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#1 JG2

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Posted 18 August 2018 - 08:30 PM

I'm new to this forum.... hope this is how it is done.

I took 15 weeks to get up to the 30mg dose of Duloxetine (Cymbalta) but I started to get suicidal thoughts, big mood swings, abnormal arm and leg movements with crossed arms outstretched etc. So my DRs decided I needed to come off the medication, and then I started to feel weak and fall and get what seems to be seizures with big muscle spasms causing my body to arc and my limbs to shake, but my Dr tells me they aren't true seizures... just related to the medication! This happens 2 to 4 times a day, and is a horrible experience. I don't lose consciousness, and I can tell when one is coming on due to a tingle in my legs, and a headache and nausea...
i'm down to 20mg per day, about to go alternate days....
Anyone else had this severe reaction and did it go quickly after you finished the medication tapering?
My last adverse reaction took over 3 months to be out of my system after the last tablet. I'm very sensitive to these meds. They probably won't prescribe another, but I'm worried about these seizure-like things continuing much longer.

#2 gail

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

Posted 19 August 2018 - 07:18 AM

Welcome JG2,

We did have a member suffering from seizures and just like you, he was pretty scared about this situation.

Fishinghat, was it Justsayno? I remember his last post and he no longer had them.

About the every other day approach, it is not recommended at all. It is needed that you bead count.

Fishinghat will come in soon, he should know more about this.

#3 fishinghat

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Posted 19 August 2018 - 07:51 AM

Welcome JG2
 
Seizures have occurred in several members when discontinuing fast. In fact the FDA warns against rapid weaning due to seizures and suicidal thoughts. Your dr should be aware of this as the FDA has issued a black box warning about it. I am going to attach some information on this subject and posts from previous members for you to review. Please keep us posted on how you are doing as that is how we all learn.
 
Caution, Ginko biloba, fennel tea, kratom,

Cymbalta, Seizures and Sodium

https://www.ncbi.nlm...les/PMC2963463/
We believe that this is the first reported case in which a person developed duloxetine withdrawal seizure secondary to deranged electrolytes after abruptly stopping duloxetine.
Her sodium was 134, potassium was 2.5, chloride 86, glucose 110, calcium 9, and magnesium 1.5.

https://www.ncbi.nlm...les/PMC3229538/
Although the risk of seizures with antidepressants is generally very low, the association with overdose is well established. However, the molecular mechanisms by which antidepressants cause seizures have not been clarified. GIRK2 knockout mice exhibit spontaneous seizures and are more susceptible to seizures induced by pentylenetetrazol than wild-type mice. The risk of seizures in overdoses with sertraline, duloxetine, mianserin, and venlafaxine significantly increases, and amoxapine overdose is more likely to cause seizures. Brain levels of the drugs in overdose cases may be considerably higher than levels during treatment at therapeutic doses, suggesting significant inhibition of neuronal GIRK channels by the drugs. Additionally, other types of K+ channels are inhibited by antidepressants at micromolar concentrations, that is, the two-pore-domain K+ channel, TREK-1 for sertraline and voltage-gated K+ channels for amoxapine and mianserin. Therefore, the inhibition of GIRK channels by the drugs after overdose together with the different types of K+ channels may contribute to increased seizure activity and the occurrence of other neurological side effects by increasing neuronal excitability.
Note - GIRK2 is a K+ ion regulatory mechinism.

https://www.ncbi.nlm...pubmed/16534127
Duloxetine-induced syndrome of inappropriate antidiuretic hormone secretion and seizures.

Description of antidiuretic hormone

Kidney
Aantidiuretic hormone has three main effects:
Increasing the water permeability of initial and cortical collecting tubules and inner medullary collecting duct in the kidney, thus allowing water reabsorption and excretion of more concentrated urine, i.e., antidiuresis.
Increasing permeability of the inner medullary portion of the collecting duct to urea by regulating the cell surface expression of urea transporters, which facilitates its reabsorption into the medullary interstitium as it travels down the concentration gradient created by removing water from the connecting tubule, cortical collecting duct, and outer medullary collecting duct.
Acute increase of sodium absorption across the ascending loop of henle. This adds to the countercurrent multiplication which aids in proper water reabsorption later in the distal tubule and collecting duct.
Note - This could severely impact sodium and potassium levels in the blood stream.

From article - "We describe a woman who developed severe hyponatremia on exposure to duloxetine and recurrence on inadvertent rechallenge, suggesting the causative relationship of this drug to hyponatremia. "
Hyponatremia - is a low sodium level in the blood.

 

http://www.ncbi.nlm....pubmed/22306002
Generalized tonic-clonic seizure secondary to duloxetine poisoning: a short report with favorable out come.
Note - Tonic–clonic seizures (formerly known as grand mal seizures) are a type of generalized seizure that affects the entire brain. Tonic–clonic seizures are the seizure type most commonly associated with epilepsy and seizures in general, though it is a misconception that they are the only type.

https://www.ncbi.nlm...les/PMC2963463/
Duloxetine Withdrawal Seizure
She came to the emergency room with complaints of nausea, clear liquid vomitus, anxiety, “electical sensation” inside the body, restlessness, decreased liquid intake, abdominal pain, and decreased sleep. She stopped taking her duloxetine two days previoiusly. She had two generalized tonic clonic seizures 20 minutes apart in the hospital.

https://www.accessda...s011s013lbl.pdfFDA
Hyponatremia — Cases of hyponatremia (some with serum sodium lower than 110 mmol/L) have been reported and appeared to be reversible when Cymbalta was discontinued. Some cases were possibly due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The majority of these occurrences have been in elderly individuals, some in patients taking diuretics or who were otherwise volume depleted.

