222 replies to this topic

[invalidusername]

So today I am still anxious, but back to the anxiety bought on largely by not seeing a way out. I got a very tight chest mid-evening yesterday and is still there today. This clearly doesn't help, but what with the stress from this week, I can at least understand where it has come from.

 

I am remaining on my 56 bead/10mg dose as suggested ('hat), and going to remain on this for some time. I just want to have some rest. Two months of withdrawal has really done a number on me - I can hear you all thinking... well I had it for n months/years... and my goodness, how you guys coped I will never know.

 

I am just apprehensive about still getting withdrawal even thou I remain on this dose.

 

Even when I was stable on 60mg Duloxetine, I was having the same symptoms. I suppose it could have been the Citalopram withdrawal, but when I came off them last time (and cold turkey), I didn't have anything like those symptoms this time around. So this leads me to think that the Duloxetine is just not right for me. Just seems I am on a loosing streak whichever way I go about it.

 

Any thoughts would be gratefully received.... although I know there isn't a lot I can do...!

[fishinghat]

I think this is a wise idea. This is not a race and to be successful you need to do it from a place of strength. Just wait until your body tells you it is ready. In the mean time go on with life as best as possible. Your body/brain ahs had a lot of chemical changes in the last 2 years. This will require a lot of patience. Time and Patience

[invalidusername]

"Your body/brain ahs had a lot of chemical changes in the last 2 years. This will require a lot of patience"

 

Sometimes I need reminding of this. So useful to have an outsider looking in when judgement gets clouded.

 

Bless you 'hat.

[fishinghat]

Thanks IUN.

[invalidusername]

'hat

 

A search on Amazon (UK) has found me this so far;

 

https://smile.amazon...mega 3 high dha

 

It has a combined EPA and DHA of ~1900mg. From you post I wasn't sure if it was a combined 2000mg I am looking for, or 2000mg each?

 

In the case of the latter, am I better of finding something closer to the 1000mg mark and taking a double dose?

[fishinghat]

FYI


https://www.webmd.co...no-154/rosemary
However, the undiluted oil is LIKELY UNSAFE to take by mouth. Taking large amounts of rosemary can cause vomiting, uterine bleeding, kidney irritation, increased sun sensitivity, skin redness, and allergic reactions.

Special Precautions & Warnings:
Aspirin allergy. Rosemary contains a chemical that is very similar to aspirin. This chemical, known a as salicylate, may cause a reaction in people who are allergic to aspirin.

Bleeding disorders: Rosemary might increase the risk of bleeding and bruising in people with bleeding disorders. Use cautiously.

Seizure disorders: Rosemary might make seizure disorders worse. Don’t use it.

 

http://pennstatehers...271#Precautions

Possible Interactions

Antiplatelet and anticoagulant drugs (blood thinners)
Rosemary may affect the blood's ability to clot. It could interfere with any blood-thinning drugs you are taking, including:
Warfarin (Coumadin)
Clopidogrel (Plavix)
Aspirin

ACE inhibitors
Rosemary may interfere with the action of ACE inhibitors taken for high blood pressure, including:
Captopril (Capoten)
Elaropril (Vasotec)
Lisinopril (Zestril)
Fosinopril (Monopril)

Diuretics (water pills)
Rosemary can act as a diuretic, raising your risk of dehydration. It can increase the effects of diuretic drugs, including:
Furosemide (Lasix)
Hydrochlorothiazide
Lithium
Because of its diuretic effects, rosemary might cause the body to lose too much water, and the amount of lithium in the body can build up to toxic levels.

Diabetes
Rosemary may alter blood sugar levels and could interfere with drugs taken to control diabetes

 

http://www.efsa.euro...cuments/721.pdf
Following a request from the Commission, the Panel on Food Additives, Flavourings, Processing Aids and Materials in Contact with Food (AFC) was asked to deliver a scientific opinion on the safety in use of rosemary extracts when used as an antioxidant.
Based on the margins of safety identified the Panel concluded that the use of the rosemary extracts described in this opinion at the proposed uses and use levels would not be of safety concern.

https://www.research...h_Collaboration
Excellent review of rosemary health effects.

