289 replies to this topic

[EBB]

Ebb,

I just read that Cymbalta made you feel awful plus the drinking like a fish.

Since effexor and Cymbalta are in the same category, I now doubt that effexor is the one for you. Sorry about the preceding post. I have not heard or read that ssri' made you feel that bad. Geez, up to this point, SSRI's could be the answer to limit the side effects.

Prozac, Zoloft, Celexa, Lexapro is a bit like Celexa. Brother and sister in law do great on it, seems that Juli and Cheryl also. If my mind is correct.

I wish that I could do more than that for you, just like myself, you may be resistant to ad's.
Which is quite a dilemma. If so, mood stabilizers can help. Talk your doctor about this!

Thanks Gail! I'm excited to know someone else who is resistant to ADs. So did you take them for a while and then had to stop? When did you finish Cymbalta and are you ok now?

[EBB]

Dear Ebb,

Please see your doctor about effexor. Same category as Cymbalta. Something needs to be done here Ebb, and you know that!

From what I'm reading, it's part withdrawal combined to the old condition coming back and worse. Now, make that appointment and ask for effexor, never mind the withdrawal about this med.,if it comes to that, now you have tools to withdraw properly.

Make that phone call, remember that it can't be worse than now! It is needed that you try something.

I can't remember why you quit Cymbalta, can you explain to me? I'll try to find your old posts Ebb.

We're turning and turning around here, you agree? A move needs to be made sweet Ebb. Please, for you first and the family. You've tried adding beads, didn't work, you may be like Juli, in need of a start over. With love, Gail

I'm not quite ready to give up on Effexor honestly. I took it for about a year and it was ok. I'd prefer to be on nothing of course AND happy, but that may not be possible. I don't want to add Effexor and it doesn't help with the Cymbalta withdrawal.

[EBB]

1. Absolutely
2. Absolutely
3. Potentially. Like all ssri/snri there is the risk of sexual malfunction, thyroid issues, liver failure,tinnitus, restless leg syndrome, tachycardia, high blood pressure, low sodium levels, weight gain, slows clotting, can damage red blood cells, alters RNA, hyperglycemia, mania, Stevens-Johnson Syndrome, and seizures to list a few
"Do you suggest the SSRIs to people because they work for most people and they are easier to get off of which is most people's goal?" Yes

Unluckily this is a common occurrence in withdrawal. Not unusual. It is horrible, devastating and terrifying. Get that clonidine going so you can feel better. Did the dr raise your hydroxyzine as well?

Ok here's the update:

1. I got lots of 25mg hydroxyzine pamoate capsules - this is different from the little 10 mg tablets (not pamoate) I was taking - is there any remarkable difference?

2. I got .1 clonidine. I took 1/2 and its made the anxiety (yay!!!) better but also made me sleepy. I don't want to poke around online too much bc that's gotten me in trouble - soooo does the sleepiness improve?

3. Is clonidine easy to get off of? There's all this stuff about clonidine withdrawal .... ugh

4. Should I work up to taking the whole tablet? Is it just time and trial and error?

[juli]

If this doesn't give you some relief I would try the Effexor.  I know how horrible it is for a mom to not be able to take care of her family.

 

It's not quite behind me EBB.  I have 13 beads to go and am praying it goes ok.

[fishinghat]

1. Now there is some hope. The hydrochloride form is far less effective than the pamoate for emotional control.
2. Yes. Most drs start you out on 1/2 the tablet at first to get your body to adjust to it.
3. There is NO clonidine withdrawal. There is a blood pressure rebound effect. If you stop it cold turkey your blood pressure may jump up. If you lower your dose over a 2 week or 3 week period there will be no effect.
4. If a half pill does the trick then you should stick to that. I would do no mare than 2 tablets a day "0.1 mg). I am so glad it helped. Now lets work on your hydroxyzine and along with the clonidine and see if we can get you tolerable.

Remember the bp trick. If your systolic is 130 or above consider taking your next med (Ativan, hydroxyzine or clonidine and if your bp is below 100 then you have enough meds in your system. This is a resting bp.