Note this article links Cymbalta to Hyponatremia caused by inappropriate antidiuretic hormone secretion.
Medical research articles linking Cymbalta to Hyponatremia

http://www.ncbi.nlm....pubmed/23075738
https://www.ncbi.nlm...les/PMC3285747/
https://www.ehealthm.../hyponatraemia/
https://www.ncbi.nlm...pubmed/25538343
https://www.ncbi.nlm...pubmed/25911354
https://www.ncbi.nlm...pubmed/18562431
https://www.ncbi.nlm...pubmed/17224730
https://www.ncbi.nlm...pubmed/17502788

Comments by Members
Grand Mal Seizure And Mouth Spasms ?
Posted by justsayno on 02 April 2017 - 07:58 PM in How to Find Support
Was trying to work it out tonight. Looking for any patterns / similarities etc
Only obvious thing being that both seizures occurred after a dosage drop from 40 to 30 mg.

Grand Mal Seizure And Mouth Spasms ?
Posted by justsayno on 01 April 2017 - 02:26 PM in How to Find Support
Hi Gail
Far as I am aware No. In 28 years I've never had any seizures until I began taking Cymbalta.

Bead Counting Advice Doesn't Jive With My Capsule Contents
Posted by PtldFrank on 04 September 2016 - 04:44 PM in Weaning Off Cymbalta
Vinpin,
Regarding seizures, that's a subject I do have personal experience with. The good news is that I'm seizure free for more than 10 years. The bad news is that I had half a dozen gran mal seizures in the 12 years prior, starting with wellbutrin. I tend to believe the seizures all came from the various meds (15-20 combinations) I went through. The only thing that seems to have stopped the seizures is the anti seizure medicine Keppra.

Involuntary Cold Turkey From 120Mg
Posted by Cassandra on 13 February 2015 - 10:32 AM in What are you feeling?
Hello world, this is Cassandra. It's been a rough month since I quit cymbalta and I think it'd be best to start from the very beginning.
I have been experiencing major depression as long as I can remember, at least from the age of 9 which is where my earliest memories are. I was put on my first antidepressant--celexa--5 or six years ago. I had been depressed before but when I started medication it just got worse. Five/six months ago I was put on cymbalta, first 60 mg then 120, and it got worse. I became violently suicidal and after a course of 12 ect treatments I attempted suicide by taking 2 bottles of cymbalta at once (my insurance had just switched me to where I could only get my meds in a 90 day supply--bad, bad idea to give someone who's suicidal a giant bag of meds.)

I woke up having seizures that went on for hours, and then on and off for a few days. When I got to the hospital, I was hallucinating, and couldn't stand or eat for days. I learned how to walk again and a month later I can ride my bike again.

Listing The Positive Events Daily Through My Cymbalta Withdrawl
Posted by FiveNotions on 24 December 2014 - 09:42 AM in ARE YOU NEW HERE? Words from the wise about Cymbalta
I was just talking with a friend about where I was last year this time ... compared to this year ... and it seemed more than worthy of a post in our "Positives" thread ...

Last year this time I was about 19 days into hard, cold turkey withdrawal ... I was overwhelmed with vertigo and nausea, confined almost totally to bed, and crawling to the bathroom to puke ... at one point, I just took my blanket and pillow in there and slept/lay curled up on the floor (less far to travel) ... I was unable to eat any solid foods, not even crackers ... and was living on broth and herb tea and water (didn't make for much to puke up, but I still did) ...
I was having constant muscle spasms, and had a couple of seizures (at least I assume that's what they were, I just blacked out and woke up on the floor) ... I was having auditory and visual hallucinations, constant cold, dripping sweats, and horrid general body aches and pains .... couldn't sleep much at all, just an hour or so at a time ... I hadn't showered, washed my hair, changed clothes, or changed my sheets, once ... and I simply did not care …

 

Article: Duloxetine Withdrawal Seizure [Cold Turkey Withdrawal]
Posted by FiveNotions on 03 January 2015 - 09:32 AM in Cymbalta in the News
I think I had at least 1, possibly 2, seizures during hard, cold turkey withdrawal ... but don't know for sure, was alone and woke up on the floor ... yet another reason not to quit this poison cold turkey!
Duloxetine Withdrawal Seizure [full text]
Psychiatry (Sept 2006)
http://www.ncbi.nlm....les/PMC2963463/

From the article:

Much has been written about the use and side effects profile of duloxetine (Cymbalta®). We report a case of a patient who had generalized tonic clonic seizures after abruptly stopping duloxetine.

Case report. Ms. X was a 59-year-old Caucasian woman with a diagnosis of major depressive disorder recurrent severe without psychotic feature. She was stabilized on duloxetine 90mg p.o. daily.

She came to the emergency room with complaints of nausea, clear liquid vomitus, anxiety, “electical sensation” inside the body, restlessness, decreased liquid intake, abdominal pain, and decreased sleep.

She stopped taking her duloxetine two days previoiusly. She had two generalized tonic clonic seizures 20 minutes apart in the hospital.