[fishinghat]

FYI

This product contains an undisclosed amount of tocopherols (Vitamin E)

Vitamin E refers to a group of compounds that include both tocopherols and tocotrienols. Regular consumption of more than 1,000 mg (1,500 IU) of tocopherols per day may be expected to cause hypervitaminosis E with an associated risk of Vitamin K deficiency deficiency and consequently of bleeding problems. Vitamin E has many biological functions, the antioxidants function being the most important and best known. Other functions include enzymatic activities, gene expression, and neurological function(s). RDA is 15 mg/day.

 

 

Hypervitaminosis E is a state of vitamin E toxicity. Since vitamin E can act as an anticoagulant and may increase the risk of bleeding problems, many agencies have set a tolerable upper intake levels (UL) for vitamin E at 1,000 mg (1,500 IU) per day. This UL was established due to an increased incidence of hemorrhaging with higher doses of supplemental vitamin E. Doses of vitamin E above the UL can also magnify the antiplatelet effects of certain drugs such as anti-coagulant medications and aspirin, which can cause life-threatening symptoms in ill patients. Hypervitaminosis E may also counteract vitamin K, leading to a vitamin K deficiency.

[fishinghat]

FYI

Vitamin D3
⦁ supplementation is only beneficial for deficiency. do not supplement long-term as it may cause toxicity

 

⦁ maintain calcium and magnesium levels. D3 - May cause constipation, nausea and vomiting as these are symptoms of an allergic reaction that require immediate medical attention. If taking vit d3 you should have your calcium and D3 levels checked each 6 months. Long term use can cause hypercalcemia (too high calcium levels and low magnesium levels (hypomagnesaemia).

⦁ 1000-2000IU per day, more than 2000IU and blood levels should be monitored

 

⦁ Vitamin D toxicity is on the uncrease due to over use/overdose of Vitamin D. Currently Vitamin D supplementation is very popular and routine levels of your vitamin D should be performed if you are taking the supplements.
 

[fishinghat]

FYU

Lemon Oil

⦁ Commonly used as a natural pesticide in gardens. It reduces food digestion and nutrient absorption in the digestive tract.

⦁ Few studies have been done.

[invalidusername]

Thanks for this info 'hat.

 

I didn't realise that D3 could be detrimental - and the amount in each dose in that bottle is over 4 times the recommended daily dose. Along with Magnesium Citrate (90mg elemental), I have been taking vitamin B complex (specifically for the B6 and B12 that veggies on't get a lot of), but this also has 200% RDA of D3. 

 

Thing is, i have salad with every meal - plenty of greens, soya, natural yogurt, at least 3 cups of pure green tea every day. Maybe I am over-supplementing?

 

It is tough trying to find the right supplements without getting a bunch of tests done.

[invalidusername]

On another note, my tight chest has gone, and anxiety levels have gone down a little as a result.

 

However, I woke after 4 hours and thoughts didn't let me sleep anymore. I tried to read and distract, but my eyes just wouldn't stay open, which then allowed thoughts to carry on. This has put depression higher.

 

I can see I am very sensitive to anxiety and depression as a result of the ongoing withdrawal, but I am so concerned about the continued exposure to it and how difficult it will be to let go.... and because I been feeling this way for so long, it will just become my everyday life.

 

I know you must have been thinking this 'hat during your 9 months of it all. So much strength to have held thru it all.

[invalidusername]

'hat, Gail... or other forum veteran...

 

I am struggling with my thoughts at the moment and need to ask.

 

Have there been cases before where other have been cross-tapering and still had the withdrawal such as those I am having, irrespective of the fact that I have a good dose of Citalopram going on?

 

It has been 3 weeks since I up'd to 30 Citalopram (and of course the drop to 10mg Dulox), but anxiety and depression is still the worst is has been for months. I could understand if I was just withdrawing, but I am worried that the Citalopram isn't doing its job (as I never really recovered in the year I was taking it before the switch to Dulox)?

 

Can the withdrawal be that prevalent in overpowering the effects of the supporting drug?

[fishinghat]

"I have been taking vitamin B complex (specifically for the B6 and B12 that veggies on't get a lot of), ..."