[EBB]

Ugh so here's the thing - I HAVE to take the Ativan on a schedule don't I?  and I have low blood pressure (always.) So for ex now my blood pressure systolic says 110 is it ok to take the Ativan? I'm concerned this will be a problem bc I have such low blood pressure

[fishinghat]

110 will be OK. Be sure it does not drop below 90, that is a little low and if it does get below 90 then you can drink a little coffee or some chocolate. My wife has hereditary low blood pressure and hers AVERAGES 90/46. I am afraid that for now you need to keep your Ativan on a schedule but if things start bothering you too much you can slide up a medication a little on the schedule. For example if your Ativan is due at 5 PM but you are feeling bad at 4:15 or 4:30 you can take it a little early just try to stay on schedule with the next Ativan. If it were me, I would stay on a set schedule for the Ativan and just try and rely on the hydroxyzine and clonidine as needed. If you start feeling bad then go ahead and take one of those. Don't wait until you are overwhelmed. You know yourself and I am sure you will not over use them. I mentioned the max limits on them in my earlier post. I am hoping that within 2 days you will settle in to a routine that works and you feel much better. Like Juli, said if this is not enough then we can look at taking an ssri but I am optimistic.

[EBB]

OK thank you. Does hydroxyzine lower blood pressure?

[fishinghat]

Yes, slightly. All antidepressants and antianxiety drugs will lower bp. They lower bp because they slow down the neurotransmitters which slows the metabolism and that  is also why they cause weight gain.

[EBB]

Ok, so yesterday I had a great evening after taking 1/2 of the .1 Clonidine. (My doc said to take 1/2 for 3 days once a day, then 1 for 3 days once a day, then ok to take .1mg twice a day.)

TODAY hasn't been super great, lots of anxiety (slept kinda bad). So far I've taken:

9am 50mg hydroxyzine

11am .5mg Ativan

1:30pm 25mg Hydroxizine

2:50pm 1/2 .1mg Clonidine

5pm .5 Ativan

Anything I can do to bring the anxiety down a notch?

[EBB]

OMG FH,

Since starting the Clonidine - only 1/2 .1mg once a day I've had to pee constantly!! No!!! Does this get better with time? Its listed as a side effect. So so discouraged. Afraid I will be up all night again peeing

[fishinghat]

"(My doc said to take 1/2 for 3 days once a day, then 1 for 3 days once a day, then ok to take .1mg twice a day.)"

Excellent plan.

"Anything I can do to bring the anxiety down a notch?"

Just keep phasing in the clonidine and hydroxyzine. Because the half lives of those two are around 12 hours and your doses are a little more often than that it will build in y9ur system over the next 4 days and you should see more relief. By phasing in those two meds and the buildup in the system I would expect you to be able to reach maximum benefit in about 7 days. How is your bp doing?

I have checked the FDA website and there has been no reports to the FDA concerning frequent urination and clonidine nor have I had this issue or heard of this before. I will do a little digging band be back soon.

[fishinghat]

I did find several medical websites that list this as a "rare" side effect. The Mayo Clinic says that if this occurs to notify your dr. None of these sites mention if this is a temporary condition or not.
One site did mention that when starting this medication it can cause dry mouth which increases water intake and therefore urination but that this is temporary. There is NO information in the medical journals which surprises me.

[EBB]

You had said earlier "now there is hope." Is there no hope now? I am just freaked out beyond belief. I can't stop crying. This is ruining my life. My husband has to leave tomorrow and I have the kids and I am just distraught. Maybe this will just kill me cause it would be easier. Do you really think I may feel a little better in 2 months or 4 months? How does this work - do you just feel deathly constantly at the same intensity for 8 months and more for 20 percent? How can I get through this. 

The Mayo clinic site says "You may also notice an increase in the amount of urination or in your frequency of urination. After taking this medicine for a while, these effects should lessen." That's my tiny ray of hope as I've run to the bathroom ALL night and ALL day. Seriously, as soon as I pee, 5 minutes later I have to pee again. I weighed 125 last night and this morning I weighed 118.

WHAT AM I GOING TO DO? This was my big solution. This was the thing that was going to get me through this. I can add an SSRI cause it prob won't work and then I'll be stuck on an SSRI. I can't ad effexor bc it sucks and it may not do anything and then I'll be stuck on another med with a horrible withdrawal. I am feeling very very hopeless.

