221 replies to this topic

[Vinpin]

Hi FH.

 

Want to thank you in a special "shout out" here for all you do. I noticed you are categorized as "God-Like", and it is truly a deserving description. You do so much for not only me, but for everyone in these forums. It is quite remarkable, and you've been doing it for quite a long time; I don't know what we would all do without you.

 

On a separate note, I have stabilized reasonably well over the last five days (yay!!!!). With my current short term memory loss, and now my newly found knowledge of the Alprazolam's link to dementia, and .... considering I've been on it for 3-4 years ..... I'm wondering whether it would be even more important to wean off the Alprazolam while temporarily holding the Dulox. What do you think? Which of the two has greater severity and permanency of long term effects????

 

If I were to do this, my plans was to stay on 0.666mg this week, and if OK, then cut to 0.600mg next week, then move onto to 0.500mg at some point, and stabilize there. Then ..... I would drop from 3 beads to 2 beads on the Dulox.

 

Would love your impressions and take on my plan (IUN - would love your opinion, too .....)

 

BTW - I am so hellbent on getting off BOTH of these medicines - the less intense withdrawal symptoms over the last five days have made me so motivated to do it!

 

Thanks forum family!!!!

 

-Vin

[Vinpin]

HI Flower,

 

Just wanted to offer you some encouragement to keep up the fight, if you are doing this.

 

I will default to FH & IUN on a final decision on "weighing" vs "counting", but IMO, I think both work sufficiently well at higher bead counts. However, at lower bead counts, they both have their drawbacks - where the variation of just one bead can really bring on inter-symptoms for me, especially 4-8 hours after taking, if that one bead was lacking in potency. To me - even if I weigh that one bead and it weighs in where it should .... theoretically there could not be enough Dulox contained in the bead.

 

But for you at your higher bead count right now, you will probably succeed with either approach. 

 

Good luck and hugs,

 

-Vin

[invalidusername]

You are absolutely right about the weighing. This has been an on-going topic of debate  for some time. In my opinion, there can be discrepancies either way. One can count, or one can weigh, but it all comes down to the manufacturing process. The bottom line is we will never know short of splitting the bead open. It really sucks for someone in your situation, and I doubt anyone would believe your story if you presented it to them. For something like this to be a matter of research and scrutiny could damage the Big Pharma name extensively. No-one would go near it. That is a sure way to ruin a researchers reputation. In addition, it is such an isolated case and thus cannot be readily replicated, so this doesn't bode well for hard science unless there were more "Vins" out there.

 

Regarding the benzo taper over the Cymbalta, I am of the ilk that would opt for one at a time purely for the reasons of isolating the effects of each withdrawal. Just as the same goes for compounding drugs. If I went to the doctor and mentioned the side effects I have, there would inevitably be another pill. I don't want this. Just as I am sure the p-doc will want to switch me again, but again, people do not understand that I am in the throws of anxiety and depression BECAUSE of the pills. My brain has become used to such a pattern of KNOWING there is something wrong with me, even now the side effects have started to debate, there is this continuation of nervous energy that has to go somewhere. If it cannot focus on a physical symptom, it will find another path to maintain the comfort that has become a life of psychological problems. I don't know how to deal with a "normal" life after so long. As Hat has said before, the answer in my case does not lie so much with meds, but with my approach to my condition that has been bough about as a result of conditioning over the last couple of years.

 

Sorry. I digress. Back to your withdrawal conundrum. I can see your train of thought, but I suppose it also comes down to how muh you feel the Alprazolam is aiding you at your present course of recovery. If you do decide to reduce the dose, you will need to make sure you leave sufficient time either side so as to clearly differentiate between the withdrawal symptoms. It has the potential to open up a can of worms, but if approached as clinically as possible, there may be some distance in it, but it will need careful planning and journaling. 

 

Interested to hear Hat's opinion having "been there, done that" himself. Each will be to their own on their response, but opting for the voice of reason is the way forward here. Unfortunately, there can be no certainty in the measures followed here, regardless of the evidence for and against. Subjectivity - you art thou and a pain!

 

Rooting for you the whole way!

 

IUN

 

p.s. Yes, it is my friend's son that was subject to the circumstance mentioned before. You got it

[fishinghat]

"....in order to provide finished pellets in the desired preferred size range of from about 0.5 to about 1.5 mm in diameter."

This indicates to me that they are desirous to produce pellets in the 0.5 to 1.5 mm range. A 300% difference.

 

"It is always preferred for the beads to be of a reasonably narrow particle size distribution, in order to improve the uniformity of the various coatings to be added and the homogeneity of the final product. For example, the beads may be specified as being of particle size ranges such as from 18 to 20 U.S. mesh, from 20 to 25 U.S. mesh, or from 25 to 35 U.S. mesh to obtain acceptable size distributions of various absolute sizes."

 

This particular paragraph deals with controlling the size of the beads at the center of the pellet. It indicates that the beads can vary in size from 15 to 30% approximately in diameter. Being a sphere the weight of a bead would be determined by the volume of that bead (assuming a consistent density which has its own variability).

For example take a 2" diameter rubber ball and a 3 inch rubber ball. If the 2" ball (volume equals (pi radius squared = 3.1416 square inches) weights 200 grams and the 3" diameter rubber ball would have a volume of 7.07 square inches. This is nearly twice the volume and therefore twice the weight, 400 grams. So a 50% increase in diameter causes the weight to be twice as much. So the variability of the weight of the balls is significant on its own let alone the variability of the layer of medicine and the layer of the enteric coatings which also vary as well.

FYI -
Conversion of mesh size to diameter.
18 to 20 U.S. mesh - 1 mm to 0.85 mm 15% variation
20 to 25 U.S. mesh - 0.85 mm to 0.71 mm 16.5% variation
25 to 35 U.S. mesh - 0.71 mm to 0.50 mm 29.6% variation

Mesh has a fairly larger variation then this because not all beads are round some will be oval. If the width of the bead is 1 mm but the length is 1.5 mm then it can still pass through the 18 to 20 US mesh.

"If I were to do this, my plans was to stay on 0.666mg this week, and if OK, then cut to 0.600mg next week, then move onto to 0.500mg at some point, and stabilize there. Then ..... I would drop from 3 beads to 2 beads on the Dulox."

