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Eleven Weeks Off Cymbalta And Desperate For Advice...


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#1 jltshop

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Posted 18 August 2018 - 06:48 PM

Hi fishinghat,

 

I've been a regular visitor to this site for several months and I can't thank you enough for your intelligent, thoughtful advice and the staggering amount of research you've done to assist those of us struggling through this arduous process.  This is my first time posting and I'd be so grateful for your thoughts on my situation - I'll try to be brief!

 

I started taking Zoloft (75 mg) about 15 years ago for clinical depression and it worked reasonably well until the summer of 2015 when my depression increased substantially and a dose increase to 100 mg caused extreme anxiety.  I have severe kyphoscoliosis, osteoarthritis and neuropathy and my psychiatrist at the time suggested we "kill two birds with one stone" and switch to Cymbalta to hopefully also offer some pain relief.  I tapered off Zoloft fairly easily and started 30 mg of Cymbalta in August 2015.  Essentially, I've been trying to get off it ever since - I had a brief period of relief (brightening of mood, slight arthritis relief) and then multiple side effects started including vision and cognition issues.  I did have some slight pain relief, but my concern was the sense that Cymbalta was masking or "clouding" my pain and emotions, and with a major back surgery now pending, I wanted to have a greater awareness of what I was physically feeling, if that makes any sense.

 

I did a very slow, deliberate bead counting taper off and got down to 40 beads (about 5 mg) eleven weeks ago and in frustration and sick of the entire process, stopped taking it altogether.  For the first two or three weeks I felt much better - proud of myself for getting off this horrendous drug and thinking I could for the first time in almost 20 years potentially be antidepressant-free.  Then all hell broke loose - suicidal thoughts like never before, crying uncontrollably, completely anxiety-ridden, and my pain level has skyrocketed to a degree I've never experienced.  I'm terrified about what's happening to me and I'm barely functioning.

 

About six weeks ago I did a pharmacogenetic DNA test which indicated that I have a high risk of poor response or intolerance to all SSRIs (after 15 years on Zoloft!), and that SNRIs, non-SSRI antidepressants or dopaminergic stimulants could be considered.  I briefly tried Wellbutrin SR 100mg once a day and it caused anxiety, nervousness and palpitations.  I've tried Tramadol for the pain which does help, but the effect on my mood is terrible - while I definitely notice a positive change in mood on the day I take it (likely the opiate and weak SNRI effect), the next day I can feel myself plummeting back into severe depression.  I've also taken Ativan 0.25 mg every other day or so in the last few weeks when the depression and anxiety have become too overwhelming.  Which leads me back to Cymbalta...

 

I desperation, I started taking the dose I was at when I quit, 40 beads or 5 mg, three nights ago and I feel somewhat calmer, but very scared, certainly not myself and really defeated.  I don't really even know what "stabilized" would feel like if reinstating at this small dose is effective, and I'm very unsure if this is even the correct approach to take...

 

Again, many thanks for any advice you or other members may have, I sincerely appreciate it!     


#2 lady2882Nancy

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Posted 18 August 2018 - 10:06 PM

Hi Jltshop

Like you when I was tapering off I hit a point and said enough and stopped altogether. Not a smart move on my part although it seemed I was fine to start with. Then the withdrawals hit me. I suffered for quite a while until I was blessed with an on the ball psychiatrist. I was put on Zoloft which was a huge change and within days I felt so much better. There were side effects with the Zoloft that could not be allowed so I tapered off that and almost back to my normal self. My psychiatrist diagnosed me as Bipolar II so the depression is something I have to deal with but no SNRIs or SSRI for me so with a mood stabilizer and an old school anti-depressant (amitriptyline) I can manage most of the time.

I am not the same as I was on Cymbalta but at least I am fairly stable and not hiding from the world anymore. There is a warning on the insert for Cymbalta about causing mixed episodes for those with Bipolar and I always wondered how was I supposed to know that I was Bipolar when I had never had anything but the mildest mood swings. Oh well life is for learning and I have certainly learned a lot about myself in the last 5 1/2 years.

All the best to you and I hope you can Stabilize at 40 beads again an then bead count further. There is no harm in using another med to help along the way. 

Oh yes and the pain happens quite often for those with pain issues. I had the same and discovered it was what they call rebound pain which is your normal pain plus added pain the Cymbalta was masking.


#3 fishinghat

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Posted 19 August 2018 - 08:07 AM

Welcome Jltshop

 

Your decision to go back to 40 beads was a good one. It has only been 3 days and while you have achieved some relief it is minimal. Cymbalta has a half life of 12 hours so it takes 72 hours for it to reach stable blood levels in your body. Don't give up yet as you should improve more over the next 2 days. I would suggest you hang in there a little while longer.

 

Have you tried Benadryl (the diphenhydramine one) or Omega 3 to see if that will help any? Check for drug interactions first just to be safe. Be careful, the Benadryl can make you drowsy.


#4 fishinghat

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Posted 19 August 2018 - 08:09 AM

LadyNancy!!!!   What a surprise. You have made my day. How are you doing oh great one? I hope all is well.


#5 jltshop

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Posted 19 August 2018 - 03:09 PM

Thank you both for your replies.  I'll continue at 40 beads for a few more days and I'm taking Omega 3, but I'm wondering if you have any thoughts about alternatives post-Cymbalta such as Fetzima, other SNRIs, or nortriptyline for both depression and pain?  My goal, of course, would be to be antidepressant-free, but my long history of depression going back to childhood unfortunately seems to warrant medication of some kind.  I've thought of just going back to Zoloft which was relatively effective for a few years, but it quit working for me and my genetic test suggests caution with all SSRIs...?

 

Many thanks again!  


#6 fishinghat

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Posted 19 August 2018 - 04:09 PM

Really, the question about which antidepressant is next to try is open ended. Everyone is different. What works for one doesn't for another. It can be really hit and miss. I would only say if Zoloft worked for you before I would not give up on the ssris just because of the genetic tests (which are generally fairly accurate). The ssris usually have less side effects than the snris but that varies too.





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