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Been Off For 8 Weeks


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#1 LDN

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Posted 30 June 2018 - 08:36 PM

Hi guys this coming from London. Firstly, this website has helped me so much, so thank you!

 

I was on cymbalta for over 2 years at 120mg for depression and anxiety. My doctor treating me for Lyme Disease has been keen for me come off for a while and then earlier this year I found I wanted to sick them out straight after I took them. I decided to come off them and my doctor took me off quicker than I expected. I went between 120 and 60 for a week, then a week on 60 and finally a week going 60 and 0 alternatively. Having read this site I realise that was pretty extreme!

 

I’ve been off completely for 8 weeks now. At first it was tough, I was crying, felt spaced out, had diarrhoea and couldn’t concentrate. However I had good days and generally felt I was slowly improving. I also lost about 10 pounds and had more energy, plus my sex drive came back. So basically things were quite positive and I felt really lucky. The last two weeks have seen a massive change unfortunately. I started getting really bad panic attacks and could barely concentrate. Then things got even worse the last few days. I’m getting severe anxiety, feel depressed and just feel my brain and body cant take the pressure any more. So I was wondering what you guys suggest ? I was thinking of going back on at 60mg and then bead counting my way down. Or should I go back to 120mg and work my way down? Alternatively I could just try a different drug? Maybe Prozac? Sorry this is so long and for so many questions!

 

Thanks so much. Peace


#2 gail

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Posted 01 July 2018 - 05:18 AM

Hello London,

Welcome to the USA and Canada of course. This is a touchy situation here. The fact that it's been 2 months, you saw improvement even though the way it was done was unorthodox.

Two months in, then boum, the shit hits the fan.

Suggestion here, jump on Prozac or Zoloft. And forget about Cymbalta. Speaking on jumping, Fishinghat should jump in real soon and will suggest something for anxiety. At the same time will offer other solutions.

After 2 months, we all hate the idea of going back on it.

Gang, what do you think? Vince? Others?
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#3 fishinghat

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Posted 01 July 2018 - 07:25 AM

Welcome London

Prozac, Lexapro and Zoloft are all possibilities but just remember they may not bring immediate relief.
Another choice is to go up to say 10 mg and see if that takes the edge off. If you can stabilize at that level you can bead count from there. This option usually kicks in faster. If 10 mg does not bring enough relief in 2 or 3 days then you may have to go to 20 mg.

Sorry your dr put you in such a bad situation but that is a common story around here. Please keep us informed on how you are doing.

God bless
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#4 LDN

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Posted 01 July 2018 - 09:31 AM

Wow thanks for getting back so quickly gail and fishinghat! 

 

I’m really caught in two minds about what to do. On one hand having got so far, I feel so scared about going back on cymbalta! However, I feel I came off way too quick and so should just go back to 60mg, stabilise and then bead count. Or maybe start at 10mg like you suggest. I only have 60mg capsules, so to get 10mg do I just take beads out till it weighs 10mg? Sorry if a stupid question!

 

It’s a real dilemma for me. It’s weird I was coping so well after about a month off. I had more energy, I was going out more having been basically house bound with Lyme Disease for about 2 years. I went away to country for a week and had a great time. Then everything started to fall apart and now I feel a mess and just so confused. I don’t get how I was coping so well and then for everything to suddenly go boom!  Gail you described it perfectly the shit hit the fan! If I went on to prozac what dose do suggest? 5mg? 10mg?

 

I feel if I go back having been clean for 2 months then maybe I’ll never get off it! Cymbalta just controls you and takes over your life. I feel i’ve got so far! But i’m really struggling right now. Just feel so scared and lost! Everything feels weird and different. Everything just feels wrong. My chest hurts and heart rate is going crazy! 

 

Anyway thanks so much for your advise. It really means a lot and it’s great to feel I’m not alone. This site gave me more info than anything else out there. I’ll get back to you soon.


#5 fishinghat

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Posted 01 July 2018 - 10:04 AM

To get a 10 mg capsule you open one capsule and count the number of beads inside. Lets say 300 beads. If it is a 60 mg capsule then you would want to put back in 1/6th of the total numb er of beads. In the case of 300 beads that would be 50 beads. The reason you can't weight them is because they contain other things than just Cymbalta. Enteric coating, binders, etc. One thing about it, if 20 mg is not enough you can always work your way up until you get relief but by starting low and working up you assure yourself not to take any more than necessary.