At this point i would see no problem to this approach. also, thank you very much for the kind words. I did this type of thing professionally for nearly 30 years so an easy transition to helping on this site.

When it comes time to wean off the benzo let me know as there is a method to use that leads to no withdrawal symptoms and is a lot easier to deal with than Cymbalta for sure. Definitely, definitely don't try to wean both at the same time. A disaster for sure.

 

"I think both work sufficiently well at higher bead counts. However, at lower bead counts, they both have their drawbacks - where the variation of just one bead can really bring on inter-symptoms for me, especially 4-8 hours after taking, if that one bead was lacking in potency. To me - even if I weigh that one bead and it weighs in where it should .... theoretically there could not be enough Dulox contained in the bead."

 

 

At this point I tend to agree with you Vin.

 

"One can count, or one can weigh, but it all comes down to the manufacturing process."

 

Fully agree.
 

[fishinghat]

Also I am about half way through my review of the posts from members that weighed their beads.

 

I should be able to post it later today.

[invalidusername]

Top post there, Hat. Really bought home this issue. 

 

Some say, between the three of us, that we are overthinking, but there is comfort and much benefit to be gleaned from knowledge.

[fishinghat]

"... there is comfort and much benefit to be gleaned from knowledge."

Absolutely.

[Vinpin]

HI again IUN,

 

Thanks for the response and encouragement.

 

So, so weird that tonight, I read your post, and your one statement saying "this continuation of nervous energy that has to go somewhere" describes exactly some nervous symptoms that I am having right this very minute. Along with my typical symptoms, tonight, I feel like my body is an engine stuck in a gear - and I cannot quiet it.  I was good for 4 days, but now, back to the withdrawal symptoms in earnest, unfortunately. So, for sure, we are in the same boat ....

 

I will say this ... this morning I worked out a little harder on my elliptical - a slow "jog" of 2.5 miles over 35 minutes. This is up from the same exact pace, but over 30 minutes two days ago. Did OK, but slowly and surely thereafter and through the day, my symptoms have returned. In setting my exercise regimen, I may need to choose between my brain and my heart, even though the exercise in theory should help both. Isn't that awful????

 

Thanks a bunch,

 

-Vin

[Vinpin]

Hi FH,

 

As always, thanks for your awesome response.

 

OK, I think you have set me straight. I should have known it was more of a case of you making me understand, rather than you yourself misinterpreting.....

 

I wasn't differentiating between "bead" and "pellet" well enough – even though you explained it in your 6/15 post. I understand now, Eli’s referring to the core of the pellet as a “bead”. Confusing!!

 

Also, you are saying we shouldn't confuse "variation in diameter size" and "variation in overall pellet weight" - the pellet weight's variation would be far greater, based on the physics (and accompanying equations) of sphere volume. I see what you are saying. But this is bad news, for sure, because if for example one pellet is 0.5mm and one is 1mm, the diameter size of the larger is double (200%), but the actual weight could potentially be much more than double (given equivalent density), right??? And regardless .... the actual dulox layer, even on a fatter bead could be lower than average. Ughhhh!!!!!

 

I have a scale that I’m using to weigh Alprazolam fragments (!!), but it’s not high quality enough to weigh single Dulox beads. (1 bead doesn’t register even 0.001g, and that as “granular” as my scale goes. I may just stick with selecting a single bead by “feel”; I typically press my index finger against it to see how “meaty” or substantial it feels. I look as well, to make sure it isn’t on the smallish side diameter-wise. Can some better scales weigh down to 0.0001g?

 

I know … some readers of the post think we are really in the minutia of it all … and most people don’t want to get this far into the weeds. But for me, it helps to discuss – and to know that my rollercoaster ride of on-and-off symptoms could be due a lack of consistency in manufacturing quality control. I feel vindicated that there’s a good reason for the up-and-down ride.

 

Regarding my next steps – I’m going to go forth as mentioned, since you don’t see an obvious misstep with the approach. I’ll try to get to 0.5mg of Alprazolam per day over the next 3 weeks, then stay locked in there until the Dulox withdrawal is over. Might take a year at this point – who knows. But getting down to 0.5mg of Alphazolam will at least partially mitigate my concerns about the long term linkage to Dementia.

 

Oh, how I wish

[fishinghat]

"...because if for example one pellet is 0.5mm and one is 1mm, the diameter size of the larger is double (200%), but the actual weight could potentially be much more than double (given equivalent density), right???"

Now you are beginning to understand the complexity of the issue.

"I have a scale that I’m using to weigh Alprazolam fragments (!!), but it’s not high quality enough to weigh single Dulox beads. (1 bead doesn’t register even 0.001g, and that as “granular” as my scale goes. I may just stick with selecting a single bead by “feel”; I typically press my index finger against it to see how “meaty” or substantial it feels. I look as well, to make sure it isn’t on the smallish side diameter-wise. Can some better scales weigh down to 0.0001g?"

There is a couple options here and I will address this later today when I post on the bead weight issue.

"I know … some readers of the post think we are really in the minutia of it all."

This is definitely not minutia. As you realize when you are talking about variations of 15 to 50% you are talking about a significant effect on the withdrawal.

Don't give up hope. I have some ideas how to help this issue. More to follow.

[fishinghat]

Information from other posts


Weighing Beads
Summary

Data
 

Avg weight of a capsule/beads
Average weight of one bead is 0.001 to 0.012 grams per bead depending on brand.
Supporting data.
 

The last 6 days I've weighed my pills at .133 but most of the other pills in my bottle weigh in at .130. (Single pill weighs 0.139 to 0.133)
 

When I weigh some pills, there can be up to a 10% difference in weight
 

my .0070 ounces weighted, full, cymbalta pill, weighed .0017 ounces empty.
(Single full capsule 0.198 grams) (Empty capsule 0.048 grams) (Therefore beads equal 0.150 grams)


5 beads. It weighed .0021 ounces. (0.012 grams per bead)


30 mg pills weight the pill first in ounces and it is usually .0070 (or .0069 or .0071) .0070 is the average.
 

