328 replies to this topic

[Noush]

Cymbalta does poop out. That is possible and when it does you will have withdrawal type symptoms. Unluckily no way to be sure. Definitely adrenaline though I agree.

HAT - After a couple of much better days, I had a day of Dizzy spells yesterday & extreme fatigue. Didn't sleep great last night & woke up with that unexplainable anxious feeling this morning. My question is, if Cymbalta poops out, can that in itself cause anxiety, adrenaline & waking in the night? In that question I mean, even if the symptoms of anxiety are no longer there from 6 years ago, could poop out create these symptoms?

[invalidusername]

Glad you had a good couple of days Noush, and obviously a shame that the onset of the physical symptoms has bought it back a bit. I had one of those unexplained moments yesterday evening. Just like yours. Heart started thumping - nothing else - but all I was doing was playing Sudoku!

 

When a drug poops out, as I said before, we do not know whether it is just not doing what it should, or whether the brain has got used to what it is doing - highly likely the latter of the two. So, this means that receptors are still being blocked, but it is not giving the balance required to ease the psychological symptoms. Therefore an imbalance occurs, thus bringing on anxiety and/or depression in accordance with the chemical levels.

 

As Hat has said before, the Norepinephrine which regulates the production will have stopped in a poop out, so the brain is confused and must therefore work things out for itself. It is like it has to feel the emotion, and your subsequent reactions to it, to then know how to balance the chemicals accordingly - commonly known in the "stages of withdrawal" such as anger, agitation, sadness, anxiety, depression and so forth. These moments of anxiety are where the signal in the brain is being detoured as a result of blocked receptors. They don't get unblocked - new ones get produced. 

 

I know this is a lot of theory, but it is the only way I can best explain it for you. I am sure Hat will go about it another way, but I want to do what I can to help you, just as you do so for me. You have been great in supporting me - so glad we have you on the forum. 

[invalidusername]

The medical name for poop-out is ADT, or anti-depressant tachyphylaxis. There is an interesting paper on it if you wanted to burn a few minutes of your Saturday afternoon!

 

https://www.ncbi.nlm...les/PMC4008298/

[PrincessNutella]

No thanks, I burned my brain with these

[invalidusername]

LOL

[Noush]

IUN - I will have a read of that this evening thank you. And I'm glad we're all here to support each other!

I may be being thick here, but I guess what I'm asking is, could it be possible that I no longer suffer with the anxiety/depression tbat I had 6 years ago, but the sudden poop out is causing the morning anxiety? Or is it more likely that the Cymbalta is simply not controlling my symptoms anymore?

[Noush]

No thanks, I burned my brain with these

Ozgun, how did you cross taper after your Poop Out? Or did you stop the Cymbalta & then start a new med?

[PrincessNutella]

I did not taper at all (serotonin syndrome). If I tapered, I would have a solid plan and would do it VEEERY slowly.

[Noush]

I did not taper at all (serotonin syndrome). If I tapered, I would have a solid plan and would do it VEEERY slowly.

Well I tried dropping a bead a week & after 20 weeks, I started with insomnia, pounding heart & dizzy spells. Would you recommend going slower than this? I reinstated after a week of these symptoms. Should I have waited longer for the withdrawal to pass?

[invalidusername]

I would argue that it is likely to be the imbalance bought about by the medication. Given the recent stop/start and the fact that it is occurring in the mornings is a good indication. The morning is when the levels are at their lowest, whereas if it were "you" controlling these symptoms, you would suffer them as a result more of your thoughts and circumstances. 

 

When I first started my withdrawal from Cymbalta, I could feel the anxiety very differently. It was there doing all its physical things, but my thoughts did not set it off. They would just occur as and when they wanted to. I tried my best to ignore these symptoms. They were typically churning stomach and the heart palpatations like you have. You find yourself saying to your body "what are you doing? I am not telling you to be anxious?!".