Urine drug screen was negative. Urinalysis was negative. Complete blood count (CBC) was normal. Her sodium was 134, potassium was 2.5, chloride 86, glucose 110, calcium 9, and magnesium 1.5. Her blood urea nitrogen (BUN) and creatinine were normal. Her liver function tests were normal except mildly elevated alkaline phosphatase of 126. Computed tomography (CT) scan of her head was negative. There was no sign of infection at the point of admission. She was stabilized and was then started on a different antidepressant due to her history of nonadherence. She had no further seizures during her hospital stay.

 

Seizure?
Posted by sarahb on 04 April 2014 - 10:59 AM in What are you feeling?
My mother has been on Cymbalta I think 90mg and she recently started having seizures. I wonder if there could be any correlation. I'm the one who was on it 5 days and found your group and has decided to get off. Now my thoughts are with my mom. I know different things about her health are shorting her health but I hate to think what this drug is doing to her and God forbid she needs to get off.

And Here I Am- Am I Screwed Forever?
Posted by jenniesue on 09 December 2013 - 12:49 PM in ARE YOU NEW HERE? Words from the wise about Cymbalta
The DVT/Blood Clots were after I lost a pregnancy. Yes I was placed on Cymbalta for pain. The seizures I had started within 2 weeks of taking Cymbalta. Yes I have discussed all issues with my Dr. and they give me a diagnosis of something else, and have told me just keep taking the Cymbalta. Where do I start to get off of this evil med? I go to see my Dr. Monday Dec 15.

Seen The New Commercials?
Posted by Pixi on 10 June 2012 - 02:32 AM in Cymbalta in the News
I'd thought I was unsubscribed...but this thing emailed me for a reply so here goes. I can't believe it's almost a year to the day since I made the post on here. That means I've been totally Cymbalta free for 6 months! I took my healthcare into my own hands & I'm glad I had the fortitude to go through this & come out as well as I have.

I'm taking nothing for depression/neuropathy and still having the odd brain zap & dizziness - my "Cymbalta moments" as I call it. . Still having seizures at night, bouts of horrible dementia and just wish I'd never listened to the Doctors & allowed myself to be their labrat for this evil drug. Depression is still much better off it and bladder control is almost back to normal. The ONLY way to go is wean slowly, count the grains even tho it's tedious - over months, even if you're only just on it a few weeks, start to cut it down really slowly - your brain is way more delicate than you know. This shit does pretty weird things to you - that's how it's supposed to work - alter your neurology. Don't let them mess with you. It caused me DID/MPD, made my diabetic neuropathy 100 times worse & a host of other shit I've probably posted about elsewhere on this forum.

Seizures From Cymbalta
Posted by Namaste on 02 May 2012 - 02:04 AM in Weaning Off Cymbalta
Doctor changed celexa to cymbalta And was ok with it for a month and
I started Having hives, itching and bruises. My doctor stopped cymbalta and gave me prednisone. Then i started having seizures where i was fully aware of what was happening so I'm now on lamictal for seizures. Anyone of you having the same experience?

 

My Chapter Of Hell
Posted by distill on 06 December 2011 - 02:55 AM in ARE YOU NEW HERE? Words from the wise about Cymbalta
I have already wrote this once, but if I can help out another person then I've done what I set out to do.

I know some people have done great while taking it but the withdrawal is what gets them. I was not depressed, I was injured on the job crush three disc in my lower back. I was put on it for sciatic help.

I had a house, cars, and my best friend for a fiance. Within two weeks of taking it I lost my mind. Manic aggression, seizures, nightmares, etc. I did things I never wouldve done before this. Its like i either knew what i was doing and didnt care or i flat out dont remember. We were losing the house and my demeanor drove her away. Workers comp denied paying for all psychological meds and I flat out couldn't afford $400 for 90days. That was in January of this year.

 

Neuropathy As A Side Effect?
Posted by cookie on 28 November 2011 - 11:57 AM in Weaning Off Cymbalta
Dear Pixi
I took cymbalta for depression, other than than I was a pretty healthy person. After 6 years of taking it, I have sugar problems and now I am experiencing prickling sensations and pin & needles. I also have problems remembering names. I also experienced seizures and problems with my joints which I never had prior to the medication

Check In On Your Progress Here!
Posted by CindiEponabri on 16 October 2011 - 01:31 AM in Weaning Off Cymbalta
1) Method you're using
Counting bead method, kinda... I take out about 1/4 of the beads out of one of the two capsules for each day's dosage, for a week. The following week it will be 1/2 of the beads of one capsule.

2) Starting dose
120mg

3) Current dose
105mg (roughly)

4) Withdrawal symptoms you're having
more pain, anxiety, dizziness, tired, nausea, cold/flu symptoms, nightmares, itching,


5) Things that have improved.
Seizures.. we had thought they were being caused from the Oxycotin, but now I see it was from the Cymbalta, because for the most part they are now gone. I have a little one every now and then.

My Story
Posted by cookie on 26 July 2011 - 02:25 PM in Weaning Off Cymbalta
Dear Imdone:
.....However I learned to differentiate the initiall symptoms from withdrawals. I took the medication for severe depression. When I reduced dose I started experiencing asthma, itching, joint pain, problems finding words to talk and comprehending language, dizziness, vomiting, seizures, facial tics, sensitivity to noises and light, tremors, allergies, sore throat, etc which I definitely didn´t have when my depression appeared 6 years ago.

