328 replies to this topic

[Noush]

Got an appointment with a GP in half an hour. So will see what they think. Looks like I might have to bite the bullet & cross taper sooner than planned.

[fishinghat]

"No nothing. I take 40mg Cymbalta & that is all. I was prescribed 10mg Propanolol if I need it, but have taken 10mg before bed the last 2 nights & it has not helped at all. I don't think I have ever used it & noticed any improvement.

Do you think it could be the 20no bead difference in the capsules that is causing this? As I am super super sensitive to these dose fluctuations.

I have read about something called Kindled. Where the more you have failed taper attempts, the more your body becomes super sensitive to these changes. Have you heard of this? "

Did the racing heart/heart pounding start when you first started cutting back on the propanolol? It is prescribed to assist with these symptoms but if stopped rapidly the symptoms come back strongly and rapidly for around 2 weeks. This is called a rebound revate the issue.effect. Weaning ovwer a 1 or 2 week period avoids this.


The difference in the bead count could also aggrevate the issue.


Yes, I have heard of Kindled. It is well supported by medical research. There are two closely related occurances. The more times you use a specific antidepressant then the less likely it is to work AND the more antidepressants you use in general increases the odds of them not working in the future.

[invalidusername]

How did it go at the Dr, Noush?

[Noush]

I'm only ever used the propanolol like 6 or 7 times in in a year. So it can't have anything to do with that.

So the Dr wants to get me off Cymbalta & recognised how hard it can be. She suggested weaning off over 1 month, taking a month off work & just writing a month of my life off. She said she's prescribe me Diazepam for the anxiety whilst doing so.

I suggested cross tapering to Escitalopram & showed her Juli's cross taper regime & she said that they don't really use Escitalopram (Lexapro) over here in the uk and wouldn't want to use it to cross taper from Cymbalta as it has a moderate to high interaction rate. So she is going to speak to the Psychiatrist on Monday for their opinion.

[invalidusername]

Think she is scared about serotonin syndrome - as are many doctors. And both the wife and myself are on escitaolpram so it is used, but because it is quite an expensive SSRI, this would rule it out as a popular choice among the NHS. I would say there is little risk having done my own homework with regard to risk between the two as long as it is carried out carefully and to plan.

[fishinghat]

I just don't understand why drs keep prescribing benzos when there are other options like clonidine, hydroxyzine, atenolol, etc which are not habit forming and have no withdrawal. If these don't work then they can always come back to the benzo.

Most of what I have read indicates that Lexapro has a low rate of interaction and is a wide spread use for treating anxiety/depression. That is just from my reading of the medical journals.

[Noush]

Well Juli used Lexapro to cross taper with very good results, so I am going to push for that! I now have 40mg propanolol to try & see if that helps. So fingers crossed.

[fishinghat]

WOW, Lexapro is expensive there. Generic is only $12 at my pharmacy without insurance.

[Noush]

That'll be why they don't want to use it then!x

[invalidusername]

£60.19 ($76.50) for my prescription... with FREE Viagra!!

[fishinghat]

Yikes. That is terrible.

[Noush]

Is the Escitalopram not helping you at all IUN? The way I would like to cross taper is:

Week one: start on 5mg Lexapro and drop Cymbalta from 40mg to 30mg.
Week two: Increase Lexapro to 10mg drop Cymbalta to 20mg.
Week three: Keep Lexapro at 10mg drop to 15mg Cymbalta.
Week 4: Keep Lexapro at 10mg drop Cymbalta to 10mg
Week 5: Increase Lexapro to 15mg and lower Cymbalta to 5mg
Week 6:
Lexapro 15 Cymbalta 2.5 mg
Week 7: reduce one bead a day to zero Cymbalta.
Some “weeks” may be more like 8 or 9 days.
It all depended on how I feel.

But I have to get my GP to agree with this first.

[fishinghat]

That looks like a good schedule to me but drs usually like to go a little faster, say a 4 or 5 week schedule. Let me know what he/she thinks.

[Noush]

Why do they prefer to go faster Hat? Mr Dr wants me wean off over a month & would prefer me not to Cross taper. But I am going to push for a cross taper.

[invalidusername]

Noush - I am only on my 2nd week of 15mg (1 week previous on 5mg), but don't forget, I am only 6 weeks off the dreaded C, of which I cross-tapered back to Citalopram, and then I stopped Citalopram 2 weeks ago, and onto Escitalopram. Then the "all-knowing" MH team put me on Pregabalin a week ago. I dare not think what state my head is in at the moment. Add into the mix that it is Christmas, the wife is severely depressed and popping Valium like there's no tomorrow and I have been bedridden 3 out of 5 days this week!!

 

So any improvement asked of the Escitalopram at the moment would be like someone trying to save weight on the Titanic by throwing a deckchair overboard...

[invalidusername]

Why do they prefer to go faster Hat? Mr Dr wants me wean off over a month & would prefer me not to Cross taper. But I am going to push for a cross taper.