I'm have the pills emptied to weight .0033 on the scale (Empty pill 0.0033 grams)
 

30 mg TEVA (beads only) weighs .264 on my gram scale.
Citron 20 mg (beads only) weighs only .124 g.
60 mg Teva .501 g to .515 g ( a 2.6% difference)
 

The average bead count is 308 per capsule and the average weight is .509 mg. There are on average 5.13 beads per mg. (Their math does not compute correctly. Assuming the 308 beads weighs 509 mg then it would be 0.00165 mg/bead which does not come close to other members values)
 

My current dose is 39.37mg (bead weight of 0.230g)
 

18mg was 109g on my scale (data not accurate as 109 grams is nearly a 1/3 of a pound.)
 

These 2 brands are both 60mg. Lupin - these are the 12 little pills .275 g, Breckenridge - the little balls .334 g (334 grams per capsule)
 

Duloxetine HCL DR 60 MG CAP only weighs 43MG on my scale, which I believe to be accurate since it's brand new and is weighing 10G weights properly.
 

Each 30 mg capsule of Cymbalta is different in weight ranging from .221g - .225g. So average is FULL weight .223g. Each EMPTY capsule weighs in at .046g.Taking the average FULL capsule @ .223g and subtracting the EMPTY capsule's weight of .046g I get an average of .177g of medicine(+ fillers). (a variation of 1.8% in the weight of full capsules)(Empty capsules 0.046 grams) (Beads only 0.117 grams)


The contents of 1 pill weighs .36 (not sure the unit of measure). (probably 360 mg)


I'm down to 42 beads or around .044 grams. (0.001 mg/bead)
60mg pills in the capsule weigh .24 grams (240 mg)
a full 60mg Cymbalta weighs approx 7.7gn (I assume that is gm not gn and that value is way higher than others have obtained)
60mg capsules all contained ~210mg of beads.



Limitation of using scales

10 to 12 beads do not register on scales
 

I have to count now since the beads are too light in weight to weigh. now at 26 beads


Sense the scale became so sensitive. I had to go back to counting beans

Note: If you are reducing by only 1 or 2 beads at a time, weighing might not work for you. I've found that between 2 and 4 beads are needed to change the weight at least 0.001g.


I broke capsules apart and went by weight on a medication scale. Currently I'm counting by hand because the weight become unquantifiable to my scale.



What scales others used

https://www.amazon.c...ds=microscales
 

Gemini 20 American Weigh scale from Amazon
 

American Weigh Gemini 20 scale from Amazon for about $20
 

​https://www.amazon.c...scalemilligram


Gemini-20 Portable Milligram Scale AWS.
 

The Gemini-20 Portable Milligram Scale (referenced above) weights in increments of 0.001 mg BUT will only ne accurate above 0.15 mg. Insufficient for weighing beads.

Fast Weigh MS-500-BLK Digital Pocket Scale, 500 by 0.1 G
The MS-500 is no longer sold but the MS-600 only weighs in increments of 100 mg and would be insufficient.
 

the brand is j-scale and the model is JS-VG)
This scale reads in 2 mg increments and is not accure enough for just a few beads.
 

Why not buy a cheap powder scale that reloaders use to measure gundowder.
These gunpowder scales only weigh down to 1 to 6 grams which is not sufficient.
 
There are several key things when using/buying a good set of scales. As one member pointed out air currents effect readings at low weights. A good set of scales will need to have doors to shut when weighing.

Scales are very sensative to vibrations and all scales should be set on grommets. Grommets are usually rubber and used to ansorb vibrations. Many labs use a layer of memory film below their scales.

A food set of scales need to be able to accurately weigh down to at least 10% of the weight of your smallest object. If one bead weights approximately 0.001 grams then the scale must be able to read down to 0.0001 grams or 0.1 mgs.



Process
See...Posted by KathyInFL on 21 June 2017 (below)
 

See.... Using a Digital Scale to Measure Doses
http://survivinganti...-measure-doses/
 


See ... Weighing Dose Instead Of Bead Counting & Dealing W/ Generics
Tria - Posted 24 August 2014 - 07:58 PM (below)

[fishinghat]

Just incase you are curious these are the original posts from members and their efforts to weight beads/capsules. If reading this does not put you to sleep nothing will.  lol

Posted by KathyInFL on 07 April 2019 - 03:25 PM in Weaning Off Cymbalta
One thing, when I got down to about 10 or 12 beads I had to start counting because that few beads did not register correctly on my scale.

Posted by ForLyla on 17 March 2019 - 11:10 AM in Weaning Off Cymbalta
Currently my doses weigh .133

Posted by ForLyla on 05 March 2019 - 06:29 PM in Weaning Off Cymbalta
I think weighing is better in my opinion. Beads come in all different shapes and sizes so I don't trust that method. The last 6 days I've weighed my pills at .133 but most of the other pills in my bottle weigh in at .130. Should I bump them up to .133 or leave them as is? I also don't feel like I can 100% trust my scale.

Posted by ForLyla on 05 March 2019 - 02:49 PM in Weaning Off Cymbalta
So here is a MAJOR issue for me. I get my prescriptions from a compounding pharmacy and they don't appear to be accurate at all but I can't be sure. I've gone to two different ones and both have been the same. When I weigh some pills, there can be up to a 10% difference in weight but where I'm confused is when it comes to filler. How can we make sure our dosage is accurate accounting for what is filler and what isn't?
Should I just continue to weigh all my doses and adjust them to the same weight? My current weight is 0.133 but some pills weigh as low as .122. That's a rather huge difference.

Posted by Tiredcymbaltamom on 15 February 2019 - 01:31 AM in ARE YOU NEW HERE? Words from the wise about Cymbalta
Well tomorrow is my surgery. Note to those who use a jewelry weight to weigh the pills to determine how to reduce, weigh and full pill and then remove all beads into a bowl and weigh an empty pill. THEN you will know what you are reducing.
So, that same day, I realized my .0070 ounces weighted, full, cymbalta pill, weighed .0017 ounces empty. The day before I was down to .0024 or 25. I can't remember. I obviously reduced too fast, but now the bandaid was pulled off. So today I finished a pill off at 5 beads. It weighed .0021 ounces.

Posted by Tiredcymbaltamom on 09 February 2019 - 06:03 PM in ARE YOU NEW HERE? Words from the wise about Cymbalta
The first day I had the really sick feeling, I added more and it seemed to bring relief. That's why I was wondering if my system isn't getting the amount it wants.
I have 30 mg pills and a jewelry scale. I weight the pill first in ounces and it is usually .0070 (or .0069 or .0071) .0070 is the average. Right now I'm have the pills emptied to weight .0033 on the scale. The first days I weighed and i felt good for 3-4 days I was doing .0028. So I don't know if after a couple days I went through withdrawals and now I'm in a somewhat constant state of withdrawal, or if .0028 was good and I should have kept going or at least stayed there. I moved up my amounts to the .0040 range after I felt the worst, but now I'm just constantly feeling a little yucky until I take the pill and then I feel awful.