Drug insert from Eli Lilley for Cymbalta
https://dailymed.nlm...f2-c185fbad64ba

5.7 Discontinuation of Treatment with CYMBALTA
Discontinuation symptoms have been systematically evaluated in patients taking CYMBALTA. Following abrupt or tapered discontinuation in adult placebo-controlled clinical trials, the following symptoms occurred at 1% or greater and at a significantly higher rate in CYMBALTA-treated patients compared to those discontinuing from placebo: dizziness, headache, nausea, diarrhea, paresthesia, irritability, vomiting, insomnia, anxiety, hyperhidrosis, and fatigue.
During marketing of other SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures. Although these events are generally self-limiting, some have been reported to be severe.
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)].

 

 

6.12 Postmarketing Spontaneous Reports
The following adverse reactions have been identified during post approval use of CYMBALTA. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Adverse reactions reported since market introduction ....., seizures upon treatment discontinuation, supraventricular arrhythmia, tinnitus (upon treatment discontinuation), trismus, and urticaria.

Medical Research on Seizures and Cymbalta.
Other info on seizures,

https://www.ncbi.nlm...les/PMC3229538/
"Although the risk of seizures with antidepressants is generally very low, the association with overdose is well established [80]. However, the molecular mechanisms by which antidepressants cause seizures have not been clarified. GIRK2 knockout mice exhibit spontaneous seizures and are more susceptible to seizures induced by pentylenetetrazol than wild-type mice . The risk of seizures in overdoses with sertraline, duloxetine, mianserin, and venlafaxine significantly increases, and amoxapine overdose is more likely to cause seizures. "
80. Montgomery SA. Antidepressants and seizures: emphasis on newer agents and clinical implications. Int J Clin Pract. 2005;59:1435–1440. [PubMed]
81. Whyte IM, Dawson AH, Buckley NA. Relative toxicity of venlafaxine and selective serotonin reuptake inhibitors in overdose compared to tricyclic antidepressants. Q J Med. 2003;96:369–374. [PubMed]
82. Isbister GK, Bowe SJ, Dawson A, Whyte IM. Relative toxicity of selective serotonin reuptake inhibitors (SSRIs) in overdose. J Toxicol Clin Toxicol. 2004;42:277–285. [PubMed]

https://www.ncbi.nlm...les/PMC4683813/
"Epilepsy is a serious condition which can profoundly affect an individual’s life. While there is some evidence to suggest an association between antidepressant use and epilepsy and seizures it is conflicting and not conclusive. "
"Conclusions
Risk of epilepsy/seizures is significantly increased for all classes of antidepressant. There is a need for individual risk-benefit assessments in patients being considered for antidepressant treatment, especially those with ongoing mild depression or with additional risk factors. Residual confounding and indication bias may influence our results, so confirmation may be required from additional studies."

https://www.ncbi.nlm...pubmed/16534127
Neurology. 2006 Mar 14;66(5):773-4.
Duloxetine-induced syndrome of inappropriate antidiuretic hormone secretion and seizures.
Maramattom BV1.
"The syndrome of inappropriate antidiuretic hormone secretion (SIADH) and hyponatremia is a well known side effect of older selective serotonin reuptake inhibitors (SSRIs) such as paroxetine, sertraline, fluoxetine, citalopram, escitalopram, and fluvoxamine.1,2 The frequency of hyponatremia is around 8 per 1,000 among elderly women receiving fluoxetine.2 Although the second-generation dual blockers, selective serotonin–norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine and duloxetine, are touted to have a wider therapeutic index, hyponatremia is encountered even with venlafaxine. To date, Medline searches do not reveal any reports of hyponatremia associated with duloxetine. We describe a woman who developed severe hyponatremia on exposure to duloxetine and recurrence on inadvertent rechallenge, suggesting the causative relationship of this drug to hyponatremia. "


http://www.psychforu...topic69139.html
This is a thread about seizures and Cymbalta you might want to check out.

http://www.ehealthme...mbalta/seizure/
95,293 people reported to have side effects when taking Cymbalta.
Among them, 1,077 people (1.13%) have Seizures

https://www.ncbi.nlm...pubmed/16534127
Duloxetine-induced syndrome of inappropriate antidiuretic hormone secretion and seizures.
http://www.ncbi.nlm....pubmed/22306002
Generalized tonic-clonic seizure secondary to duloxetine poisoning: a short report with favorable out come.
Abstract
Duloxetine is a potent and selective inhibitor of serotonin and norepinephrine reuptake (SNRI) with a weak activity over dopamine reuptake used in the treatment of major depressive disorder. Daily doses of 60 mg are effective in treatment of major depression. There are few cases of isolated duloxetine overdose in humans. We think this is the first report of a generalized tonic-clonic seizure following isolated duloxetine poisoning with a very high dosage.

https://www.ncbi.nlm...les/PMC2963463/
Duloxetine Withdrawal Seizure
She came to the emergency room with complaints of nausea, clear liquid vomitus, anxiety, “electical sensation” inside the body, restlessness, decreased liquid intake, abdominal pain, and decreased sleep. She stopped taking her duloxetine two days previoiusly. She had two generalized tonic clonic seizures 20 minutes apart in the hospital.