 

The issue is that after 2-3 days of these "pseudo" anxiety symptoms, the real anxiety sets in. Your brain starts syncing with the body and makes the assumption that something is wrong - so you start to get the thoughts. This is where I get upset with the whole process. You start to fight the symptoms when they start, knowing that in 2-3 days you will be controlling the anxiety yourself. But we all know that fighting it is not the answer, rather just to let it be... but this is so damn difficult as we all know! 

 

So to sum up, I would say that it IS the cymbalta controlling your symptoms, but by having introduced the imbalance in your system. Your levels of norepinephrine are not being managed anymore, so your brain spikes your adrenaline (the result of norepinephrine from the brain) in trying to get the balance back, but in so doing, occasionally throws out a little too much thus causing these symptoms you are experiencing.

[Noush]

I would argue that it is likely to be the imbalance bought about by the medication. Given the recent stop/start and the fact that it is occurring in the mornings is a good indication. The morning is when the levels are at their lowest, whereas if it were "you" controlling these symptoms, you would suffer them as a result more of your thoughts and circumstances.

When I first started my withdrawal from Cymbalta, I could feel the anxiety very differently. It was there doing all its physical things, but my thoughts did not set it off. They would just occur as and when they wanted to. I tried my best to ignore these symptoms. They were typically churning stomach and the heart palpatations like you have. You find yourself saying to your body "what are you doing? I am not telling you to be anxious?!".

This is exactly what happens each time I drop 5% of the dose. I get the anxious feeling in the pit of my stomach. Like a strong feeling of fear, but I'm not actually thinking of anything or going into any fearful situation. It's just there.

So maybe what I am experiencing is a type of withdrawal & not that I still have underlying symptoms that require medication for?

[invalidusername]

That's exactly it. There is a fine line to be drawn when it comes to these sort of things.

 

The usual means of occurrence would see a given situation which will trigger a thought. This thought will then release chemicals in the brain appropriate to the response, resulting in the physical symptoms. So we have a pathway from thought to physical feeling. For example;

 

"Oooh, there's a picture of a big dog... I got bitten when I was younger... ooh, I feel anxious and scared"

 

If the physical feeling comes first, the thought clearly didn't initiate the response and it came directly from the brain. What controlled the chemicals in order to give you that physical reaction?? The brain obviously controls everything we feel from pain through happiness - the body doesn't do anything unless our brain has something to do with it.

 

You could control the additional adrenaline with beta blockers or similar as you well know, but we are always hoping that these symptoms will pass. Still they are a royal pain in the a$$ until they do!!

[Noush]

Well as my GP won't cross taper me onto a SSRI, I'm leaning towards trying a slow taper again, but trying to control the physical symptoms with Beta Blockers etc. My GP wants to fast taper me off C over a month & get it iver & done with & prescribe me Benzo's. But I really don't fancy that option.

[PrincessNutella]

We tolerate no Benzos in this household!!

Benzo group isn't any better than Cymbalta?

[Noush]

So what would you do Oz?

[PrincessNutella]

I'd cross-taper to a SSRI with the help of supplements and anxiolytic meds that doesn't have withdrawal periods. With your sensitivity, I would drag the process as long as possible and within my comfort zone.

Pantoprazole 40 mg for nausea, omega 3 supplement for smooth recovery, 2x0,25 mg Xanax if needed (pooped out on me), Hydroxyzine 25 mg for sleep aid.

This is all for 50 mg of Zoloft.

[Noush]

I'd cross-taper to a SSRI with the help of supplements and anxiolytic meds that doesn't have withdrawal periods. With your sensitivity, I would drag the process as long as possible and within my comfort zone.

Pantoprazole 40 mg for nausea, omega 3 supplement for smooth recovery, 2x0,25 mg Xanax if needed (pooped out on me), Hydroxyzine 25 mg for sleep aid.

This is all for 50 mg of Zoloft.

The problem is Oz, my Doctor will not prescribe a SSRI until I am completely off Cymbalta.

[invalidusername]

I'm right with Oz here.

 

"get it over and done with"

 

Those words haunt me as they were the last thing I heard the doctor say as my bead stash was taken away!!

 

I think everyone would share the same opinion here, so we speak in their absence! Speaking of which, I think Hat may well be having a day off - has been Saturday's before and of course we all wish him well. 