"It’s a real dilemma for me. It’s weird I was coping so well after about a month off. I had more energy, I was going out more having been basically house bound with Lyme Disease for about 2 years. I went away to country for a week and had a great time. Then everything started to fall apart and now I feel a mess and just so confused."

This is a mild form of mania that occurs in may of those that come off fast. Not unusual.

As far as switching to a different AD, the dr would normally start you on a low dose and up the dose every week or so. 5 ,g, then 10 then 20, etc.

There are things that can be taken to help you get your heart issues under control. Clonidine and Atenolol both work on adrenaline and are not addictive. Clonidine often helps with the anxiety/fear as well.
Feel free to come back any time with your questions. Hang in there.

#6 LDN

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Posted 02 July 2018 - 08:17 AM

Firstly, thank you so much fishing hat! That was incredible kind of you to give me such detailed help! 

 

So unfortunately I think the pressure of the last 8 weeks has taken it’s toil on me. I’ve fallen into a really bad depression. The last time I felt this unstable was when I was hospitalised 5 years ago. I’ve started to feel suicidal for the first time properly for a long long time. 

 

I’ve mentioned I’m recovering from lyme disease, but I also have ME. I’ve been treated for these really well over the last year and a half and I’m improving a lot. I’m scared if I get hospitalised this will ruin my momentum. When I mentioned going into to hospital to my doctor he said it would mean when I come out starting from the beginning again. This thought terrifies me. At the moment I’m taking vitamins, have an infrared sauna every day, an epsom salt foot bath and get osteopathy once a week for the ME. My ME treatment lasts another year and I’m so stressed about not being able to finish it. I’m still very limited in what I’m allowed to do physical, as recovering from ME is about taking things slow. This time 2 years ago I could barely walk, so i’ve improved a lot but still a long way too go.

 

I just wish I had never come off the cymbalta since it keep me calm, stable and could just focus on my physical recovery. I felt like my body couldn’t take them any more, my testosterone had dropped and I wasn’t really feeling things. These factors plus the fact my doctor suggested the cymbalta could be making my physical recovery slower meant I decided to come off. Man I regret it now, but I realise you can’t live in the past.

 

My close family have been amazing support, but I can see it’s tough for them, that’s part of the reason I want to go hospital to give them some peace. They’ve noticed i’m panicking a lot at the moment, which is not like me. Also they’ve mentioned huge mood swings. 

 

Fishinghat I followed your advice and went onto 10mg yesterday. I would have had no idea what to do, so thanks so much for explaining! My thinking now however is to get back on 60mg straight away to stop me feeling so unstable I have to go to hospital. I may then go back up to 120mg. Then get through this last year of ME treatment and then come off really slowly. I will hopefully be able to properly exercise then, so that so make it easier coming off. 

 

It weird though because coming off the cymbalta has just made me feel so much stronger and healthier, the best I felt for years. So on one hand it feels mad to go back on it, but at the same time I’m just so panicky, stressed and sacred and do feel suicidal at times. 

 

One last thing I’m on clonazepan 0.5mg twice a day, would I have to stop this to take clonidine?

 

I’m really sorry for such a long post but felt If would good to give you more detailed picture of my situation. Thank you so much for this platform and I wish you all the very best on your own personal journey! 

 

Peace


#7 fishinghat

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Posted 02 July 2018 - 09:27 AM

Suicidal thoughts and seizures are fairly common for those who wean too fast according to the FDA.

 

The drop in testosterone, did it occur on Cymbalta or as you came off. This is fairly common and usually corrects itself after being off Cymbalta for 3 months. This same thing happened to me.

 

Remember these mood swings are not the way you are. They are just the withdrawal talking.

 

Did the 10 mg increase help any at all? If not go up another 10 mg tomorrow. Keep going up to mg every 2 days until you get some relief. It will get there. By only taking the amount necessary to feel better you will have less withdrawal later. Also realize that by going back on the Cymbalta the low testosterone may not return to normal. Are you on testosterone replacement therapy (TRT)?