Drugs.com
Applies to: Wellbutrin (bupropion), Cymbalta (duloxetine)
Talk to your doctor before using buPROPion together with DULoxetine. Combining these medications may increase the risk of seizures, which may occur rarely with either medication. In addition, buPROPion can increase the blood levels of DULoxetine, which may increase other side effects. You may be more likely to experience seizures with these medications if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma.
"Early in my treatment for CFSi, my doctor prescribed both Cymbalta (duloxetine) and Wellbutrin (bupropion). Although not listed in this table, you can find from Dr. Flockhart’s tables that bupropion is a strong inhibitor of the 2D6 enzyme used to metabolize duloxetine. Combine this interaction with the possibility that I am one the 10% of Caucasians who are slow 2D6 metabolizers, and you have a plausible explanation why after a few months duloxetine became toxic for me to take. Recently on the cpnhelp.org site, "

Lamictal - The subjective evidence is overwhelming in the blogs and forums as well as in advertisements for drug withdrawal programs that there is Lamictal withdrawal although as you may notice not a lot of medical research on this subject. Lamictal is often prescribed to Cymbalta patients if they develop seizures.
I also noticed that it is approved for seizures and not as an antidepressant as it is rarely effective on this condition.

https://www.ncbi.nlm...pubmed/21881472
"Immediately following the abrupt discontinuation of lamotrigine, RBD symptomatology was severely aggravated, with dreams becoming more vivid and frightening and occurring almost every night. RBD symptomatology gradually subsided over 2 months, reaching levels comparable to those before lamotrigine."

https://www.ncbi.nlm...pubmed/11886370
"Withdrawal syndrome caused by anti-epileptic drugs has been rarely reported. However, in our personal experience of patients monitored for epilepsy surgery, many patients complained of minor reactions when the treatments were quickly decreased. Severe reactions are exceptional and may be explained in this case by the pharmacodynamic effects of LTG. It has indeed been suggested that LTG could have psychostimulant and antidepressive effects."

https://dailymed.nlm...ed-762cbea0d737
From the drug insert from the manufacturer.

Discontinuation Strategy
Epilepsy: For patients receiving lamotrigine in combination with other AEDs, a re-evaluation of all AEDs in the regimen should be considered if a change in seizure control or an appearance or worsening of adverse reactions is observed.
If a decision is made to discontinue therapy with lamotrigine, a step-wise reduction of dose over at least 2 weeks (approximately 50% per week) is recommended unless safety concerns require a more rapid withdrawal [see Warnings and Precautions (5.8)].
Discontinuing carbamazepine, phenytoin, phenobarbital, primidone, or other drugs such as rifampin and the protease inhibitors lopinavir/ritonavir and atazanavir/ritonavir that induce lamotrigine glucuronidation should prolong the half-life of lamotrigine; discontinuing valproate should shorten the half-life of lamotrigine.
Bipolar Disorder: In the controlled clinical trials, there was no increase in the incidence, type, or severity of adverse reactions following abrupt termination of lamotrigine. In the clinical development program in adults with bipolar disorder, 2 patients experienced seizures shortly after abrupt withdrawal of lamotrigine. Discontinuation of lamotrigine should involve a step-wise reduction of dose over at least 2 weeks (approximately 50% per week) unless safety concerns require a more rapid withdrawal [see Warnings and Precautions ].

https://www.fda.gov/...s/ucm454864.pdf
From the FDA

Withdrawal and Rebound
Withdrawal and rebound were assessed during Trial SCA102833 by monitoring AEs in the OL and Double-blind Taper Phases. Few AEs were reported during the Taper Phases. In the OL Taper Phase, 14 (40%) subjects reported AEs. AEs reported in ≥5% of subjects included headache (20%), somnolence (6%), and suicidal ideation (6%). All other AEs were reported in ≤5% of subjects.
In the Double-Blind Taper Phase, 18 (34%) subjects in the LTG group and 14 (25%) in the PBO group reported AEs. Headache was the only AE reported in ≥5% (8% in the LTG group and 7% in the PBO group). All other AEs were reported in ≤5% of subjects. One (3%) SAE was reported in the OL Taper Phase (bipolar disorder) and 2 (3%) subjects reported SAEs in the Double-blind Taper Phase (infectious mononucleosis,
152 Reference ID: 3702139 Clinical Review Francis E. Becker, M.D. NDA 22251 SD-220, 20764 SD-545, 20241 SD-1541 Lamictal (lamotrigine) urinary tract infection, and suicidal ideation). Both of the subjects in the Double-blind Taper Phase were in the PBO group.
No seizures were reported in the taper phases of Trial SCA102833, however as with other AEDs, Lamictal should not be abruptly discontinued. In patients with epilepsy there is a possibility of increasing seizure frequency. In clinical trials in adult subjects with BPD, 2 subjects experienced seizures shortly after abrupt withdrawal of Lamictal; however, there were confounding factors that may have contributed to the occurrence of seizures in these BPD subjects. Unless safety concerns require a more rapid withdrawal, the dose of Lamictal should be tapered over a period of at least 2 weeks (approximately 50% reduction per week) (see Lamictal Prescribing Information).

 

https://www.fda.gov/...ew summary).pdf
From FDA
LAM20006 was a randomized, double-blind, placebo-controlled parallel-group study. It
followed an enrichment design. Patients were first enrolled in an open-label period.
Lamictal was added on to existing therapy (patients could be taking 1-2 concomitant
AEDs) and seizure diary data was collected. Patients who demonstrated a protocolspecified
percent reduction in seizures during this phase were eligible to be randomized
to 1) continue Lamictal, or 2) undergo a gradual withdrawal to placebo. The withdrawal
occurred over 3 weeks with a 25% reduction in dose each week (75%, 50%, 25%, then
discontinue). The double-blind phase that followed lasted 8 weeks.

https://www.fda.gov/...e/ucm234471.pdf
Mild thrombocytosis has been reported in some infants and withdrawal symptoms can occur if breastfeeding is abruptly discontinued.