Posted by invalidusername on 31 January 2019 - 10:01 AM in ARE YOU NEW HERE? Words from the wise about Cymbalta
Some other users opt for micro scales to alleviate the stress of bead counting. The following would be ideal;
https://www.amazon.c...ds=microscales
This way you can weigh the beads rather than count them - and if some of them are stuck together and are different sizes, this would be a better way to go as it would be more accurate.
Therefore, if you get the scales, you would put a small container on, zero the reading, empty the beads from one capsule out, and for arguments sake, we'll say it reads exactly 20mg. Then simply canter beads into another container off the scales and re-weigh. When you reach 10mg, you will have both containers with the right amount. Put both back into a capsule each - and it is job done! 10mg capsules of Cymbalta!

Posted by gardenlady on 13 December 2018 - 07:34 PM in Weaning Off Cymbalta
I am having to switch to Citron brand from TEVA brand generic because TEVA is backordered and may no longer be available. However, the weights aren't making sense. A 30 mg TEVA (beads only) weighs .264 on my gram scale. The Citron 20 mg (beads only) weighs only .124 g. I don't have a Citron 30 mg or a TEVA 20 mg to weigh, so am having to compare, proportionally. However, these proportions don't make sense.
20 mg is 2/3s of 30 mg. So, if a TEVA 30 mg weighs .264 g then logically, a 20 mg should weigh .174 g. However, the Citron 20 mg weighs only .124 g. Something is wrong.
The bead sizes are different...the TEVA beads are larger than the Citron beads. But, the weights should be the same, or shouldn't they? Perhaps that assumption is incorrect.

Posted by gardenlady on 04 August 2018 - 04:57 PM in Weaning Off Cymbalta
I reweighed and recounted eight 60 mg Teva duloxetine capsules (they all weigh different amount and have different bead counts). The beads numbered anywhere from 300 to 314 per capsule and the weights ranged from .501 g to .515 g on my Gemini 20 American Weigh scale from Amazon. The average bead count is 308 per capsule and the average weight is .509 mg. There are on average 5.13 beads per mg.
I developed a spreadsheet that tells me what dose I am on depending on bead count and weight. Yesterday and today, I'll take 179 beads which weighs about .298 g and comes out as 34.9 mg. As you can tell, I've become obsessed with this taper and the mechanics and arithmetic surrounding it. I wish I could get interested in something else, but I can't.

Posted by KathyInFL on 14 July 2018 - 01:53 PM in Weaning Off Cymbalta
I'm talking 10 beads a day now, I'm going to reduce 1 per week and see how that goes. I'm doing well. I have to count now since the beads are too light in weight to weigh.

Posted by sparkybird on 17 February 2018 - 01:31 PM in ARE YOU NEW HERE? Words from the wise about Cymbalta
I have also been withdrawing from 20 mg of the generic Cymbalta. I started my journey in May 2017. It has been very hard at times. I started with counting beads.

With my head swimming at times and having to count more than once or twice, I just cited to purchase a scale. I continued with the with drawl using the scale until approximately 35 beads were left. That was using a 5% reduction every 7 to 10 days.

Sense the scale became so sensitive. I had to go back to counting beans. I am now at 26 beads. I started the reduction at one bead every two or three days. That has gone well with no side effects. I have now just cited to do the one bead reduction every two days. If that proves unsuccessful I will go to every three days before reducing a bead.

Posted by gardenlady on 12 February 2018 - 10:09 PM in Weaning Off Cymbalta
I have found that weighing beads on a gram scale is much easier and faster than counting beads, especially when working with 60 mg capsules. I'm 65 and find that it's very difficult on the eyes to count beads. I ordered an American Weigh Gemini 20 scale from Amazon for about $20 and it works great for this purpose.

Posted by gardenlady on 09 December 2017 - 05:08 PM in Weaning Off Cymbalta
FH, Do people do this daily micro taper that you suggest with a scale? If so, that means I'd have to weigh my dose everyday which concerns me as the scale isn't very reliable and I wonder about the accuracy with cuts this small. Currently, I weigh a month's worth of capsules at once so there is less variability as I'm weighing them all at one sitting. But, turning the scale off and on affects consistency...these are cheap scales and you get what you pay for.

Posted by cminsd on 16 October 2017 - 06:51 PM in Weaning Off Cymbalta
I have a little scale that I use to weigh the beads and make my own pills. My current dose is 39.37mg (bead weight of 0.230g). The plan that I have now has 34 phases, each lasting two weeks. That is about one year and four months until my last dose.

Posted by KathyInFL on 12 October 2017 - 01:26 PM in Weaning Off Cymbalta
18mg was 109g on my scale. I am filling capsules with 100g now. I will just keep at this slow wean.

Posted by KathyInFL on 23 June 2017 - 08:08 PM in ARE YOU NEW HERE? Words from the wise about Cymbalta
Very strange. I'm confused. I don't know the unit of measure so I just wrote down what was on my scale. I weighed the meds w/o the capsules. These 2 brands are both 60mg.
Lupin - these are the 12 little pills
.275 g
.0097 oz
4.26 gn
.177 dwt
1.375 ct
.0089 ozt
Breckenridge - the little balls
.334 g
.0118 oz
5.16 gn
.215 dwt
1.670 ct
.0107 ozt

Posted by KathyInFL on 21 June 2017 - 09:48 PM in ARE YOU NEW HERE? Words from the wise about Cymbalta
I think my above answer was pretty confusing, I've re-written it in another post and am copying it here:
1. Make sure you have a brand that has the tiny beads, some 60mg have about 300 balls.
2. Empty, exactly weigh and average 3 capsules. Let's say the average weight is 43.33MG.
3. You have to decide how fast you are going to wean. I'm weaning 5% every 2 weeks.
4. Let's say you are removing 5% for 2 weeks. Open a capsule, weigh the contents and only return 95% (41.16MG) of the beads back to the capsule. Don't throw out the 5%, this amount will grow so you can make extra pills for empty capsules you can buy.
5. I make 7 capsules at a time. I stay on the same amount for 2 weeks, and after that I wean down 5% more (so weeks 3 and 4 I take 90% of the 43.33MG). I've been told when I get down to 10 or 20 mg, that 5% will be too big of a wean. If so, I will go down 4, 3 ,2,1 percent until I find what works.