[fishinghat]

"now there is hope"

Actually I said "Now there is some hope." inn reference to switching you from the hydrochloride form to the pamoate form of hydroxyzine. What I was referring to was that now the dr put you on the right form of hydroxyzine there is hope it will work better for you.

"The Mayo clinic site says "You may also notice an increase in the amount of urination or in your frequency of urination. After taking this medicine for a while, these effects should lessen." That's my tiny ray of hope as I've run to the bathroom ALL night and ALL day. Seriously, as soon as I pee, 5 minutes later I have to pee again. I weighed 125 last night and this morning I weighed 118."

That quote if from their page on Clonidine And Chlorthalidone, a combination medicine. Chlorthalidone is a diuretic and causes frequent urination. It does not apply to y9ur situation. The Mayo site also says to contact your dr if frequent urination occurs. I think you should do that and find out if there is an issue.

The severe symptoms like yours USUALLY last around 6 to 8 months for most. DURING that 6 to 8 months it slowly fades and by the end of the 8th month it is gone or nearly gone.

[juli]

Even if the SSRIs didn't manage the depression and anxiety couldn't they still help with withdrawl.  I know that I had moved on from them but they definitely help the withdrawl.  Seems like it would be worth a try.

[EBB]

FH, Juli,

Thank you for all of your help. Turns out I have a slight bladder infection. Ugh. Never been so happy to have a bladder infection, lol - meaning it's not the Clonidine. 

FH, what do you think about trying an SSRI given my lame gene mutation as Juli mentioned above? Do you think it's possible it could help the withdrawal, even though it may not "help" me hugely? I've taken Zoloft twice, Lexapro and Celexa. And one day of Prozac and it made me very anxious but who knows at this point what that was. I guess I'm afraid that things could get worse? And then I'm on another drug I need to taper and I'm even worse? I can't imagine what I'd do. 

What do you all think/know given the risks? I'm sure you would have told me this but have you seen anyone with this gene mutation who was still helped in wd by an SSRI? That would be my dream. If I could just take Zoloft and this would improve, I'd be so so happy I can't even tell you...

This is so very hard. Thank you for your knowledge, thoughts and encouragement. It's everything to me now.

[fishinghat]

Of the 3 you listed I would lean towards the Zoloft or Lexapro as your best bets. Juli is right, it is possible for it to help the withdrawal, it may not, it may cause side effects this time even though it didn't originally. One thing I can promise you...you won't know until you try. Antidepressants are notoriously unpredictable. What ever you choose you have my support and best wishes.

[EBB]

Thank you FH. For everything. Your knowledge is incredibly helpful and much-needed in this labyrinth.

Just feel awful today. So So much anxiety. In terms of the risk of the Zoloft, etc., given my genetic mutation, is Zoloft a better risk - even though SSRis aren't recc, than Effexor? I am not yet to full dose on the Clonidine yet, but this is just awful. These bad moments are so bad. And how does trying Zoloft work? Do I start on a small dose at first? What do I do if something bad happens? Obviously I'm having anxiety about all of this while having anxiety about anxiety. This is all so frustrating. 6 to 8 months like this at best is making me very scared. 

Will I EVER feel better?? I feel right now I can't keep doing this. Am I just a total wuss? It's been 3 months and it feels like a million years.

[gail]

Hello EBB,

Three months is a really long time when you feel as you do. We've been there. Fishinghat has had the worst withdrawal that I've read about.

I was in this mess for seven months and I don't know how I managed to go to work.

Not as bad as our boy, but anxiety seven days a week. I was so scared of going on another med. So scared. My thoughts were that it couldn't get worse so I dived in and started on something else which gave me relief for a time.

Ebb, it can't be worse, so dive in like many of us do. Courage Ebb, I repeat, it can't be worse than now.

[fishinghat]

Gail is right. At some point you just have to do something. SSRIs in general are thought to have less side effects but that really depends on the individual. Zoloft is considered one of the ADs with the least side effects.

The dr will start you on a low dose of Zoloft (eg. 50 mg) and work the dose up every week or 2 until you are stab le. Each time you raise the dose there will be about 2 or 3 days of being sick at your stomach but that passes.

No good answers Huh? That is why I suggest to people to get as much good out of the clonidine and hydroxyzine as possible. It may not clear up everything but kit will at least lower the amount of AD you have to go back to.