 

Oooh - new reply. Yes, so your doctor is scared of serotonin syndrome. You need to get the opinion of another doctor if she won't allow this route. Remember you never need to do anything that the doctor tells you! It is your body Noush! Doctors are only there for ADVICE. You are under no obligation to take it. Just hold onto your beads!!!

[Noush]

Oz - isn't Xanax a Benzo?

[Noush]

IUN MY doctor went on the advice of a psychiatrist and has put this on my record. Therefore, I don't think I will get a different outcome from a different GP.

[fishinghat]

Xanax is a benzo. The benzo withdrawal is not as bad as Cymbalta but close. IT CAN be done with no withdrawal effect if done slow enough (say over 3 or 4 years) BUT now that they have been tied in to dementia that isn't a good option either.

 

I hate to suggest this but 5htp, tryptophan and St. Johns wort act exactly like an ssri BUT there is a significant risk of serotonin syndrome if cross tapering is not done properly. A safer choice to try first is suntheanine. It has helped many here on this site and there is no chance of SS.

[Noush]

Xanax is a benzo. The benzo withdrawal is not as bad as Cymbalta but close. IT CAN be done with no withdrawal effect if done slow enough (say over 3 or 4 years) BUT now that they have been tied in to dementia that isn't a good option either.

I hate to suggest this but 5htp, tryptophan and St. Johns wort act exactly like an ssri BUT there is a significant risk of serotonin syndrome if cross tapering is not done properly. A safer choice to try first is suntheanine. It has helped many here on this site and there is no chance of SS.

Hey Hat! So would you attempt another slow taper and try to tough out the withdrawals?

[fishinghat]

With your history Noush the taper would have to be extremely slow and could take 3 or 4 years. Have you tried the suntheanine yet?

 

The only other option would be to use a little 5htp or tryptophan to take the edge off the withdrawal if it gets too bad but you would have to use a minimum and just use it from time to time. Watch out for serotonin syndrome. Not a good choice is it?

[invalidusername]

Arrgghh - I hate the doctors over here. Not to generalise, but they think they know everything.

 

If you wait to come off the Cymbalta before going on another SSRI, you will already be at a point where you could tough it out. The SSRI is there to support you through the weening as much as it is the withdrawal. I don't think that would be the best approach as your weening would need to be very slow as it is.

 

I forgot about L-Theanine. There is a lot of evidence for this. Doesn't work for everyone. Gave me a lot of energy when I tried it. But not going to be mixing it with where I am at the moment. Think we need to tool you up with some supplements and aids and put your best metaphorical foot forward!

[Noush]

With your history Noush the taper would have to be extremely slow and could take 3 or 4 years. Have you tried the suntheanine yet?

3 - 4 years is fine with me! I've been on this 6 years & did my first failed weaning attempt over a year ago. So at the minute, I'm pretty much stuck in limbo. So if I thought that I could crawl off this with bearable withdrawal & still function & work, then I am good with that. However, I think it'd be more like 7 years, as I have 380 beads. Unless I am able to tolerate bigger drops as I go down.

No Hat, I have never tried Suntheanine. How would I use that?

[fishinghat]

It is a pill. Theanine is an amino acid.

L-theanine:

Member's comments

(puritan's pride) 200 mg capsules 2- 3/ day. I have been taking this prior to cymbalta detox. It helped me reduce my dosage of clonazepam. Within 20-30 mins I feel more calm. I do believe it is helping keep the anxiety in check.

Tinabee - For now I have started taking fish oil and a supplement called Theanine Serene that is supposed to help with anxiety. I know it sounds silly since I've only taken the anxiety supplement for a couple days but I really feel like it has helped.
200mg L-Theanine in the morning with a full glass of water on an empty stomach, you can take again in late afternoon 100 to 200 mg if needed (make sure it is suntheanine - it helps with headaches and pain as any painkiller I had just did not cut it)

Member's comments were generally favorable.

http://www.cymbaltaw...page-2?hl=helps
Page 1 and 2, detailed information on L theanine and its usage.