Posted by potatoes on 21 June 2017 - 08:56 PM in ARE YOU NEW HERE? Words from the wise about Cymbalta
So I ordered a milligram scale so I could begin the process of weaning myself off Cymbalta, but now I'm confused how to do so...
My Duloxetine HCL DR 60 MG CAP only weighs 43MG on my scale, which I believe to be accurate since it's brand new and is weighing 10G weights properly.

Posted by crbach on 22 April 2017 - 06:38 PM in ARE YOU NEW HERE? Words from the wise about Cymbalta
I can't measure that small of an amount on my scale. To get any kind of a measurement, I would to have to start off at a minimum of .001 grams per day and once I get some sort of measurable daily base total of medicine (4-5 days), then I think I could guess at that .0005 grams per day.
OR..rather than guessing at .0005 grams...what about starting off .001 grams every other day..this way I could actually measure out your suggested .3% taper or .0005 grams per day over a two day period. Could start off slowly like this, monitor, and build it up to more if after the first 2 weeks things are progressing without incident.
And that is the purpose of this post..I need help figuring her Cymbalta Taper daily dosage for the remaining 30mg.
Remember, I have the generic form of Cymbalta, so bead counting is "out" and using my new digital scale is "in".
-Each 30 mg capsule of Cymbalta is different in weight ranging from .221g - .225g.
I weighed out five 30mg Cymbalta capsules and all five were different in weight. Bummer..
So average is FULL weight .223g.
-Each EMPTY capsule weighs in at .046g.
-Taking the average FULL capsule @ .223g and subtracting the EMPTY capsule's weight of .046g I get an average of .177g of medicine(+ fillers).
I'm going to be emptying a bunch of capsules into a container in which I can store the medicine without the unnecessary capsules. Then I will pour the medicine onto the scale for the daily allotted amount. Then I will pour the weighed amount into new capsules that I've already purchased, and BAMB..new daily dosages brought to you by CRB. I'm thinking this would be the easiest way to accomplish the daily reductions.

Posted by KathyInFL on 08 March 2017 - 09:37 PM in Weaning Off Cymbalta
Today was my 3rd cut of C. I got the Citron brand this time. I bought a scale because I don't have the patience to count the 300+ little balls. Since I was on 83% of a full pill, I went to 95% of that.
This is how I have to calculate:
1. The contents of 1 pill weighs .36 (not sure the unit of measure).
2. I was on 83.33% of a full pill up to this point = .2999
3. 95% of that is .285. I decided to go down only 5% at first to see how this weighing thing works out.

Posted by crbach on 23 December 2016 - 05:58 PM in ARE YOU NEW HERE? Words from the wise about Cymbalta
​As for a scale, I found one on Amazon like you suggested that has a good rating. Won't be in again until after Christmas, but looks good.
Here is the link:
​https://www.amazon.c...scalemilligram

Posted by jennjak on 12 July 2016 - 12:38 PM in Weaning Off Cymbalta
After getting down 50 beads looking at the capsule it appears to be approx 2/3 full, which to me would indicate I'm ready for the 20s...
Sooo I went to 2 pharmacies and asked if they would please weigh the 30mg capsule less 50 beads to see if it was 20mgs. The first pharmacy basically told me I was ducking crazy get out of here with that nonsense we won't do that for you. Great. The 2nd was willing to weigh the beads for me...0.140g, or 140mgs!! Wtf?? She said this is not an accurate way to taper because there are fillers surrounding the actual medicine, so some weigh more than others and there is no way to truly weigh the medicine itself.

Posted by Menolly07 on 22 March 2016 - 10:34 PM in Weaning Off Cymbalta
Initially, I broke capsules apart and went by weight on a medication scale. Currently I'm counting by hand because the weight become unquantifiable to my scale. I did a super slow gradual taper, taking out five more beads every fourth day.

Posted by ralphi on 14 November 2015 - 02:40 PM in Weaning Off Cymbalta
Hm, I think my scale may have been the problem! Was re-measuring to stay at 42 beads for a few days, started counting and some caps only had 30-something beads?! I weighed before and thought 1 bead = .001 gram, but that doesn't seem to be accurate. Add to that my scale needs calibrating and I've lost the weights.
Do I get a new scale or keep counting? Obvs will count until a new scale arrived, at any rate
I'm refilling for the last time and made sure to get the exact same brand that I'm taking, so brand variations shouldn't be a problem.

Posted by ralphi on 14 November 2015 - 02:35 PM in Weaning Off Cymbalta
I'm down to 42 beads or around .044 grams.
Taking out 1 bead per day.
My scale seems to be a little inconsistent with weighing that small of an amount. Like, if the heater is running and blowing air in the room, it'll throw the weight off.

Posted by thismoment on 19 June 2015 - 01:34 AM in Weaning Off Cymbalta
A weigh scale needs to accurately measure to .001 of a gram, and the reviews online are all over the map-- it'll cost about $100. with no real guarantees of accuracy. I've tried both weighing and bead-counting and prefer to count beads. I know the number of beads varies from capsule to capsule, but that doesn't matter-- count the beads in a few capsules and work out an average number and work with that.

Posted by Sfava987 on 18 June 2015 - 07:12 PM in Weaning Off Cymbalta
I do have a gram scale, but it rounds to the nearest gram, and so far, going down 1gram for two weeks has not been good for me. If I need to go down only half a gram, I would need another scale. And using bead counting can't be accurate when weaning slowly either. Any and all opinions and advice would be greatly appreciated.