B6 (pyridoxine) is involved in many aspects of macronutrient metabolism, neurotransmitter synthesis, histamine synthesis, hemoglobin synthesis and function, and gebe expression. It is a factor in the biosynthesis of five important neurotransmitters: serotoniin, dopamine, epinephrine, norepinephrine, and gamma-aminobutyric acid (GABA). The RDA is 1 – 3 mg/day. Doses of pyridoxine in excess of the RDA over long periods of time result in painful and ultimately irreversible neurological problems. There are 7 forms; Pyridoxine (most common), Pyridoxine 5'-phosphate, Pyridoxal, Pyridoxa 5'-phosphate, the metabolically active form (sold as 'P-5-P' vitamin supplement) Pyridoxamine (PM), Pyridoxamine 5'-phosphate (PMP) and 4-Pyridoxic acid (PA). Due to its half life of up to 25 days it is easy to buildup toxic amounts in the blood stream. Vitamin B6 toxicity is on the rise in the USA.

Vitamin B6 Toxicity
https://www.ncbi.nlm...pubmed/26417231
Fenugreek seed extract treats peripheral neuropathy in pyridoxine induced neuropathic mice. Our data showed that fenugreek has anti neuropathic effect and restores the function of nerve fibers
The German Commission E monograph recommends 6 grams per day, which can be taken all at once or divided between three meals. Since most fenugreek capsules are available in either 580 or 610 milligrams, a common dosing scheme would be 2-3 capsules three times a day.

https://www.ncbi.nlm.../pubmed/6308447
We describe seven adults who had ataxia and severe sensory-nervous-system dysfunction after daily high-level pyridoxine (vitamin B6) consumption. Four were severely disabled; all improved after withdrawal. Weakness was not a feature of this condition, and the central nervous system was clinically spared. Although consumption of large doses of pyridoxine has gained wide public acceptance, this report indicates that it can cause sensory neuropathy or neuronopathy syndromes and that safe guidelines should be established for the use of this widely abused vitamin.

https://www.ncbi.nlm...ooks/NBK114313/
Half-Life is 15 to 24 days.

https://www.ncbi.nlm.../pubmed/3630649
A newly recognised neurotoxic syndrome due to pyridoxine (B6) overdose is described. It is the largest series of B6 intoxication hitherto reported. A raised serum B6 level was present in 172 women of whom 60% had neurological symptoms, which disappeared when B6 was withdrawn and reappeared in 4 cases when B6 was restarted. The mean dose of B6 in the 103 women with neurological symptoms was 117 +/- 92 mgs, compared with 116.2 +/- 66 mgs in the control group. There was a significant difference (P less than 0.01) in the average duration of ingestion of B6 in the neurotoxic group of 2.9 +/- 1.9 years compared with 1.6 +/- 2.1 years in controls. The symptoms were paraesthesia, hyperaesthesia, bone pains, muscle weakness, numbness and fasciculation, most marked on the extremities and predominantly bilateral unless there was a history of previous trauma to the limb. These women were taking a lower dose of B6 than previously described (1,2), which may account for the complete recovery within 6 months of stopping B6.

https://www.ncbi.nlm...pubmed/25137514
Supplementation with pyridoxine at doses greater than 50 mg/d for extended duration may be harmful and should be discouraged.
https://www.ncbi.nlm...pubmed/25056196

"I know you must have been thinking this 'hat during your 9 months of it all. So much strength to have held thru it all."
Oh yea, for sure.

"Have there been cases before where other have been cross-tapering and still had the withdrawal such as those I am having, irrespective of the fact that I have a good dose of Citalopram going on?"

It is possible. In my case when i decided I had had enough the dr first put me on Lexapro which worked but I had a significant side effect; then Prozac which did absolutely nothing even though I was on it for 8 weeks and then the Zoloft. Other members have had similar experiences. I would estimate though that in around 80 to 90% of the cases the new AD works well.

Most drs like to adjust doses over a 4 or 5 week period. They know that going slower just extends the withdrawal out as you make drops in the Cymbalta. Get it over with, get on a significant dose of the new AD and hold on until it fully kicks in. BUT, just my opinion, your Citalopram should have taken a significant bite out of the symptoms by now. Unluckily there is no way to be sure if the citalopram is going to work out or not. I wish I could be of more help with this.
 

[fishinghat]

PS - My wife and one of her friends have had Vitamin B6 toxicity. They were taking a popular stress supplement which contained 25 mg of B6. Due to the half life it took them 6 months to fully recover. Amazon use to sell B6 capsules with up to 500 mg per dose. B6 mega doses have become a 'popular' issue in recent years.