 

I don't know about over there but here if you check into the hospital the first thing you do is come off all meds and start from scratch. Members here who have tried it say it was the worse experience they have ever had.

 

You can take clonazepam and clonidine at the same time. Remember that clonazepam is very addictive and recommended for short term use only (4 weeks or less). I am not saying to not take it I am just wanting you to be informed.

 

Hang in there and I am so glad you have your family's support. That is important.


#8 LDN

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Posted 05 July 2018 - 04:28 PM

Hi sorry not to respond sooner.

So if i give you an overview of the last few days - 

 

Sunday - went on to 10mg still had a bad panic attack/seizure that evening, emotionally I was a mess

 

Monday - completely panic so went up to 60mg, then had the worse panic attack of all. I felt as if I was going to die, felt very close to killing myself in a moment of madness in the grip of the panic attack. Yet only an hour after I felt so suicidal I suddenly felt fine. One of the most extreme mood swings I've ever had. My family said that evening I was much more calm than I have been for a while.

 

Tuesday - I stayed on 60mg, and felt much more calm, and didn't really have a panic attack that afternoon. That evening the side effects of cymbalta started to hit me again and so I thought I would come off again (yes I know crazy!). I thought that having been off for 2 months I couldn't face doing it all again.

 

Wednesday - I went to my gp to ask to clonidine, instead she gave me propanolol. I took 30mg that day as I didn't want to come off from 60mg straight away. I had a pretty good day Wednesday, including no real panic that afternoon.

 

Today - Took 0 cymbalta and had a good day, then this afternoon out of nowhere got hit by a massive panic attack. My heart rate going crazy, could barely breathe. It was so scary. I have very mild ashtma, so I think I'll stop the propanolol, as my gp mentioned it could affect breathing.

 

Sorry if I sound all over the place! I'm just completely lost. Do you think this is withdrawal or just a depression? Seeing as when I went back on the cymbalta the panic attacks stopped, I think it probably it's severe withdrawal. Man this drug is horrible, I've been off 2 months and it's doing this to me? Why are my withdrawal affects worse now than when I came off at first?

 

I've been on the clonzapam for 5 years, and recently been slowly reducing my dose. Since I'm struggling right now maybe I should take a few more just to get by? I'm prescribed up to 5 a day of 0.5, but at the moment taking just 2 a day.

 

Tommorow I'm thinking of going back on again. What dose do you suggest? Maybe do what you said 20mg for 2 days, then up till I find some relief.

 

Thank you so much fishinghat for everything. I really can't thank you enough. 


#9 fishinghat

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Posted 05 July 2018 - 05:59 PM

Hi London

Propanolol is a beta blocker which means it blocks the beta binding sites of adrenaline IN THE BODY but not the brain as it does NOT pass through the blood brain barrier. It will only treat the physical symptoms of stress not the mental ones. So the heart pounding, fast pulse etc will be reduced. I am surprised she did not go the clonidine route as it not only helps the physical symptoms of stress but also the emotional symptoms.

This is all just plain typical Cymbalta withdrawal. I would not go back up on the clonazepam as research shows that going back up on a benzo during a weaning period does not help 47% of the patients. You came a long way to get down to 1 mg a day.

"Maybe do what you said 20mg for 2 days, then up till I find some relief."

I think this is your best bet. When you do find the minimum dose that makes you fairly comfortable then you will need to start a slow bead count so you can avoid most of this suffering. I would start at 20 mg for 2 says and if not better then 30 mg for 2 days, etc.

I wish I could help more London. I remember what this was like and it can be horrible. Just hang in there and we are always here for you.

#10 LDN

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Posted 06 July 2018 - 10:18 AM

Thanks you so much fishinghat!

 

I spoke to my psychiatrist today on skype and mentioned the breathing problems brought on by propranolol. He told me to stop and has put me on chlorpromazine. He said this would help with the high heart rate.

 

Also I was wondering when counting the beads one time it came to 300, the other time 290. Do they have a slightly different number in each? Or maybe I miss counted? Should I count how many are in each capsule separately each time do you think? The beads are so small so I find quite tough counting them. 