Research
The research shows that all green tea leaves contain both L-theanine and D- theanine BUT only the special processing used by the manufacturer produces pure L-Theanine and is the choice of many of the research biologists.

https://www.ncbi.nlm...pubmed/22214254
https://www.ncbi.nlm...pubmed/16759779
https://www.ncbi.nlm...pubmed/14755608

Rapid Commun Mass Spectrom. 2004;18(3):251-6.
Analysis of derivatized and underivatized theanine enantiomers by high-performance liquid chromatography/atmospheric pressure ionization-mass spectrometry.
Five of the six products contained significant amounts of D-theanine. Only one product, SunTheanine, appeared to contain only the L-theanine enantiomer.

https://www.ncbi.nlm...les/PMC3049752/
Note - Suntheanine is the pure ingredient and that is what you want. That is the pure L-theanine. D-theanine is not absorbed by our bodies.
L-theanine is an amino acid precursor to glutamate and glutamine.

Key Points
It can cross the blood brain barrier. It is only produced by plants and fungi. It inhibits glutamine transporters and glutamate transporters, and thus blocks the reuptake of glutamine and glutamate. Theanine increases serotonin, dopamine, GABA, and glycine levels in various areas of the brain. Caution – Most plants that contain L-theanine also contain caffeine and it can be a significant contaminant in L-theanine supplements. Theanine has been studied for its potential ability to reduce mental and physical stress, improve cognition, and boost mood and cognitive performance in combination with caffeine. In combination with caffeine it may increase anxiety.

Scientific Information
A National Standard monograph that reviews current research on theanine reports that it is likely safe in doses of 200–250 mg up to a maximum daily dose of 1,200 mg. Theanine is used to help with anxiety, blood pressure control, mood, and cognition. Natural Standard rates the evidence to support the usage for anxiety, blood pressure control, and mood as “unclear or conflicting scientific evidence” and the evidence for cognition as “fair negative scientific evidence.” Many of the studies of theanine were done in combination with caffeine as found in tea. While the studies found that the combination had some effect on mood, the studies found that theanine alone had little effect. More sufficiently designed studies in humans are warranted to further our understanding of the effects of theanine.

https://www.ncbi.nlm...pubmed/21208586
Effective, 400 mg/day
https://www.ncbi.nlm...pubmed/15378679
Not effective on anxiety, 200 mg/day
https://www.ncbi.nlm...les/PMC4137547/
Used to treat PTSD. It was successful in treating 8 gene problems associated with PSTD in the hippocampus and amygdala.
 

[Noush]

It is a pill. Theanine is an amino acid.

L-theanine:
Member's comments
(puritan's pride) 200 mg capsules 2- 3/ day. I have been taking this prior to cymbalta detox. It helped me reduce my dosage of clonazepam. Within 20-30 mins I feel more calm. I do believe it is helping keep the anxiety in check.
Tinabee - For now I have started taking fish oil and a supplement called Theanine Serene that is supposed to help with anxiety. I know it sounds silly since I've only taken the anxiety supplement for a couple days but I really feel like it has helped.
200mg L-Theanine in the morning with a full glass of water on an empty stomach, you can take again in late afternoon 100 to 200 mg if needed.

Thanks for all that info Hat! And this is definitely safe to take while still taking Cymbalta?

[fishinghat]

I just checked 3 drug interaction websites and none list any interaction with Cymbalta and Suntheanine (L-Theanine). In addition we have had many members who have used this combination with no issues.

[Noush]

I just checked 3 drug interaction websites and none list any interaction with Cymbalta and Suntheanine (L-Theanine). In addition we have had many members who have used this combination with no issues.

Great! I will purchase some this week! Thank you.

[PrincessNutella]

Xanax lost its effect on me and was actually helpful when it worked (0,375 mg in total now). But there's the psychological addiction thing that worries me when I recommend it. And yes, be very careful of serotonin syndrome. Start very slow and be mindful of your symptoms, please. Hydroxyzine did not work for my anxiety as well, by the way.