[invalidusername]

'hat PLEASE some help.

 

I have hit a real low point.

 

I woke up with the most intense paranoia. I am scared of EVERYTHING. Any noise. Movement. I can't cope 'hat. Can't eat, can't go outside, I am stuttering when I try to talk.

 

I am aware it has been three weeks on the 10mg, and that I had car problems, twice to the hospital, tight chest, work and shopping. None of this will have helped, but I am scared of myself, every thought is a causing panic. It feels like I am standing at the edge of a cliff and looking down... all the time. 

 

Taken Valium, but not helped. 

 

I am SO worried.

[fishinghat]

Classic during the height of withdrawal. Read Axeljames last posts. You have some choices,

1) go on up on the citalopram

2) get some hydroxyzine and/or clonidine from the dr

3) try to switch from citalopram to a different AD and wait 4 to 6 weeks for it to kick in.

By any chance have you read that document I posted on things that have helped other members? There are some otc stuff that had some fairly consistant results. Maybe one of them will help.

[fishinghat]

You know, I was just thinking. I read a research article where a dr was helping his patients with withdrawal and he said he had good success but it was unorthodox. Every time the patient would have severe withdrawal to the point where the patient couldn't cope with it he would have the patient take a few beads of Cymbalta to help calm down. The patient would continue with their regular Cymbalta schedule. If the severe withdrawal returned take another few extra beads again. He said that with time the need to take any extra beads slowly faded until it was unnecessary. I don't know of any members here who have done this.

[invalidusername]

Thank you 'hat.

 

So you say "classic during the height of withdrawal". Meaning this level of fear can be expected? I am still unmoved from the bed, but still feel I am moments away from being taken off to the funny farm.

 

So you are not suggesting I do anything to the dose of Duloxetine? 

 

I really worry about switching again given my intolerance. Effexor badly increased my tinnitus to the point I couldn't bear, Sertraline instantly gave me panic attacks for some reason. I suppose the safest would be Lexapro. 

 

I did read the main post you have written, from which the above came from. This is largely for the physically effects, which is useful, but those are behind me as of the start of the week, and I am left with this anxiety which has quickly got to the point that it has today. 

[invalidusername]

The post you just made answers my question about the Dulox. It would be useful to find that paper. 

 

I will have a search....

[invalidusername]

Still looking, but I have found a better definition of what I have.

 

Rather than paranoia, the definition of Stress-response hyperstimulation fits very well.

 

Back to the beads you mentioned, the problem here is "a few beads" is obviously an ambiguous term. And not knowing how many to take could cause a problem. But I guess I could start with 10 for example and observe the effects. 

 

Can you recall whether these were taken in a capsule or not?

[fishinghat]

"So you say "classic during the height of withdrawal". Meaning this level of fear can be expected?"

I am afraid so. It would get better if the citalopram would kick in.

"So you are not suggesting I do anything to the dose of Duloxetine? "

No just the citalopram.

"I did read the main post you have written, from which the above came from. This is largely for the physically effects, which is useful, but those are behind me as of the start of the week, and I am left with this anxiety which has quickly got to the point that it has today. "

There are some otc stuff mentioned that helped some people. Omega 3 and L-theanine I believe you are using but there is also also pseudoephedrine, phenylephrine and others.

Can you recall whether these were taken in a capsule or not?

He didn't say but considering he was bead counting the individual I would assume in a capsule. I would suggest trying a small number if beads first. Say 5 or 6. If that doesn't do a good job then the next time it is real bad try 7 or 8. We want to find the minimum amount that gives some relief.

[invalidusername]

Whilst I did go back onto the Citalopram following the relapse, true enough the symptoms (anxiety, dizziness, brain zaps etc) did abate, but there is no knowing that wasn't me getting through it on my own merits. The fact that I saw no improvement for the year following does tell me that it had lost its efficiency. Thus, dealing with Duloxetine withdrawal following a 13 year dependency on Citalopram may mean that I am coping with this with less support than I may think I should be getting (from the Citalopram). 

 

I have read here on the forum where people have come off with supporting AD's and really thought my path would be the same, However, I did go too quickly down the doses.