 

My goodness - forget anything about a month. I don't think anyone really knows until they start the cross-taper regarding how long it will take. As you say, your body will tell you - just make sure you listen to it. When I dropped 60 to 30, it took about 3 weeks, 30 to 20 took about 4 weeks, and then as you all know, I was not on 10 long at all before my pills were taken from me, but had I been given the opportunity to do it the way I wanted, I guess it would have taken at least a couple more months of bead counting even while using a supporting SSRI.

 

Please, please, think carefully on this one, and remember you don't have to do what the doctors tell you... unless they take your pills away of course...

Oh my goodness. Absolutely not. Please Noush

[fishinghat]

"Mr Dr wants me wean off over a month & would prefer me not to Cross taper. But I am going to push for a cross taper."

Weaning off on a month is similar to going cold turkey. You are asking for suffering. My recommendation (if not cross tapering) is to wean over a one year period. You still feel bad but not terrible and it seems to breakup faster at the end. This dr sounds like so many that are not aware of the FDA warnings on sudden withdrawal from Cymbalta and the serious effects it can have.

[Noush]

Oh don't worry, I won't be doing it over a month. And I won't let them take my pills away. If I have to go private I will.

How did your GP have you cross taper from Dulox to Citalopram IUN? Glad to hear you've had a much better day today. No more Pregab for you!

[Noush]

She said that she has had patients bead count over a long time, however, as I had bad withdrawal after only a 20 bead drop at 1 bead a week, she said that method clearly doesn't work for me. So she thinks I should do it over a month & get it over with quickly.

[fishinghat]

Actually that does make sense. I am surprised the dr didn't suggest a cross taper to handle the symptoms but to be honest I don't disagree. Just my opinion you understand but my opinion is hydroxyzine and/or clonidine first, then a benzo and then if you have too then a ssri. Buspar usually helps a little (a real little).

[Noush]

Well my plan is to get her to agree on a cross taper. She is speaking to the Psychiatrist on Monday to get their opinion.

[invalidusername]

Being my tutor to many things medical, I would more often than not agree with Hat, however I am on the fence here...

 

I would still take it as it comes rather than a bull at a gate approach. You need to find something that will support you as you are coming off. At the point the symptoms hit, you need to know you have the support through an anti-h, stablier or some such. The last thing you want to do is make assumptions that what is chosen will carry you through. An SSRI will not be wise at this point obviously as you would need to wait 6 weeks up for any counteracting effect - unless you are one of the lucky ones! 

 

It may be that you still need time to balance doses as you come off the Cymbalta. As you can see from my experience I had to wait until I was right in the thick of it before I was give the Pregabalin and we all know how that turned out!

 

I don't trust my to open a can of beans let alone write up a cross-taper. Hat and myself went through this and planned it absolutely fine until my pills were taken. Admitedly I was initially in favour of getting the last 10 out of the way, but this was a mistake. The MH team then made a reinstatement impossible again, as you are aware. But when I went to 30mg I was on 10mg Citalopram, then 20/20, and 10/30... and days later just 30mg Citalopram. 

[Noush]

Well I will see what my Dr says next week & if it isn't what I want to hear, I will push for what I want. My last resort is that my Uncle is a GP & I will get his advice on how best to get what I want. If that is by going private, then it will have to be.

[invalidusername]

With a well-reasoned and factually-based argument for a particular treatment plan, we really shouldn't have to "push"...

 

...but they always know best!! 

 

If not, give them 'Hats line... "with 20,000 medical papers coming out every month (is it?), how can a doctor be sure his knowledge is accurate?". Very true. I have a very limited research field and I can't keep up with the publications that keep pouring out of the Universities.

[KathyInFL]

£60.19 ($76.50) for my prescription... with FREE Viagra!!

 

So you might need the pregnancy pack after all.

[Noush]

😂🤣😂 Good point Kathy! Hope you are well!

[Noush]

So each morning for the past week I have woken with anxiety. Not thinking about anything in particular, just a crippling feeling of anxiety, on top of the not sleeping etc. It's like the depression/anxiety that I had 6 years ago is back. Could it be that the Cymbalta has simply stopped working? Has my previous weaning attempts of only dropping 20 beads & then reinstating effected it effectiveness. Or could just being on Cymbalta cause this after almost 6 years?

[Noush]

This feeling of anxiety/depression starts to lift around lunch time each day & I then feel quite calm towards the end of the day.

[fishinghat]

If it is from the withdrawal then it will slowly fade. Id it is your old symptoms coming back it will stay the same or maybe worsen a little. Try to keep a log of how many hours a day you deal with it and over a few weeks you will see a pattern.

[Noush]

So far the anxiety has lifted around 11.30am -12pm each day. I slept better last night than I have in the past week. Would the 11am lift have anything to do with me taking my Cymbalta in the morning? Usually around 6.30/7am