Posted by FiveNotions on 11 October 2014 - 04:26 PM in ARE YOU NEW HERE? Words from the wise about Cymbalta
Using a Digital Scale to Measure Doses
Started by AltoStrata in 2011
http://survivinganti...-measure-doses/

Posted by ShadyLady on 19 September 2014 - 11:29 PM in How to Find Support
Welcome, Joe...i ain't the one that knows about weighing;). There is a 'Search' bar at the top of the page and if you enter Weighing Dose Instead of Bead Counting, there is an excellent post written with the details of how to weigh the doses. It was posted by our member, Tria, the pro in that department, of using that scale and her method she fine tuned.

https://www.cymbalta...ics/#entry47540
Weighing Dose Instead Of Bead Counting & Dealing W/ Generics
Tria - Posted 24 August 2014 - 07:58 PM
I know the majority of the people here use the bead counting method for weaning but thought I'd share my experience with weighing the dose and dealing with generic Cymbalta, especially if you keep getting drugs made by different manufacturers. Ideally, I'd stay with the brand name Cym, but I really can't afford. Sometimes, the pharmacy can order a generic by the same manufacturer but this hasn't been the case lately so I came up with a way to be ensure that my dose stays the same when I have to switch manufacturers. Bead counting has obviously worked for lots of people here but thought I'd share this in case anyone's interested.
Note: If you are reducing by only 1 or 2 beads at a time, weighing might not work for you. I've found that between 2 and 4 beads are needed to change the weight at least 0.001g.
This is the method I came up with for weighing my dose. I read online about someone else doing it, and took their instructions then tweeked them a bit. Weighing my dose sounded intimidating at first and it took some practice but please don't let all these instructions scare you! I'll be happy to help anyone who's interested or has any questions.
Getting Started:
1. You'll need a scale. I ordered mine from Amazon. It's a Gemini-20 Portable Milligram Scale AWS. Weighs down to 0.001g. I think it was around $25, not exactly sure. Follow the instructions when you get the scale on how to calibrate it.
2. You'll also need a calculator, pen & paper, dark colored towel (or piece of paper or cloth), and two small cups (like the kind that come with cough syrup). If you want to save your extra beads, you'll need an empty container for this as well.
3. Turn the scale on, place the small round tray on the scale and press the Tare button. This removes the weight of the small round tray. My scale came automatically set to grams but be sure that's what your unit of measure is (it will have a little "g" on the display). If it's not grams, there are instructions on how to change it.
4. If you are already bead counting, open a capsule of your current dose and pour the beads into one of the small cups. Then pour them onto the small tray on the scale. (I find it easier to pour from a small cup vs directly from the capsule, but you can try pouring from the capsule also.)
5. Note the weight displayed on the scale and write it down. This is your dose in grams. Also write down how many beads, and if this is the brand or what generic manufacturer it is. Ex: 60 beads = 0.057g - brand name Cymbalta. (made up these numbers to use as an example.)
6. Remove the tray from the scale, and pour the beads back into the capsule over your dark colored surface. This way you can see if any beads escape and you can use the tweezers that come with the scale to put them back in the capsule.
7. Now, open a full capsule and weigh the beads. Write this down and keep it as you may need it if you have to switch to a generic or switch generic manufacturers. Pour the beads back into the capsule.
A note about the scale - it will turn off after a short period of inactivity (which is annoying).
Weighing Your Dose:
(I usually weigh a week's worth of capsules at a time)
1. Turn the scale on, place the small tray on the scale and press the Tare button. The display should reset to 0.000g.
2. Open a full capsule, pour the beads into a small cup then pour then slowly onto the tray until the display reads close to your dose. Using the tweezers, add or remove beads to reach your exact dose. I've found that between 2 and 4 beads are needed to change the weight at least 0.001g. Sometimes the scale goes back and forth and you have to keep removing or and adding beads to get that right dose, which can be frustrating. I guess this happens because not every bead weighs exactly the same.
3. Try to keep the beads spread out evenly in the center of the tray. I've found this helps getting a more exact measurement.
4. Pour the beads back into the capsule.
5. I usually weigh mine twice just to be sure, so just repeat the steps above. The scale is very sensitive so even air blowing over it or breathing on it can affect the weight.
6. Pour the beads left in the small cup into your second small cup and begin weighing your next capsule.
7. If you are saving the beads, pour them into your container when you're done with all your weighing and label the container with the manufacturer and dose (20mg etc). DO NOT MIX beads from different dosage capsules or from different manufacturers.
Reducing Your Dose:
1. When you need to reduce your dose, you'll need to figure out how many micrograms you'll have to reduce it by.
2. If you were reducing by 10 beads, weigh 10 beads on the scale and see how many micrograms that is. Write it down.
3. Now, take your current dose (ex 0.057g) and subtract the weight of the beads you got in the previous step (ex 0.002g).
This will give you your new dose (ex 0.055g).
4. You can choose to reduce your dose by micrograms or you can also choose to reduce your dose by a percentage rather than number of beads. Take your current dose and times by a percentage then subtract the result from your current dose. (Ex 0.055g x 5% = 0.0275g. 0.055 minus 0.003 = 0.052g).
Changing from a Brand to a Generic or Switching to a Different Generic Manufacturer:
Ok, this truly drives me crazy! If you can, stick with the brand name or at least see if you can get the same generic manufacturer each time you fill your prescription. If you're like me and can't do either of these, here are some things I've found that may help ensure steady dosing.
Not all manufacturers have the same number of beads in a capsule, and the weight of the beads can also vary. I've discovered that some aren't even close. The beads in a 20mg capsule of the brand name weigh 0.106g. The beads in a 20mg capsule of the generic made by Citron weighed 0.124g. So if you need to switch and are weighing your dose, here's what you can do. Bear with me, this may seem complicated. It took me and my mom to figure it out, then running it by my pharmacist to be sure I was figuring it correctly. Whether you want to try this or not depends on how precise you want your dose to be. I seem to be very sensitive to any change in dose, so we came up with this to ensure the amount of medicine I was getting was consistent. If you switch manufacturers and just keep using your same dose in weight (ex 0.057g), you will probably be close to the same dose of medicine.
1. Open a full capsule of your current manufacturer and weigh all the beads. Write down the manufacturer and the weight.
2. Note your current dose in weight for this manufacturer.
3. Ex - full capsule = 0.124g = 20mg Citron generic current dose = 0.055g
4. Now divide your current dose by the weight of the full capsule (Ex 0.055 divided by 0.124 = 0.4435)
5. This translates into 44.35%. In other words, your current dose is 44.35% of the full dose.
6. Next, weigh the beads in a capsule of the new manufacturer you will be switching to.
7. Write it down. Ex - full capsule = 0.129g = 20mg Actavis generic
8. Now times that weight by the percentage. (Ex full capsule of new generic = 0.129g x 44.35% = 0.057g)
9. This weight (0.057g) will be your dose on the new generic. Again, write it down.
10. If you have to switch manufacturers again, follow these steps.
I know this sounds confusing! It still sounds confusing to me, and I've been doing this for a while!! But trust me, it does work! If anyone has any questions or suggestions, please let me know!