Misc.
Benzos can trigger seizures.
------------------------------------------------------------------------------------------------------------
Hyponatremia
Note - Hyponatremia is a know cause of grand mal seizures, but low potassium is not. Cymbalta can cause Hyponatremia (low serum sodium levels). See below

 

 

https://www.accessda...s011s013lbl.pdfFDA
Hyponatremia — Cases of hyponatremia (some with serum sodium lower than 110 mmol/L) have been reported and appeared to be reversible when Cymbalta was discontinued. Some cases were possibly due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The majority of these occurrences have been in elderly individuals, some in patients taking diuretics or who were otherwise volume depleted.

http://www.ncbi.nlm....pubmed/23075738
A case of severe hyponatremia induced by duloxetine and ziprasidone.

https://www.ncbi.nlm...les/PMC3285747/
Rapid-Onset Hyponatremia Induced by Duloxetine in a Middle-Aged Male with Depression and Somatic Symptoms

https://www.ehealthm.../hyponatraemia/
95,293 people reported to have side effects when taking Cymbalta.
Among them, 649 people (0.68%) have Hyponatraemia

https://www.ncbi.nlm...pubmed/25538343
Duloxetine-induced hyponatremia in an elderly patient treated with thiazide diuretics.

https://www.ncbi.nlm...pubmed/25911354
Syndrome of inappropriate antidiuretic hormone secretion: a story of duloxetine-induced hyponatraemia.

https://www.ncbi.nlm...pubmed/18562431
Severe and symptomatic hyponatremia following duloxetine treatment.

https://www.ncbi.nlm...pubmed/17224730
Duloxetine and hyponatremia: a report of 5 cases.

https://www.ncbi.nlm...pubmed/17502788
Recurrent hyponatremia after substitution of citalopram with duloxetine.
And more....

https://www.mayoclin...ms/con-20031445
Mayo Clinic
Hyponatremia signs and symptoms may include:
⦁ Nausea and vomiting
⦁ Headache
⦁ Confusion
⦁ Loss of energy and fatigue
⦁ Restlessness and irritability
⦁ Muscle weakness, spasms or cramps
⦁ Seizures
⦁ Coma
 


#4 Ayla65

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    Helping my beautiful mother to get off Cymgen (Cymbalta)

Posted 29 June 2019 - 08:51 AM

My mother has had ongoing 'seizures' that nobody in the medical profession we saw could explain.  She feels like her body is 'shutting down' sometimes random pain somewhere in the gut or just feeling like she is dying.  She looses ability sometimes to speak or move and eventually becomes unconscious for mostly almost to the minute... an hour!!!  This has only happened since she starting taking cymbalta.  

 

All her vitals before becoming unconscious, during and after are completely text book normal.  No change to BP, Pulse, temperature or blood sugars.  When we initially would get her to hospital the heart ECG normal.  Bloods usually normal i.e.nothing that shows heart episode or anything else out of the ordinary.  She has had brain scans, EEG's, ECG's, bloods, kidney xrays, abdomen ultra sounds the whole shabang! Nothing.  No one can explain it.

 

When she first started CYMBALTA she blacked out twice.   Had such shocking pain in her head that she sat and wept with pain.  Nobody thought it was CYMBALTA and I feel so bad that we did not pursue with that line as we thought it was way too coincidental.  She was on 60mg and then up to 90mg p day for peripheral neuropathy (no diabetes at that point).  

Year later down to 60mg.  Still having these 'sleeping episodes' where she suddenly just WENT as we say.  Using hands to communicate as speech going, and then boom out for the count.  We would see the signs coming on and get her into bed as quickly as possible.

 

These 'sleeping episodes" became worse over the year to follow where she would experience terrible pain somewhere in the body usually gut and a sensation of not feeling anything inside herself.  Couldn't describe it.  Just knew she was dying.  The doctors try to say it was anxiety but we know our mother.  She was actually frightened to death BUT calm and not an anxiety attack. Just a plea for help as her body started to shut down.

 

That developed into becoming unconscious literally and almost to the minute which is very strange for an hour.  

 

Two of her GP's witnessed this on different occasions and said they had never seen anything like it and that it was NOT epilepsy or anything else they know of.

 

Now that we are reducing her dose of CYMBALTA it still happens but she is unconscious for much shorter periods of time.  She now remembers what happened leading up to it.  

 

She actually does go through days of sleeping A LOT which is her reacting to the drop in dose-age and has terrible body spasms and headaches and body aches and vivid often very disturbing dreams and confusion between TV and reality etc.  But when she is lucid and 'well' usually when I have kept her on a dosage for more than three weeks - we have our amazing mother back - totally 'normal' mentally together etc.  

 

Been a while since the last episode and when one starts I can tell her it is the medication which helps her get through it better.  

 

What dreadful stuff.  I can't bear to think of all those lab animals being tested with drugs and going through HELL like humans clearly do?


#5 fishinghat

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Posted 29 June 2019 - 01:19 PM

Terrible. The onset of seizures with the use of Cymbalta almost always prompts the drs to stop Cymbalta usage as soon as possible. There is nothing new about the symptoms she has exhibited as you can see above. I am going to post some relative info below from the drug insert from the manufacturer. Also I have medical research on the occurence of the somnolence, seizures and the Hyponatremia (low blood sodium).