 

I really can't thank you enough again for all this help!


#11 gail

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Posted 06 July 2018 - 04:16 PM

Hi London,

FH must be having trouble with his computer.

At the moment, you don't bead count, so I think. It's 20 or 30mg. You must have the 20 or 30mg all made up by the pharmacist. And, oh dear love, you count the first capsule and that's it.

Even if you have to do yourself some 20mg capsules out of 30 mg it won't make a difference if there is a 10 bead difference. It will be important later but not now.

As for the difference with the number of beads, which is for later, Fishinghat will answer that. See you !ater!

#12 fishinghat

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Posted 06 July 2018 - 06:59 PM

chlorpromazine? An antipsychotic? It is only mildly effective for anxiety but is good for seizures.

On the bead count....The FDA allows +/- 10% of dosage when filling a capsule. Most people count 5 capsules and take an average.

London, you are very welcome. Anything we can do, don't be afraid to ask.

#13 LDN

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Posted 22 July 2018 - 09:15 AM

Hi guys, so back to fill you in.

 

I went back on 20mg for a week but I was still getting quite bad panic attacks and needed the chlorpromazine to help. I then went up to 30mg and after a few days I stopped getting the panic attacks and actually stopped needing to take the chlorpromazine. Last sunday I had a great day with almost no anxiety.

Since wednesday the panic attacks started coming back and I started having to take chlorpromazine again. From thursday onwards I've been facing really bad anxiety constantly. I wake up and I'm straight away either depressed or very anxious. Yesterday I had a horrific panic attack, I really thought I might die during it.

 

So what do you suggest? I don't want to go higher than 30mg since the side effects will get worse. The side effects of cymbalta make me incredibly physical weak, to the point where I can barely walk. They also give me bad pains in my legs. Also, the chlorpromazine makes me very drowsy and this got worse when I went up to 30mg. Since I've been on 30mg the chlorpromazine can send me off to sleep for up to 3 hours in the afternoon, when I wake up I then feel very out of it for quite a while. I don't mind this however as it's helps the anxiety and panic attacks. So if I go up again it will make it very hard to take the chlorpromazine as it will just make me too drowsy. So it's really go up and stop the chlorpromazine or stay at 30mg but keep the chlorpromazine which really helps.

 

My doctor has suggested escitalopram. So maybe I should try that and stay on 30mg for the moment.

 

Initially going to 30mg helped, so I'm not sure why things suddenly started going bad again? Since it did help initially maybe I should just wait a little longer?

 

So in summary - 

1. Go up again to 40mg but then have to stop taking chlorpromazine. Also, get worse side effects (meaning getting very weak)

 

2. Stay on 30mg and keep taking chlorpromazine, plus adding escitalopram. 

 

Thanks so much. I appreciate this is very difficult and confusing situation. 

 

Peace


#14 fishinghat

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Posted 22 July 2018 - 11:09 AM

I have seen this type of reaction only a few times on this site. Considering that if you go up on Cymbalta you los and going down on Cymbalta you lose I would switch over to the escitalopram and then wean from there. Sorry that you are stuck in a tough spot.

#15 gail

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Posted 22 July 2018 - 12:18 PM

Hello London,

Same thoughts as Fishinghat here.

When escitalopram builds up, get stable and start the bead count.

With those massive panic attacks, do use a benzo to help you through. This is rough, panic attacks takes all the energy from you. I am pro benzo for this type of anguish, let's call it hell. Plainly horrible moments, so London,do what you have to to ease this. We'll taper the benzo when the time is right, easily.

I remember my first big one, 45 years ago. Can't forget that, it left me traumatized. At that time, I didn't know what it was, couldn't talk about this either. Took me four weeks to recover! Benzos would have helped, but that word was unknown to me back then.

Update us as time passes by. Get the anxiety down!

#16 LDN

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Posted 15 August 2018 - 07:58 PM

Hi guys,

 

Dropping in to fill you in. I started taking escitalopram but after a day or two had pains in my kidneys so stopped taking it. So I've been on just 30mg cymbalta and chlorpromazine. The anxiety is a bit better, but I'm still very depressed. I've had a few days of it being extreme. 