Posted by JellyRoy420 on 06 March 2014 - 03:19 PM in Weaning Off Cymbalta
I have been taking an india made genertic for about 4 years and when i looked at the beads they seem to be different sizes, which i know happens. So i got my scale out and the 60mg pills in the capsule weigh .24 grams so i divided the weight by 4 and just took out .06 of weight to get a 45 mg pill instead. Im going to take 45 mgs for now but im not too sure when i should transition to the 30 mgs? From the 30mgs i was thinking about going down by 10 mgs at a time. So now its 60 to 45 then onto 30, 20, 10. I still don't know if ill need to go to 5 mg before stopping completely but ill decide that when the time comes. So far on day 2 of 45 mgs, im doing very well.


Posted by truckprincess on 29 October 2012 - 07:58 PM in What are you feeling?
OK so my motion sickness med kicked in and much better other than slight headache. I have decided to purchase a weigh scale for the tapering. If anyone is interested it's the Fast Weigh MS-500-BLK Digital Pocket Scale, 500 by 0.1 G very cheap on ebay for $6.99 free shipping. Cheap on amazon as well. Was going to order some empty gel capsules but figured I might as well wait until I am closer to needing them if I need them. For anyone wanting to do this and unsure on how to calculate say from 30mg to 25mg there is an online dosage calculator you can use. But it's very easy to configure. All you are doing is taking the amount wanted say the 25mg and dividing it by 30mg (dose available) to get 0.83 for the capsule. I don't know for sure until I get the scale but think I will have to then convert that mg to grams but that's pretty easy too and for anyone who needs to just find an online conversion chart. I think that by doing this will give me a much more accurate way of tapering rather than trying to count the little beads.

'Jnine', on 31 Oct 2012 - 09:10 AM, said:https://www.cymbalta...dpost&pid=26394
FYI a full 60mg Cymbalta weighs approx 7.7gn and I am down to 6.2gn. I will continue to try to stay at that amount this week and lower once again on Sunday Night.

Posted by cymlbc on 25 February 2012 - 05:31 PM in Weaning Off Cymbalta
Since I had a bunch of 60mg capsules and didn't want to pay for a whole new 20mg script, I decided to use a milligram scale to help me along.

I purchased a milligram scale from ebay (I think the brand is j-scale and the model is JS-VG) for under $50. I've attached a picture of the one I've got.

I dumped out the contents/beads of a 60mg Cymbalta capsule and I determined that the 60mg capsules all contained ~210mg of beads.

I did the math and figured out:

20mg=70mg of beads, therefore, 1mg of active drug=3.5mg of beads

I would weigh out 70mg of beads and fill capsules I bought at the healthfood store which gave me 90 (20mg dosage capsules, weighing 70mg of beads each).

Now that I have decided to come off Cymbalta, I will do the same, but in reverse.

My plan is to reduce my dosage by 1mg daily until I get down to 0.

I hope this is helpful to you.. I know it made life a LOT easier than counting beads, which I ended up spilling all the time.


Posted by Rico on 07 December 2011 - 04:56 PM in Weaning Off Cymbalta
Why not buy a cheap powder scale that reloaders use to measure gundowder. Weigh the full dose and do the math. Just dump the pellets slowly till you get the correct weight.


Posted by anothersideofme on 20 August 2010 - 11:26 PM in ARE YOU NEW HERE? Words from the wise about Cymbalta
So...I purchased a jewelers scale and it came in yesterday. I calibrated it, then weighed about ten of my 60 mg. pills. They are different weights! I guess when I start the wean, I will weigh about a weeks worth and take the average, divide it by the amount of my drop and make each pill for that week weigh the same.


Posted by livingdeadgirl on 06 April 2010 - 01:26 AM in Weaning Off Cymbalta
Per Eli Lilly standards, there should be 67.3 mg of duloxetine HCI in each 60 mg. capsule. If you truly want to be accurate, I strongly recommend you purchase a digital scale that measures milligrams, and has a low margin of error(mine is to 0.01g). You can purchase on the internet or in stores a very accurate digital scale to weigh the pellets/beads to make very accurate tapering capsules. I bought empty gelatin capsules at Vitamin Cottage, but they are also available on the internet or at several other stores such as GNC and Walmart. To ensure your scale is operating at the highest possible accuracy at all times, it is highly recommended that you order the official calibration weight to recalibrate your scale regularly.



 

[fishinghat]

Possible solutions to follow...

[fishinghat]

Solutions to the problem

 

             The correct analytical balance.

A good analytical balance like this one...

 

https://www.amazon.c...8-9-spons&psc=1

 

will weigh down to 0.1 mg but they cost over $1000. OK, so we will consider that just too expensive. Even if you were to buy one it is obvious from the posts that many people have a hard time correctly using a balance or doing the required mathematics

.
Using a sieve

Right now if you were to weigh beads you are at the mercy of random chance for what bead size you will get. Now that is not a problem if you are at 40 or 50 beads as it will average out but it is clear from what members have said that below say 20 beads it becomes an issue. One way to deal with that is too obtain a US mesh size sieve that will generate a fairly standardized bead. According to Eli Lilley's patent they are producing pellets in the 0.5 to 1.5 mm range (18 to 35 US mesh).

 

If a person could fins two mesh sizes close to each other then they could strain the beds to a point where there was little variation. One would want to start with a large US mesh which is a very small mm size. For example a 30 nesh will be a pore size of 0.6 mm and a 35 mesh would have a pore size of 0.5 mm. While a 0.6 mm bead would be 39% heavier than a 0.5 mm bead you are only talking about approximately a 1 mg bead minimum and a 1.39 mg bead max. The following has those size ranges.

 

https://www.amazon.c...ustrial&sr=1-21($40)

 

This is the closest I could come in finding two meshes that were in the small end of the range and were close to each other. The big problem is that one brand may have bead sizes in that range another brand might only have larger bead sizes and a different size sieve would be necessary.
 

[Vinpin]

Having some technical difficulties with the forum on this end. To finish my thought above...