This occurence has presented itself in many of our members and that is why they had to come off. I am so sorry that your medical professionals were not aware of this even though it is well published and warning from the manufacturer exist as well.

#6 fishinghat

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Posted 29 June 2019 - 01:21 PM



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

 

5.10 Seizures

CYMBALTA has not been systematically evaluated in patients with a seizure disorder, and such patients were excluded from clinical studies. In adult placebo-controlled clinical trials, seizures/convulsions occurred in 0.02% (3/12,722) of patients treated with CYMBALTA and 0.01% (1/9513) of patients treated with placebo. CYMBALTA should be prescribed with care in patients with a history of a seizure disorder.

 

5.13 Hyponatremia

Hyponatremia may occur as a result of treatment with SSRIs and SNRIs, including CYMBALTA. In many cases, this hyponatremia appears to be the result of the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Cases with serum sodium lower than 110 mmol/L have been reported and appeared to be reversible when CYMBALTA was discontinued. Elderly patients may be at greater risk of developing hyponatremia with SSRIs and SNRIs. Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk [see Use in Specific Populations (8.5)]. Discontinuation of CYMBALTA should be considered in patients with symptomatic hyponatremia and appropriate medical intervention should be instituted.

 

Signs and symptoms of hyponatremia include headache, difficulty concentrating, memory impairment, confusion, weakness, and unsteadiness, which may lead to falls. More severe and/or acute cases have been associated with hallucination, syncope, seizure, coma, respiratory arrest, and death.

 

ADVERSE REACTIONS
Most common adverse reactions (≥5% and at least twice the incidence of placebo patients): nausea, dry mouth, somnolence, constipation, decreased appetite, and hyperhidrosis (6.3).


6.3 Most Common Adult Adverse Reactions
Pooled Trials for all Approved Indications — The most commonly observed adverse reactions in CYMBALTA-treated patients (incidence of at least 5% and at least twice the incidence in placebo patients) were nausea, dry mouth, somnolence, constipation, decreased appetite, and hyperhidrosis.

 

10% eported Somnolencee (sleeping a lot) as a side effect.

 

10.1 Signs and Symptoms of overdosage
In postmarketing experience, fatal outcomes have been reported for acute overdoses, primarily with mixed overdoses, but also with duloxetine only, at doses as low as 1000 mg. Signs and symptoms of overdose (duloxetine alone or with mixed drugs) included somnolence, coma, serotonin syndrome, seizures, syncope, tachycardia, hypotension, hypertension, and vomiting.
 


#7 JG2

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Posted 30 June 2019 - 11:22 AM

I want to thank everyone who replied with amazing information to my original post. 
After posting, I lost my sign-in details and didn't receive any message updates until something arrived in my email today... so I am only now able to read and respond again.
 

My seizures from Duloxetine/Cymbalta eased off by February 2019, but I am left with a movement disorder and anxiety or emotional upset triggers body jerking, unwanted limb movements, loss of words, slow speech, and dissociation. I can fall and tremble, but the full seizures seem to have eased off..

I was referred to Neurology in January 2019 and despite me insisting it was triggered by the medication, and three GP's, one psychiatrist and two paramedics all agreeing after witnessing the reaction to the medication...they have diagnosed it (from watching videos of my seizures and talking with me)  as Functional Neurological Disorder, and None Epileptic Attack Disorder.... basically FND and NEAD.
    These are the more modern thinking of what used to by Conversion Disorder and Psychogenic seizures - both conditions where psychological distress shows as physical disorder in the body. Except, I know mine was triggered by the medication so it was a physical cause on my neurons, and it is the residual effects that remain imprinted on my brain as subconscious reactions as part of the movement disorder.
Medical professionals would have me believe it is all down to my depression and anxiety mood disorder ( though I've had that for 30 years without this happening before), but new research shows that it is the movement and emotional parts of the brain that are miscommunicating with the central nervous system, and that it is a physical change in the functioning of the brain's networks, not just a psychological shut down due to trauma causing the distress to be displayed in the physical form of seizures and movement disorders.
Sadly, too few medical professionals have any understanding of FND and NEAD... tmany believe we are imagining it or making it happen!

I have also had blood tests done and discovered my B12 was low, and my Vit D and Folate were insufficient, all adding to neurological symptoms. I believe these were failing when they prescribed Duloxetine/Cymbalta for me, and this left me suseptable to the adverse reaction.

When the movements first started, doctors all told me to keep on the medication, that my body would settle down and then I would benefit from the theraputic part of the medication. Instead I am living with a movement disorder, and other neurological problems which professionals feel can only be helped by 'talking therapy' to deal with the trauma they believe is triggering them.... my mental health team simply don't know how to help me but neurology insist it is a mental health problem.

I was going through trauma at the time of taking the medication, mainly due to the psychiatrist refusing to help me once the movement disorder started, even though they demanded immediate stop of the medication as they said I was displaying a disorder more commonly seen in users of long term antipsychotic medication. I only managed to taper the beads myself over 9 days. I have not communicated with that psychiatrist since, as I was transferred to the care of a different professional.