 

I'm going to see a new psychiatrist this week. I'm hoping a fresh perspective might help. 

 

Thanks gail and fishinghat for your support. Both of you have shown me such great kindness. I can't really put into words how grateful I am. Gail thank you for sharing that will me, I've had very similar experiences to what you had. It's so nice to feel your not alone, as at the time you think you're only person going through anything like that. For me I find it makes me very scared of going out, in case I have a panic attack. I'm hoping to get some CBT sometime to help me with this fear. 

 

Peace


#17 gail

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Posted 16 August 2018 - 07:07 AM

Hello London,

Good to see you again, I thank you for taking the time to update us. This is really appreciated. Also, thank you for your kind words.

We put our hope in your new psychiatrist, and in CBT. I understand your fear of going out, do I ever! I always brought a benzo with me in case...When the timing will be right, you will do it. I remember just walking around the house at first. With time, and time is of great value here, I made it.

Keep in mind that it's temporary, a PTSD that you get over. Or learn to live with, how many people get stuck in their own home, I feel so sorry for them. Anyway, as I said, it's temporary London. Be on the safe side, bring a benzo just so you know that it's there in case!
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#18 fishinghat

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Posted 16 August 2018 - 08:12 AM

Yea, LDN, it is about time for a fresh approach. I hope a new dr can help you. Have you ever considered that you might be bipolar? Something you might discuss with the bew dr.
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#19 LDN

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Posted 24 August 2018 - 08:00 PM

Hi fishinghat and gail,

 

I hope your well! 

 

So I went to the new physiatrist and she suggested three options -

 

1. Try Prozac

2. Try Effexor

3. Go back up on Cymbalta

 

We decided to go with Prozac. I started it last Saturday at 4mg and Thursday went up to 8mg. Since Wednesday I been in an extreme depression. Then today I had unbelievable anxiety, almost as bad as I have ever had it. I'm sacred out of mind right now. The anxiety has been okay since I've been on the chlorpromazine so today been the worst I've felt in weeks. I stopped taking the prozac today. Do you think it might be causing this new anxiety? I can't think what else it could be.

 

If I stop Prozac then it's Effexor or Cymbalta. Do you guys have any views on Effexor? I looked it up and it sounded pretty awful.

 

I'm thinking maybe just go back to Cymbalta and up the dose to what I was on 120mg. I think I just need the relief. I've been struggling since mid April and just can't go on much more. I've used up all my energy. I hate the thought of it but I feel now I have no choice right now.

 

Fishinghat I've never been diagnosed bipolar but just psychotic depression. This new physiatrist said she thought I had severe depression.

 

Thanks as always.

 

Peace


#20 fishinghat

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Posted 25 August 2018 - 07:39 AM

"Do you think it might be causing this new anxiety?"

It is possible. The only way to be sure is to go back on it and see if the anxiety returns.

"If I stop Prozac then it's Effexor or Cymbalta. Do you guys have any views on Effexor? I looked it up and it sounded pretty awful."

In my opinion it is very similar to Cymbalta including the withdrawal. Awful is a good word for it.

Psychotic depression is a severe depression and can be hard to treat. May O ask why you would wand to go back to 120 on Cymbalta. 10 mg or so might give you enough relief from this withdrawal. Give the 10 mg a few days and if not go to 20 mg, etc. Also, have you considered Lexapro or Zoloft for relief?

#21 gail

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Posted 25 August 2018 - 07:58 AM

Hi London,

The chlorpromazine is doing a good job on the anxiety, as well for panic attacks?

Fishinghat, I believe that London has tried the 10-20-30. Was an up and down experience.

I agree with Fishinghat about trying Zoloft or Lexapro, FH had good results with Zoloft after trying many others and Juli has good results with Lexapro. Combined with chlorpromazine, could be a good combo. Check the interaction.

London, this will be a tough phase, trying different antidepressants is a hard process. Then you find the right one, what a relief then.

Thanks for updating, come back anytime you need to.

#22 fishinghat

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Posted 25 August 2018 - 08:46 AM

I checked the drug interaction and found...