I assume the clonidine and hydroxyzine are still giving you some breaks in the suffering. Right? Keep working on them. You should be able to go to full dose on the clonidine by now.

[juli]

Hi EBB. 

Is it your goal to see how you do without any anti-depressant?  If so then you would want to wait it out with the Clonodine and Hyroxyzine.

Is it your goal to be on the right med long term to manage your anxiety and depression?  If so then you need to either choose Effexor or try to stabilize on the Zoloft and then maybe add a mood stabilizer.

It seems that you need to answer this question and move forward with a plan that only you can choose.  Have peace with your decision and try to have faith.

Just my humble opinion.

Hugs to you, Juli

[EBB]

New development from my life from hell: I do not have a bladder infection. Is there ANY way that one of these meds - Ativan, Clonidine or Hydroxizine could be causing frequent urination?? The guy at urgent care said if it continues it could be interstitial cystitis which is like a total life destroyer. It just seems strange that it started the day after I took one dose of the Clonidine. Thoughts?

[fishinghat]

I have dug through the FDA reports and there is not even one report of any of those meds causing frequent urination but Cymbalta withdrawal sure can. DO you think it could ne Cymbalta related?

[brzghoff]

Hi EBB,

 

I am so sorry to hear about what you are going through. What you are experiencing is, unfortunately, very familiar to many on this site. I know that doesn't make the fear and anxiety any easier but anxiety is a liar. it will get better. a good sign that you're not going crazy is when you actually have the self awareness to wonder if you are ;-). recovery can be slow and for many the process was 2 steps forward and 1 step back. some days its 2 steps forward and 3 steps back but slowly over time you will be able to see you are making progress. journaling/blogging - even tracking your posts here over a period of months - can give you a better idea of how much you've improved.

 

to respond to your most recent question, frequent urination is a major symptom of anxiety - infection not needed. 

 

however, cymbalta does cause an increased susceptibility to UTIs. that is a common side effect of ssris and ssnris - as they can act as a vascular constrictor. that's why high blood pressure is often a side effect of anti-depressants. the C makes it difficult to empty your bladder all at once, so when you think you're done, you're not. you end up going more, and you become more susceptible to infection when unable to void completely. because of that impact, duloxetine is actually prescribed outside the US for urinary stress incontinence for women under the brand name Yentreve. so depending on what ails ya, what is a curse for some is relief for others. UTIs were a major reason i decided to wean off cymbalta. i've been off for four years now and UTIs are a rare occurrence anymore. 

 

there is no magic bullet or quick fix to treat withdrawal symptoms. for the anxiety i highly recommend therapy with a licensed mental health counselor who is trained in cognitive behavioral therapy - CBT. they can help you develop ways to recognize the negative thought processes that perpetuate the cycle of anxiety and help you develop skills to challenge those things we tell ourselves that leads to catastrophic thinking.  i took the C for depression but never suffered from chronic anxiety until i started weaning off - it developed into full blown GAD. for awhile i took clonidine but no longer. anxiety remains low level for me but is very manageable - its taken a lot of work. i went cold turkey from 15 mg/day and it was very difficult. i admire all those here who've managed to raise children while in withdrawal. i cannot imagine. 

 

i am not on the boards nearly as much as i used to be but i poke my head in from time to time when i get a chance to share what i can when i can. you won't find a better support system than the folks here. 

[fishinghat]

Good to hear from you brz. I hope all is well with you.

[EBB]

I have dug through the FDA reports and there is not even one report of any of those meds causing frequent urination but Cymbalta withdrawal sure can. DO you think it could ne Cymbalta related?

Thank you FH for the research. Do you mean that other people have developed interstitial cystitis from withdrawal? Or just frequent urination? It's my theory that this wd has been such a bow to my system and caused so much extreme anxiety that I've developed IC. It's not just frequent urination, but also an ache in my bladder, consistent with IC. People who have this go through flares. I'm praying that it is wd related in that my system is just overloaded with stress. And that when wd ends as I heal it will improve. IC can make a major dent in a person's quality of life. Another concern. I also think it's related potentially to what withdrawal does to the nervous system. Can you tell me about how the nervous system heals from the impact of withdrawal? I feel as though my nervous system the sympathetic and parasympathetic do not work together in sync like they did and I'm hoping this heals. Thank you for your encouragement. I am very afraid I've developed a whole other condition due to the impact of the withdrawal. I've got to get out of this. I'm thinking it's time to start Zoloft, I'm just afraid with all I've put my body thru something all go bad. Kind of like all of this has.

