinking about whether to keep at  it for a week on the 30mg/5mg and treat the symptoms or immediately up the Lexapro to 10mg.

 

Any thoughts?


#21 fishinghat

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Posted 07 May 2018 - 02:33 PM

If you immediately up the Lexapro to 10 you risk serotonin syndrome. If you wait a week and then do the next dose change your withdrawal will get some worse but little risk of Serotonin syndrome. Most drs prefer wait a week and then make the next change.

 

You will have some rough patches during the next 3 or 4 weeks but then it should fade away rapidly (usually).


#22 juli

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Posted 07 May 2018 - 06:55 PM

Ok. That's what I thought.  I freaked out a bit this morning but the day has been manageable.  I'll stay the course :)

 

Thank you!


#23 juli

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Posted 17 May 2018 - 03:18 PM

Hi there.  I am just about through week two of my cross taper and have not had significant withdrawl. 

 

The first week I dropped from 40 to 30 Cymbalta with 5mg Lexapro added in.  Week two was a drop to 20mg Cymbalta with an increase to 10mg Lexapro.

 

This Sunday I will drop to 10mg Cymbalta and am trying to decide if I should stay at the 10mg Lexapro or up it to 20mg.

 

Any thoughts?


#24 fishinghat

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Posted 17 May 2018 - 05:45 PM

Any thoughts would just be a guess. Some people find 10 mg Lexapro enough others don't. Don't forget that Lexapro takes 4 to 6 weeks to fully kick in so you will get more benefit from the 10 mg than you are already seeing. On the other hand the last drop of Cymbalta usually brings on the worst part of the withdrawal. Wish I could be more exact but it varies too much.


#25 juli

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Posted 17 May 2018 - 06:02 PM

Yes I am trully dreading the last drops.


#26 fishinghat

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Posted 18 May 2018 - 08:38 AM

When it comes to those last few beads the best thing to do is decide how slow to go and then cut that in half.  lol

 

Slow wins the race.


#27 juli

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Posted 30 May 2018 - 11:36 AM

Hi there!  Things have been going pretty well here. 

I made my first drop from 40mg to 30mg while adding in the 5mg of Lexapro. 

Second week dropped to 20mg and upped the Lexapro to 10mg. 

Kept the Lexapro at 10mg and dropped to 10mg and then 5mg. 

With each drop I had mild withdrawl the first few days and then seemed to resolve by the end of the week. 

Sunday will be the scary part when I drop from 5mg to zero.  

I am so grateful that things have gone well so far and pray that the next couple weeks go fairly smooth.

Thanks for the support.

Juli


#28 fishinghat

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Posted 30 May 2018 - 02:16 PM

If 10 mg Lexapro will do the job that would be great. Keep up the good work.

#29 juli

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Posted 07 June 2018 - 05:46 PM

Well I dropped to 2.5mg this past Tuesday and have been having the nausea and brain fog.  I am wondering if this is all part of the process or if I should up the Lexapro a bit.

Seems like my others symptoms throughout this process have resolved within a week so I should probably give it a few days.


#30 fishinghat

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Posted 08 June 2018 - 09:07 AM

Juli, sounds like a plan. I would do the same thing.

Are you using ginger for he nausea?



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