15 replies to this topic

[Bailey1020]

Hi - I'm still fairly new here (although I appreciate the help I have received so far). Not sure if this is the right place for this post. Some of you may know my story, (like Fishinghat, sorry if I got the name wrong) - basically an idiot doctor dropped my from 60mg to 30mg one week, then to nothing the following week. First of all, anything I can do with this terrible doctor? I might mail her some printouts on all of this & what she apparently has no knowledge of (for my peace of mind). Is there anywhere I can report her to? Next question, thinking maybe I should seek out another psych to help me through this. I do appreciate all of the info here, although it can be extremely overwhelming. I am seeing my homeopathic doctor, for natural support. But honestly meds are not his expertise (understandably so). I tried working for a few hours yesterday & it was extremely apparent how "out of it" I am. Could barely carry a conversation & was very nervous behind the wheel. Please help, thank you.

[gail]

Hi Bailey,

What a good thing to to to send her print outs. Fishinghat will tell you which one to send. Doing this will save a lot of pain for the next patients she sees. That is, if she reads them.

This thing with Cymbalta should be known by all doctors around the world. But, it's not, sadly.

Indeed, do look for another shrink. Baily, are you still on 30 mg ? May I ask why you were put on Cymbalta? Thank you! Oh, and have you found relief while on it?

[fishinghat]

Oh Bailey, I don't blame you for your anger. The problem is that when Cymbalta came out the manufacturer (Eli Lilley) claimed there was no withdrawal and if there were any symptoms then it was like a mild cold. That is how the drs were originally trained on this drug. Of course a lot of people developed withdrawal and but Eli Lilley took the position that it was just reoccurrence of their psychiatric symptoms. It wasn't until it was approved for pain that it became obvious that this was not the case. Many of those taking it for pain had no psychiatric history yet suffered the same withdrawal symptoms as other. Several lawsuits later the courts ruled that a black box warning had to be put on the drug insert that comes with the medicine about the withdrawal. Unluckily the courts DID NOT force Eli Lilley to retrain the physicians. Most drs are still relying on their old training. Sad but true.

If you were going to send him some documents here are the ones I would recommend....

http://www.fda.gov/d...e/UCM172866.pdf

The following document was issued by the FDA warning of the severity of Cymbalta Discontinuation Syndrome.

Page 1
Cymbalta (Duloxetine) Discontinuation Syndrome
Issues of Scope, Severity, Duration & Management
June 9, 2009

Page 3
The effects of discontinuation can be severe and extend for weeks or even months
Extreme mood swings (anger, irritability)
Debilitating “Brain Zaps”
Physical and neurological problems

Page 4
Claims

Cymbalta discontinuation syndrome is more severe and much more widespread than acknowledged by Eli-Lilly

Lilly sales representatives and marketing materials do not adequately inform physicians about the likelihood and severity of discontinuation syndrome

Lilly Direct to Consumer (DTC) advertizing is misleading related to the probability, severity and complexity of Cymbalta discontinuation

Lilly has not developed and fielded a clinically proven protocol for safely discontinuing Cymbalta

Page 8

2) Lilly sales representatives and marketing materials do not adequately inform physicians about the likelihood and severity of Cymbalta discontinuation syndrome

Unaware physicians unable to discuss Cymbalta benefit-risk profile (including discontinuation) with their patients

Physicians can not make an accurate comparative assessment of Cymbalta vs. alternatives

Patients can not make an fully informed choice to take the drug

Practical effects (common in anecdotal reports):Patient becomes totally distrustful of the physician who did not advise/warn them in the first place

Doctor /patient relationship is wrecked

Patient in distress refuses to ingest Cymbalta under any pretext

Tapering is taken off the table

Patient fires the doctor or the doctor disengages from the patient

Syndrome mood swings militate anger directed at the physician

Physician may deny syndrome even exists

Physician may jettison a newly “difficult” patient

Physician seeks to avoid malpractice implications

Patient becomes deeply suspicious of any psychotropic medication

Underlying problem may go untreated


This is a process flaw – there is no excuse for it


Page 9

Lilly Direct to Consumer (DTC) advertizing is misleading related to the probability, severity and complexity of Cymbalta discontinuation