So I am more than a year on from where I first started the medication, and I stopped it in August 2018. The most distressing seizures where complete overwhelming feelings of utter dispair and the need to end my life have thankfully stopped since March, yet I still get movement attacks and limb weakness which accompany a depressive state that stays with me for many hours.
FND and NEAD can lead to paralysis, blindness, the list is long.... severe disability without there being anything visible on any hospital scans or tests to denote a disease or cause of the problem to treat. They are only now developing a Functional MRI which can show the areas of the brain miscommunicating in FND patients, but the brain is not damaged or diseased... so in theory it should be communicating properly... but it doesn't. There is no cure, other than retraining the brain to recognise the limbs and make them move properly again... it is a long process of specialist physio for those who lose feeling in their limbs. I'm thankful that I have not become that disabled.

So those who are having tests and getting no answers, it is likely your symptoms will be dismissed as FND (or NEAD which is a part of FND), and then you will be discharged to go live your life the best way you can as there is little treatment or understanding in the medical profession for these issues where the brain looks okay on scans, but stops sending the signals to your body.
The most helpful websites are FND Action and https://www.neurosymptoms.org/

 

I still believe Duloxetine/Cymbalta triggered this condition in my brain, but proving it when there is nothing to see on scans is almost impossible until the medical profession accept that it is a damaging drug.
I can't tolerate most kinds of psychiatric medications as I have become too sensitive to them, and react badly. I am managing Valdoxan for my depression as the side effects are few and it does not work in the same way as most other antidepressants, but it only helps a small way. I have many months of talking therapy ahead of me to try and ease my mood disorder, retrain the emotional part of my brain!!! and hope it helps to reduce the abnormal body movements along the way.


#8 JG2

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Posted 30 June 2019 - 11:45 AM

Ayla65

I'm so sorry for what your Mother is going through.
I appreciate that what is happening is down to the medication effect, but I wonder if this could be considered a functional neurological disorder, as a result of the effect of the medication on her brain?

I cannot diagnose, and I don't want to lead you to a wrong conclusion but perhaps look at the symptoms and see if this relates, as then there may be some comfort in knowing others are going through similar too.... but not always as a result of a reaction to a medication. Sometimes it is connected to a trauma or stress related incident... but it can also be triggered by medications.

Do look at the neurosymptoms site https://www.neurosymptoms.org/  as much of what you mention is recognsised there as part of Functional Neurological Disorder, which is what has been triggered in me by Duloxetine/Cymbalta.
Seizures where the person seems to be glazed over, or 'sleeping episodes' as you call them are recognised. Seizures are also called dissociative episodes.

Also, extremes of nerve pain can be part of FND, and many patients with FND also develop fibromyalgia. Non Epileptic seizures will show no spike in brain activity, unlike epilepsy, but are just as disabling. The non epileptic seizures do not respond to medication, and tend to be longer lasting, and there are small differences in signs, such as the eyes tend to close in NEAD seizures. Sometimes the person is semi aware of what is happening around them, but unable to respond. Loss of speaking ability is also common, but hopefully returns after rest. Please assure your Mum that this is very real even though the medical proessionals haven't managed to find a problem that they can treat, and some medical professionals therefor dismiss it as 'fake' but it isn't, and it is a real cause of distress and disability for many.

 

If you feel this could be what is happening to your Mum, it is a miscommunication of the brain and the central nervous system, and is very poorly understood, and very little research is being done for it. Treatment options are few and far between.

There is more information about FND here https://www.fndaction.org.uk/ This organisation is trying to raise awareness of the condition. Maybe if your Mum knows other people are also going through similar, she will feel less alone. There is also https://fndhope.org/ 
I do hope she is able to come off the medication slowly, and allow her body to heal.


#9 fishinghat

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Posted 30 June 2019 - 04:38 PM

"...they have diagnosed it (from watching videos of my seizures and talking with me) as Functional Neurological Disorder, and None Epileptic Attack Disorder.... basically FND and NEAD."

Great, in other words nerve issues from an unknown source. You already knew that.

"new research shows that it is the movement and emotional parts of the brain that are miscommunicating with the central nervous system, and that it is a physical change in the functioning of the brain's networks, not just a psychological shut down due to trauma causing the distress to be displayed in the physical form of seizures and movement disorders."

Those missing neurotransmitters cause chaos for sure. Why is Cymbalta prescribed for peripheral neuropathy and idiopathic neuropathy? Because it effects nerves. When it is removed of course you are going to have neurological problems. Like you said, this is well documented in the medical journals as well as the drug insert that comes with Cymbalta. Sometimes drs make me so mad.

Those members who have suffered from seizures, muscle and nerve issues, difficulty in walking usually recover all or nearly all function in 1 to 2 years after the last dose. I still think this will get better.

#10 invalidusername

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Posted 30 June 2019 - 05:51 PM

Really interesting this... as I suffered from EXACTLY the same coming off Cymbalta soon after you wrote the post. Much like you said JG2, the seizures were a byproduct of what the Cymbalta had done NOT of psychological condition which is what all the medical professionals told me. If that were the case, why have they all but disappeared now, yet I still have the same anxiety, stresses etc? No - it was the Cymbalta for sure.

 

You will see from my older threads that the p-doc I saw at the time was convinced that the Cymbalta had to be immediately removed from my systems to prevent them. So adamant was he, that he TOOK my remaining capsules from me and refused to return them. As all on the forum will remember, I went through hell having a number of seizures when I was forced upon this cold turkey.

 

I pleaded with the mental health team to give me the capsules back, I even took copies of the PIL leaflet highlighting section 5.7 which said to reinstate the last dose if the seizures got worse, but they still left me in the same state without the capsules. I don't have words enough to express how I felt. All I could do was complain about the doctor. Oddly enough, he has since been fired....





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