[EBB]

Hi EBB. 

Is it your goal to see how you do without any anti-depressant?  If so then you would want to wait it out with the Clonodine and Hyroxyzine.

Is it your goal to be on the right med long term to manage your anxiety and depression?  If so then you need to either choose Effexor or try to stabilize on the Zoloft and then maybe add a mood stabilizer.

It seems that you need to answer this question and move forward with a plan that only you can choose.  Have peace with your decision and try to have faith.

Just my humble opinion.

Hugs to you, Juli

Thanks Juli, I do need to manage my D/A, I'm just afraid to try the Zoloft bc of my genetic report that it may not do anything or it may cause an adverse reaction. My body is such a mess right now, in such a state of stress, I'm worried about putting it through another change. The Effexor is just a scary drug. Even though it's in the category that I'm supposed to respond to, it's intense and the taper sucks and if I had a problem with that it's be really bad I think. I am trying very hard to have faith. Thank you for your input, and help. Hugs to you too, so glad you're almost to the end.

[EBB]

Hi EBB,

 

I am so sorry to hear about what you are going through. What you are experiencing is, unfortunately, very familiar to many on this site. I know that doesn't make the fear and anxiety any easier but anxiety is a liar. it will get better. a good sign that you're not going crazy is when you actually have the self awareness to wonder if you are ;-). recovery can be slow and for many the process was 2 steps forward and 1 step back. some days its 2 steps forward and 3 steps back but slowly over time you will be able to see you are making progress. journaling/blogging - even tracking your posts here over a period of months - can give you a better idea of how much you've improved.

 

to respond to your most recent question, frequent urination is a major symptom of anxiety - infection not needed. 

 

however, cymbalta does cause an increased susceptibility to UTIs. that is a common side effect of ssris and ssnris - as they can act as a vascular constrictor. that's why high blood pressure is often a side effect of anti-depressants. the C makes it difficult to empty your bladder all at once, so when you think you're done, you're not. you end up going more, and you become more susceptible to infection when unable to void completely. because of that impact, duloxetine is actually prescribed outside the US for urinary stress incontinence for women under the brand name Yentreve. so depending on what ails ya, what is a curse for some is relief for others. UTIs were a major reason i decided to wean off cymbalta. i've been off for four years now and UTIs are a rare occurrence anymore. 

 

there is no magic bullet or quick fix to treat withdrawal symptoms. for the anxiety i highly recommend therapy with a licensed mental health counselor who is trained in cognitive behavioral therapy - CBT. they can help you develop ways to recognize the negative thought processes that perpetuate the cycle of anxiety and help you develop skills to challenge those things we tell ourselves that leads to catastrophic thinking.  i took the C for depression but never suffered from chronic anxiety until i started weaning off - it developed into full blown GAD. for awhile i took clonidine but no longer. anxiety remains low level for me but is very manageable - its taken a lot of work. i went cold turkey from 15 mg/day and it was very difficult. i admire all those here who've managed to raise children while in withdrawal. i cannot imagine. 

 

i am not on the boards nearly as much as i used to be but i poke my head in from time to time when i get a chance to share what i can when i can. you won't find a better support system than the folks here. 

 

Hi EBB,

 

I am so sorry to hear about what you are going through. What you are experiencing is, unfortunately, very familiar to many on this site. I know that doesn't make the fear and anxiety any easier but anxiety is a liar. it will get better. a good sign that you're not going crazy is when you actually have the self awareness to wonder if you are ;-). recovery can be slow and for many the process was 2 steps forward and 1 step back. some days its 2 steps forward and 3 steps back but slowly over time you will be able to see you are making progress. journaling/blogging - even tracking your posts here over a period of months - can give you a better idea of how much you've improved.

 

to respond to your most recent question, frequent urination is a major symptom of anxiety - infection not needed. 