Also states that “opening the capsule is required to taper”

Page 14

Lilly does not offer small dose Cymbalta formulations to facilitate tapering Patient required to open capsules and count drug beads
Patient may require compounding pharmacy services. At his/her expense

Tapering may take weeks or months



https://dailymed.nlm...f2-c185fbad64ba

Cymbalta Drug Insert

Section 5.7

Patients should be monitored for these symptoms when discontinuing treatment with CYMBALTA. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate [see Dosage and Administration (2.7)].

[fishinghat]

By the way fire the psychiatrist and find someone who is up to date on these issues.

[Bailey1020]

Thanks Gail & Fishinghat. To answer your question Gail, I am not on any mg! My doctor dropped me from 60mg to 30mg for 1 week, then nothing. Tomorrow will be 2 weeks. I have a long history of being on meds. Back in March, I felt my Zoloft ran its course so we switched to this.
And I agree, she probably will not read anything, but when I called her the other day so was doubtful this was from withdrawal. After telling her how bad I now am, she said well that's depression, not necessarily withdrawals. Needless to say I then lost it with her! See I've been down this road before with other drugs. But that was years ago - I thought or had hoped that doctors would know better by now.
So fishinghat, you do think it would be a good idea to find another psych (well it would have to be a good one!) to help me get through this? I'm not so sure, sometimes I just lose faith in them all. I'm seeing my homeopathic, so I can try to stick with that route. I just am not sure how long I can make it being so completely out of it. Thank you both!

[fishinghat]

I have been lucky for the most part with drs. I started on psych meds about 16 years ago and have had 9 psychiatrists. Most were very knowledgeable and quit willing to work with me on my issues and meet me half way. I have had 2 that were idiots an d after 2 or 3 visits I fired them and moved on. My problem is that most of the good drs retired o n me and I had to find new ones. I don't kn
ow if they retired or I scared them off. lol

[Bailey1020]

Yep, not easy finding the right doctor. But obviously I'm done with this one!

[gail]

Hi Bailey,

Thank you for your answers. I thought that you were on 30 mg. So that's cold turkey.

Fishingdarling, do you think that Baily would do a good thing by reinstating at 30 mg, given the fact that she has a long history with meds.? Or 10-20? Do you like your new name FH?lol

[fishinghat]

My new name is cool. I have definitely been called worse. lol

That is certainly a good idea but Bailey has made it clear that he/she has no desire to go back on the Cymbalta.

[Bailey1020]

I really dont know what I want to do anymore - I'm just so done with it all. I know I wouldn't want to go back on 30mg, but less, maybe. I might try another dr to see what they suggest. Im pretty much just out of my mind right now.

[fishinghat]

If you are open to the idea you might try going up about 10 or 20 beads and just see if it will take the edge off.

[Bailey1020]

Ok thx, I think I have to give it a try.

[Bailey1020]

Well just to follow up, thank you - I did open up the capsule & took some beads last night. As bad as I still feel, it def took the edge off so thank you for that! But after reading how many beads are in 60mg & 30mg, the way my doctor thought she was "weaning" me off of it (ha!), in reality I really did stop cold Turkey right? I am beyond words at how angry I am towards her right now!! Oh well, we'll see how this goes but so thankful for finding this site.

[Bailey1020]

Well, my previous post may have been a bit premature - not doing very well.

[fishinghat]

Many have taken a "few" beads from time to time to get a break. When things are intolerable again they take a few more beads. With time those extra beads get further and further between.

[gail]

Bailey,

Taking a few beads here and there is mostly "practiced" when you are at 20 to 30 or so beads.

Since this is not your case, I would go to 30 mg, stabalize for a while then do the proper way by bead counting. And live better!

Yes love, that was cold turkey for sure. Not recommended at all. Start over Bailey and update us please.