Interactions between your drugs

Major

Applies to: chlorpromazine, Lexapro (escitalopram)

Using escitalopram together with chlorproMAZINE can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone.

The irregular heart beat is why I had to stop the Lexapro when I tried it for my Cymbalta withdrawal. That effect is more pronounced if you are over 60. I can tell you I am lloooooonngg over 50. lol

#23 LDN

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Posted 25 August 2018 - 08:16 PM

Fishinghat I'm not taking Lexapro anymore as it gave me pains in my kidneys, but I had an ECG before I started taking because of the interaction you mention. Thankfully ECG was all good. 

 

I'm feeling even worse today. Such bad depression. My new doctor mentioned maybe going into hospital, I don't really want to but maybe I need to. Prozac seems to have shaken everything up. I can hardly remember feeling this bad.

 

I wanted to go back on a higher dose of cymbalta because I thought it might be the only thing to give me relief. 

 

Gail the the chlorpromazine was working on the anxiety and panic attacks really well but since the Prozac they have come back really bad. Hopefully a few days off the prozac and things will settle down. I read a review of prozac where someone said it took them 5 days to feel better after getting bad side effects when trying it and then stopping. 

 

Thanks so much for your kindness. You've both helped so much!

 

Peace


#24 fishinghat

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Posted 26 August 2018 - 07:11 AM

You are probably right LDN. A few days off the Prozac may settle you back down. That is one of he hard things for the drs to deal with. What helps one dr may not help another or may even makes things worse for a third person. It can simply be trial and error.

I think going back up on the Cymbalta, once you settle down, may be a good decision also. Time will tell.

#25 LDN

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Posted 14 March 2019 - 09:00 PM

Hi again,

 

Thanks so much gail and fishinghat for the help in the summer!

 

My situation now - 

 

1.  Went back up to 60mg of cymbalta and immediately felt much better. 

 

2. Because I was suffering from such bad depression my physiatrist thought I should increase to 90mg and 120mg.

 

3. I've been on 120mg since mid september and I am still very depressed and not really improved. Also the side effects of cymbalta are hitting me worse than before and I can barely walk now. 

 

4. So my physiatrist wants to move me on to Desvenlafaxine and take me off cymbalta. 

 

5. Since 60mg was the dose that I felt better from my withdrawal, I was thinking of going down to 90mg while starting desvenlafaxine. Then after 3 to 4 weeks of 90mg go down to 60mg. Then after 3 to 4 weeks on 60mg start to bead count. What do you think?

I know bead counting from 60mg will take a long time but since last time I came off I felt close to suicide I want to be super cautious. 

 

Thanks and hope you are well. Gail and fishinghat you helped save my life in the summer, I was so lost. Sorry if I sound a bit crazy! Even though I'm still depressed and have terrible side effects I'm in a better place now as get on really well with my physiatrist and also have a great therapist, so I have much more support. 

 

Sorry for bothering you again!

 

God bless


#26 invalidusername

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Posted 14 March 2019 - 10:00 PM

Hey LDN...

 

Looks like we just missed each other when you were last here, but I am happy to be meeting you now. I have read through your thread and got up to speed, and looks like you have been through plenty of proverbial hedges here, for which you have my every sympathy. So, onto your present situation....

 

The most obvious thing to flag up is the risk of serotonin syndrome - we need to be very careful that you do not go over the top with the two at the same time. The guidelines for cross-tapering one SNRI to another SNRI are to taper the first before starting the other, but givn your history I really do not advise this. The guidelines are there because of the risk of SS, but if you are careful, this doesn't need to become an issue.

 

Personally, I would still avoid the jumps of 30mg. You will do well to hang on the dose for a few weeks, but the drop is still 30mg whenever you do it, and the shock to the system will still be the same. I would start from 90mg and start the ven at 12.5mg whilst tapering to 60. By the time you get to 60mg, the ven should be kicking in. Rather than plan ahead from this point, I would suggest getting this far and then weigh up options. 

 

Hat, Gail and the rest of the crew will be along tomorrow, but for now you have the night-shift!! Hope this gives you a bit of a start.