 

however, cymbalta does cause an increased susceptibility to UTIs. that is a common side effect of ssris and ssnris - as they can act as a vascular constrictor. that's why high blood pressure is often a side effect of anti-depressants. the C makes it difficult to empty your bladder all at once, so when you think you're done, you're not. you end up going more, and you become more susceptible to infection when unable to void completely. because of that impact, duloxetine is actually prescribed outside the US for urinary stress incontinence for women under the brand name Yentreve. so depending on what ails ya, what is a curse for some is relief for others. UTIs were a major reason i decided to wean off cymbalta. i've been off for four years now and UTIs are a rare occurrence anymore. 

 

there is no magic bullet or quick fix to treat withdrawal symptoms. for the anxiety i highly recommend therapy with a licensed mental health counselor who is trained in cognitive behavioral therapy - CBT. they can help you develop ways to recognize the negative thought processes that perpetuate the cycle of anxiety and help you develop skills to challenge those things we tell ourselves that leads to catastrophic thinking.  i took the C for depression but never suffered from chronic anxiety until i started weaning off - it developed into full blown GAD. for awhile i took clonidine but no longer. anxiety remains low level for me but is very manageable - its taken a lot of work. i went cold turkey from 15 mg/day and it was very difficult. i admire all those here who've managed to raise children while in withdrawal. i cannot imagine. 

 

i am not on the boards nearly as much as i used to be but i poke my head in from time to time when i get a chance to share what i can when i can. you won't find a better support system than the folks here. 

Hi brz,

Thanks so much for your input. I definitely have awful anxiety, really awful, but I think the stress has actually caused my body to develop interstitial cystitis, not most frequent urination. My bladder is sore like someone punched it and I have to pee constantly. I don't think it's from the Cymbalta I'm taking bc I'm only on 10 beads. I think the withdrawal has just thrown my whole system into shock. IC is related to stress and anxiety, so I really hope this is something that improves with withdrawal fading. When that is who knows? I've been at this horrible withdrawal fro 4 months now and I was tapering Cymbalta since Oct. of 2016. This drug has stolen so much from me and wreaked havoc on my life and my poor family. And now I need to be near a bathroom constantly. My freedom is ever shrinking and that only seems to increase my anxiety. I am working with a therapist. I am eating very well. No gluten, dairy, alcohol, sugar. My life feels very limited, constrained and scary. The future feels bleak. 

[fishinghat]

Cymbalta withdrawal frequently causes frequent urination. It also can cause bladder pain/discomfort as well.

The effect on the nervous system is pretty straight forward. In a normal person the body produces neurotransmitters. These are transported by special proteins across from one cell to the next which is what carries the signal. So for example when you are stressed one nerve in the brain starts the ball rolling. It releases an adrenaline molecule that is carried by a protein across a small gap to the next nerve cell which then releases it adrenaline which is transported to the next nerve cell. So it is a steady from of adrenaline from one nerve cell to the next. It occurs so fast your brain registers the emotion in milliseconds.

When you develop anxiety you are started on an AD like Cymbalta. Cymbalta bonds to this transport protein and interferes with the pickup of the adrenaline and the release of it at the next nerve cell. That is why they use the term transport inhibitor. This interference of the transport protein slows the signals and causes less of a reaction and the person calms. Now for the problem. Cymbalta and the other ADs do not exactly fit the proteins or the binding sites on the next nerve (called synapses). So your body causes slight changes in the protein and synapse structures so the Cymbalta will fit better and work better. That is why ADs take 4 to 8 weeks to kick in.

Now that is fine and dandy until you start withdrawal. As the Cymbalta is removed the transport proteins and synapses can no longer accept adrenaline because their shape has been changed. These proteins and synapses must be repaired by our body. Research has shown that it takes around 2 years for them to completely return to normal. During that time the nervous system *both sympathetic and parasympathetic are essentially out of control. There production of neurotransmitters go up and down like a yoyo as the body tries to compensate. That is why it is so essential that withdrawal be a very slow process.

This principle applies to addictive drugs like oxycodone, benzos, heroin, etc. I have come of benzos successfully 4 times with no withdrawal because I take 2 to 4 years to withdraw. Super slow to give my body time to heal as I withdraw. Of course in my example I picked on adrenaline as the neurotransmitter but the same applies to serotonin in, dopamine and other neurotransmitters.

If anything is unclear let me know and I will try to clarify.