 

I will try some extra beads tomorrow if needed. I have also just had notice that I have a medical review with a psychiatric nurse on the 13th. Not sure how this will pan out, but it is something. I'd much rather a p-doc, but that is the NHS in the UK for you....

 

Given the support of the forum, I will open up the advice given to me at this appointment for yourself, Gail et al. to consider before I make any choices. I will not put words into their mouth because I want to know just how well versed they are with withdrawal etc such that I can base my level of trust in the advice given. A bit back-handed, but this is my mental health, and I am not going to put that in the hands of someone who doesn't know what they are talking about.

[fishinghat]

That sounds like a good plan. Let us know how it goes and good luck.

[fishinghat]

This is a copy of a post I just gave AJ but I thought it night be of interest to you as well.

You mentioned that you can't control your racing thoughts. One of the things in the How to Sleep Better document deals with this because it can be such a problem when trying to go to sleep. This method is based on how military personnel are trained to handle psych stress when captured by the enemy.


Pick a subject that you are familiar with and are comfortable with. One that is not exciting, stressful or depressing. I have a large garden and that is the subject I choose to focus on. When I have racing thoughts, paranoia or OCD type symptoms I simply close my eyes and start 'planting my garden' in my head. I picture every seed I pull out of the package, how deep I plant it, how I cover it with earth, etc. I plant in the order of how I actually plant. Some early some late. But there is a trick to it.


During this process if I find my mind begin to wonder and thoughts creeping in I stop planting the garden and go back to the beginning and start planting all over again. This works but it can take months to get your brain retrained. I have been using this method for years and it has really helped. I k now one person with OCD that uses this method also. He takes apart his motorcycle and puts it back together in his head.


There is another similar method as well. That is counting something real. This involves counting something you can actually see. Being able to focus the eyes helps in being successful. The ceiling in my bedroom has a swirl coating of paint on it. I open my eyes and look at the paint and start counting the number of swirls. If thoughts begin to invade my brain I then start counting all over again.


Time and patience.

[invalidusername]

Thanks for the advice 'hat.

 

I do practise a lot of meditation, but at times when it is overbearing, I really find it difficult. And yes, I did read the document - and have adopted some of it already - particularly about the light in the evenings and electronic devices.

 

I woke up 4 hours ago and anxiety was there waiting for me. It took an hour, but it took hold just as it did yesterday. I forced myself out for a quick walk - only 10 mins - but didn't change anything. I have taken 10 beads, and whilst I can feel something, I still do not feel like I can face anything.

 

What really worries me is that I will not be able to face work, shopping or any of the essentials. The wife is the same. It has made me worryingly suicidal. 

 

Three of the worst days I have ever known and I just don't feel I can face another one. If I don't manage work, it will make me worse - not that I even want to consider what can be worse than what I am currently feeling.

[fishinghat]

You took 10 beads yesterday. You still have 2.5 beads worth left in your system today. so take another 7 or 8 beads today if things are still too bad. You are not trying to feel good only tolerable.

[invalidusername]

OK. So I made myself go out to see a friend for an hour, and then stopped off a bought a few groceries. 

 

I took 8 beads before I went, so I am not sure if it was the beads or the fact that I did the things I didn't want that has got me here.

 

But yes, I feel tolerable now. Just.

 

n.b. I am taking them without capsule as two hours for it to release is too long when you are right on the edge.

[fishinghat]

Good, now stick with your regular schedule until things get bad again and then repeat as necessary. As long as you get a break every now and then it will make it easier to handle things. Thanks for the update.

[invalidusername]

OK - will do.

 

So just to clarify, I should try to limit this "bead injection" to once a day (if that)?

 

And just to give me some peace of mind, this is a common occurrence and will pass?

[fishinghat]

From what the dr wrote, only do this once a day when withdrawal is so bad you can not stand it any longer. As time goes by the amount of extra beads you need and the time between bad events gets longer. So right now you may have to do the 18 beads in 2 days and then you may have 2 or 3 tolerable days. Then when it is real bad again you take your 18 beads over 2 days but this time you may feel tolerable for 4 or 5 days. Each time the number of days in between increases. And eventually you may only need the 10 beads on the first day. It may not be necessary to take the 8 beads on the second day.

 

I do have one concern for this method. It seems like you are raising the blood level of Cymbalta only to let it drop again and repeat part of the same withdrawal. I just thought I would give this as an option.