 

IUN


#27 fishinghat

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Posted 15 March 2019 - 08:07 AM

Good to hear from you LDN
 
120 mg Cymbalta is a lot of Cymbalta and IUN is rigfht that there is a serious concern for serotonin syndrome. If you want to go on Desvenlafaxine (a form of Effexor)you will need to drop rapidly so you can get started on the new AD.

This is an interesting situation as 50 mg is the starting dose on Desvenlafaxine and the therapeutic dose and the maximum dose. There is a 25 mg which is prescribed for withdrawal but drs seldom use it for doing a cross taper. In fact many just go to 0 on the Cymbalta and direct to 50 on Desvenlafaxine. This cross taper can be a rough ride. I will check the medical research and see if I can find anything on doing a cross taper with this drug. This drug has been on the market since 2008. Be back with more info shortly.


#28 fishinghat

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Posted 15 March 2019 - 08:09 AM

Some notes from Summary of Cymbalta Withdrawal

Desvenlafaxine (brand name: Pristiq) is a drug closely related to Effexor.

Desvenlafaxine (Pristiq) - is a synthetic form of the major active component of venlafaxine (Effexor). It is approximately 10 times more potent at inhibiting serotonin uptake than norepinephrine.

It has a reputation of as bad or worse withdrawal than Effexor or Cymbalta.

https://www.ehealthm...a-and-vomiting/(FDA)
15,653 people reported to have side effects when taking Pristiq.
Among them, 475 people (3.03%) have Nausea and vomiting
15,653 people reported to have side effects when taking Pristiq.
Among them, 731 people (4.67%) have High blood pressure
15,653 people reported to have side effects when taking Pristiq.
Among them, 1,129 people (7.21%) have Exhaustion, fatigue, lethargy, tiredness, weariness


