6 replies to this topic

[Flower]

I have been on Cymbalta for 5 years. for the past 2/3 years i have been on 30mg until recently i was advised by my GP to wean down every other day as i found out 10 days later i ended up in a mess and went back to see a new psychiatrist due to mine retiring..

I had to go back up to 60mg to get stable, this is where I really need some advice. im going to see him tonight and his plan is to go back down to 30mg and put me on Prozac???   happy with this but want to get it right.  I have read so many of the post's on here but still not sure the right way to do this.

 

Am I right in thinking I drop back to  30mg go on the Prozac for 4 weeks  (with Cymbalta)then start bead counting ???  I went back up to 60mg 3 weeks ago

 

any advice would be greatly appreciated 

[fishinghat]

Hi Flower, welcome.

Just my opinion but typically a dr will start you out at 5 mg of Prozac the first week and drop the Cymbalta by 10 mg. This type of increase in Prozac occurs each week with a corresponding drop in Cymbalta. Now some have little problem with this method while others suffer quite a bit until the Prozac fully kicks in (4 to 6 weeks). Some members have bead counted during that cross over time instead of making weekly drops BUT if you go to slow on the bead counting you can get too much Prozac and Cymbalta in your system at the same time and get serotonin syndrome. I wish I could be more precise.

By the way the every other day thing is NOT recommended by the FDA as it jerks your blood levels of Cymbalta up and down and you repeat the same withdrawal over and over.

 

I hope this helps. Please feel free to ask questions. We will be glad to help as best we can.

Has your dr given any thoughts to an other medicine to help you cope with any withdrawal symptoms that may occur? Many use clonidine and/or hydroxyzine to help. They are not addictive and have no withdrawal. Most drs prefer to immediately put people on a benzo, which is very effective, but they are very addictive with a strong withdrawal. I usually recommend people try the other two first before considering a benzo.

[Flower]

Thank you Fishinghat for your quick reply .I  have just returned from seeing my psy and discussed at length but here in the uk they don't really know how to treat this withdrawal, My psy is very nice and understanding but we are trying to work together for the best solution.  We came up with either dropping to 30mg Cymbalta or doing 30mg cymabalta 60mg every other day for a month then on 1st September taking 30mg Cymbalta with 20 mg fluoxetine then bead counting after 6 weeks.   I did mention Clonidine and hydroxyzine but as I don't know anything about these drugs am a little reluctant to try them but saying that I have never had fluoxetine either ,i'm only on Cymbalta.  

[fishinghat]

I would strongly recommend avoiding the 30/60 every other day routine as it really jerks around your blood levels of Cymbalta and makes any withdrawal symptoms worse. Otherwise I don't see anything wrong with what your psy dr suggested. Most of our members have little problems with dropping from 60 mg to 30 mg on the Cymbalta. Be aware you will still have some withdrawal. Did your dr tell you that Prozac takes 6 to 8 weeks to reach full strength? Still, all in all not a bad plan.

[Flower]

So I would be best to drop straight to 30mg then on 1st september introduce the fluoxitine for 4 to 6 weeks?  then iI have another appointment mid october to maybe go up on the fluoxitine whilst bead counting,im not sure on the drop ratio at the moment but told him im in not in a rush although you have mentioned not to drop too slowly.  I have read soo many post's from you and respect your advice. Can you recommend a plan for bead drop if I do the above?  many thanks for your knowledge and help on this forum

[fishinghat]

You are very welcome flower and thank you for your kind words.
 
Drop to 30 now
Add 20 mg fluoxetine on Sept 1st
Start Cymbalta bead counting on Sept. 1st. Assuming around 300 beads I would drop about 10 beads a day so you would be off the Cymbalta in 6 weeks. You can always pause your drop for a few days here and there if necessary but you need to avoid having too much fluoxetine and Cymbalta in your system at the same time. Watch out for symptoms of serotonin syndrome and fever.

This could be a little rough trip so be prepared to take it easy on yourself and get plenty of rest. Your dr can also increase the fluoxetine some during the bead count if things get too bad.

I will be back first thing in the morning if you need anything else. I think you are on the right track.

[Flower]

Great advice once again.

I will update you all on a weekly basis x

 

many thanks 

Flower