Member Comments
Matt123 - Things were going fine until I began to get a constant dizzy/off balance feeling in February while on Pristiq and it has not gone away, even after swapping tablets to Paxil. In fact now the dizziness becomes intolerable if i try to up any anxiety tablet above a small dose.
albergo11 - To give a brief background, in January of 2013 I was prescribed 50mg of pristiq, had a bad reaction to it,
Mrs301 - My doctor first had me on Pristiq 100mg. Well insurance won't pay for it so it cost me well over $100.00.
Pups4Life - I have a family member who is on Pristiq and happy with it.
vonmarie - (because I had a really bad experience with going off from Pristiq and didn't want to relive that nightmare!)
AaronSD - I eventually started taking Pristiq, which was moderately effective,
sk8mom - By January 2009 I had tried about 7 different antidepressant and had major side effects and bad reaction to them all (I remember trying Paxil, pristiq, celexa,- my psychiatrist tried to combine these with seroquel, risperdal and zyprexa.. zyprexa was the only one I could tolerate..
windupbird - I've been off Cymbalta since Sunday now and have taken Pristiq for 3 days. I'm feeling really sleepy and a lot of dizziness and light headedness. How long will this last? I think its to late to go back to Cymbalta and wean off slowly. I just wanted to be done with it and on Pristiq cause I want to feel better.
My wife was put on Pristiq and weaned off Cymbalta in one week. The results were horrendous. You must wean off Cymbalta very, very slowly. See the post on the official protocol by Professor Healy. The side effects of Pristiq are similar to Cymbalta but it works amazingly well in some patients. See if your doctor could give you a small dose of Prozac whilst you come off Cymbalta and then try the Pristiq. Hope this helps. DonMH.
beachmama - To Kylie, I see that you are going to go to Pristiq. Be advised of the side effects including but not limited to, Increase in BP. I was on it for a short period of time and my normal hypotension (low blood pressure) jumped to stroke status. this is another seratonin drug and you will need to wean off of it.
rigby941 - Easiest.... um - none, really. I've been on so many... Pristiq is pretty bad, I remember - but not as bad as Cymbalta...
Nola - I work nights/weekends at a hospital. I have four consecutive days off. Last Monday, I went to sleep and didn't wake up again till Tuesday night. At that point I decided not to continue taking the Pristiq. I pretty much slept until I had to come to work on Friday night.
Marcia - Feeling like the floor is not solid beneath my feet. (way worse with Pristiq, though)
TinyTimmyTom - I took my Pdocs advice and started taking Pristiq. Apparently I'm sensitive to medications, and I had to get off it ASAP because I was having blurred vision.
rosie - I am a totally different person today. After one day on Pristiq, my mind is clear, my mood is great and the nausea, dizziness and those annoying brain zaps have gone. I will never forget that feeling and the sound when I moved my head too quickly ("ch, ch, ch" sound). I hope this lasts as I have to say, I am excited and optimistic about my future.
sandy63 - My Psychiatrist said it was fine to and do on Pristiq-I have to quit because gave me bad stomach pain which they want my Drs, records from that ordeal of eight months-I have been through hell with this-so sick with vimiting-sweats-chills-severe neck pain--severe depression which Has not ended--after several day my dr. put me on 20mg of Prozac to help-it does but not alot yet been on it for one week- still have alot of sadness,worry and want this to end.
Angela - I was originally on 60 mg but they stopped working for me so a dr prescribed me a new A/I, Pristiq. I took that for a week and a half and was weaning off the Cymbalta too. I started losing weight, no appetite, nauseous and diarrhea. He said to stop taking the Pristiq because that was a side effect, which I never had on the Cymbalta.
Kim - After Pristiq came on the market, he thought it would be a wise decision to switch me from Cymbalta to 50mg of Pristiq right away and should have had "no symptoms at all". WELL I call BS within 2 days I was out of work for a week, vomiting, diahrrea, fever, brain zaps like crazy, every thing I've read about people basically going cold turkey. He upped my Pristiq to 100mg and still it did nothing. Crying all the time, thinking I didn't even want to live like that anymore. I stopped going to him, stopped taking the Pristiq and went back to my 60 of Cymbalta and have been back to that routine for the last year and a half.
really nervous - The Pristiq dosage hasn't been working and I've been anxious and feel like my body is made out of lead! I've also had an upset stomach.
Christy - I am experiencing the same problem. I have been taking Pristiq for 1 yr and half. I recently asked to switch to Welbutrin because I gained 30lbs while taking Pristiq.
saratty45 - I am in Day 5 off Cymbalta. My doctor switched me to Pristiq because I wasn't feeling well and felt the Cymbalta was not working. While I feel relatively mentally clear... able to work productively, etc. physically I feel TERRIBLE. I first experienced nausea, diahrrea, headaches (not extreme) and feelings like mild electric shock going through my body. The intestinal issues are calming down. However, the feelings of electrical shocks seems to be increasing.
wmaraionet - The doctor had put me on Pristiq but my blood pressure is out the roof.
isabell - Now I'm on the new anti-D Pristiq no side effect for me at all and for me it has been like a wonder drug. been on it for 3 1/2 months and I finally feel great, like the old me I haven't been in over 15 years.
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#29 gail

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

Posted 15 March 2019 - 08:12 AM

Hello again London,

You are never a bother to us, never. I'm happy to see you back.

IUN has given you real good advice and I have nothing to add for the plan he made for you.

BTW, IUN is very knowledgeable, just like Fishinghat, you can trust his judgement. We are so happy to have him in the forum.

If I understand right, it's jump to 90. At this point, introduce desvenflaxine, then bead count from 90. Easy...anyway, life is a trial, do come back London. Love

#30 invalidusername

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Posted 15 March 2019 - 09:33 AM

This is such a tricky subject to approach when considering SS, but sometimes in the midst of a suicidal stretch, mild SS seems like a holiday! 

 

I want to be very careful in what I say because of this, but as Hat said, the taper and fresh start I feel would be an extremely rough ride. I was advised to do this when going from Citalopram to Cymbalta, but I didn't. There were times when I felt a bit manic, but I dealt with it when it occurred. The truth is that SS has to be very advanced to be considered lethal BUT the amount at which is tolerated in each person will be different. Please do not assume that you would be able to tolerate a given dose.

 

What I have calculated would be based on maintaining the 120mg dose of Cymbalta, which should be tolerable, but factoring drug interactions, we can not be 100%. There is some weighing up to do, but I stand firm that a direct switch in your case will be a bad idea given your history. 





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