 

"Oh, how I wish I could do it all over again and stay away from this junk"

 

Going to read all your new posts now FH. But, thanks in advance for all this incredible research.

 

Best,

 

-Vin

[Vinpin]

Oh FH - I cannot believe you've done all this work. I am speechless....

 

So, in short, a sieve with appropriately small mesh size is the way to go. Sounds like you are suggesting two sieves - one 30 mesh sieve and one 35 mesh sieve. It looks like they are $20 each on Amazon - cost is very reasonable, but really, anything that lessens the risk of hitting on a bad bead and suffering the horrible symptom consequences would be worth its weight in gold (except that crazy $1,000 scale , especially since equivalent weights don't guarantee equivalent Dulox potency, anyway.....)

 

But, some good news - I may be able to use the sieve approach without even having to buy the mesh sieves you've pinpointed on Amazon. I do mosaic art work, and a few months ago I had a desire to make my own "frit". All frit is is vitreous glass ground up into different sizes of granularity - usually five different granule sizes (pieces/large/medium/fine/powder). This YouTube video shows how to make frit:

 

 

The videos shows five sieves used to make the frit. As luck would have it ...... I already own a set of five sieves very similar to the ones in the video!!! (I could use a little luck these days ......)

 

Another bit of luck .... when I set up my Cymbalta dose capsules for the upcoming week each Saturday, I start by opening a 20mg Duloxetine capsule (having ~ 80 beads), and dump the contents out. Then, I take a "plump" bead  and place it into one of my pre-purchased, empty Vegan Enteric Capsules. I take a total of three beads (one for each 8 hour dosage), so that means I have about 77 or so beads leftover. Although I do wind up throwing some out over time, I've been keeping a good size inventory beads all along, thinking there might be a reason to use them in the future (for example, to have an emergency stash in case for some horrific reason I cannot fill a prescription, or I get changed to a new manufacturer that doesn't seem to work well for me). I think I have several hundred at least.

 

Well, the future is now!!! (lol). I will take the full allotment of these leftover beads, and run them through my sieves. We will see how the beads separate, I will tackle this tomorrow and summarize my findings in a post soon after. I think my smaller frit sieves might correspond with your suggested 30 & 35 mesh sizes. If not, I can always by the two you have suggested.

 

I say these all the time - but sincere thanks FH for taking the time to help me.

 

Best,

 

-Vin

[fishinghat]

Your very welcome Vin.

 

I am sure you figured it out all ready but you sift the beads through the #30 mesh (larger mesh) screen first to remove everything over 30 mesh. The ones that go through are size 30 or smaller. Take those and screen them through the #35. The ones that stay in the sieve will be between 30 and 35 mesh.

[Vinpin]

Yup, got it FH. The process may be slightly different because I'm not sure my frit sieves translate exactly to 30 and 35 mesh - but I bet they are close.

 

Going to work on this right after I finish my breakfast smoothie. Will be back in touch with results!

 

-Vin

[Vinpin]

Oh jeez - it didn't work out for me. So much for my brilliant ideas .....

 

Just about every bead fell through my 2nd finest sieve, and were caught by my finest sieve. Only about 8-12 were caught by the 2nd finest, and given another good shake, about half of those fell through to the finest sieve. I could possible pick out those 4-6 that were left ..... but overall I probably need a higher proportion of beads to fall into the larger group.

 

I will purchase 30 & 35 mesh sieves you have recommended, FH. Since they are on Amazon Prime, shouldn't take too long to get.

 

Will report back with my findings as soon as I can!

 

-Vin

[fishinghat]

Nice try. Not all manufacturers of Cymbalta produce #30 to #35 beads so to get an idrea of your bead size I think it may be prudent to roughly determine the size of your finest sieve you already have.

 

An example...A #30 mesh screen has 30 wires per inch in both directions. So using a ruler to measure off one inch square on your finest and second finest mesh and counting the wires will tell you their mesh size and all of your beads will be between those two mesh sizes That will get you in at least the ballpark..

[invalidusername]

If Eli Lilly could see this now..

[Vinpin]

FH,

 

In retrospect, the finest sieve was not worthwhile at all for the intended purposes. I wouldn't be able to measure the wires per inch as you say, because I cannot even see the individual mesh wires and gaps between them. From another perspective ........ when I make frit, only a very fine sand falls through it. Even grains of salt would probably not make it through it. So, there in lies the problem - there is too big a gap between mesh wires between my finest and 2nd finest frit sieve.

 

It sounds like the #30 mesh & #35 mesh sieves will be much better. They are already on the way from Amazon.

 

IUN: LOL, agreed. But, for all we know, they may be reading our posts on these forums. They probably couldn't care less about our struggles. As long as our struggles and desperate measures don't become "too public", then there is no "negative PR" effect that would impact their precious profits.  

 

I'm glad I never followed a profession that led to a product/decision/end result that helped some but recklessly harmed so many others. I just can't disregard morals and ethics the way so many people do - not just in big pharma, but more and more commonly everywhere in our society. It's just not something in my DNA makeup.

 

-Vin

[invalidusername]

We have quite a high Google position with Cymbalta withdrawal search terms, so it wouldn't surprise me if there were some of the "officials" snopping around here - but like you say, I sincerely doubt they give a flying f---

 

[Vinpin]

Good morning friends,

 

Some recent happenings with me:

 

• Unfortunately, I'll be waiting on my ordered sieves awhile longer. They were ordered on 6/19, and shipped on the same day, but Amazon shows an expected delivery date between 7/10 & 7/31. Amazon's tracking does not show the country of origin, but I suspect they are being shipped via International "snail mail" from somewhere in Southeast Asia - probably China. Until then, I will continue to "feel" the size of the individual beads with my index finger, selecting only the "meaty" ones for my capsule dosages.

• My Psychologist was able to provide a referral to another Psychologist that has specialized knowledge in Pharmacology. According to my Psychologist, this new Psychologist commonly receives patient referrals made by doctors who would like to wean off SSRIs, Benzos and prescription sleeping meds. I have an appt to see her (the new one) tomorrow (6/26). My own Psychologist has provided some feedback and confirmation on the entire weaning off process I've undertaken --- but really, she isn't super-knowledgeable about Withdrawal effects - she is more sympathetic than anything else. This new Psych, hopefully, will have more critical feedback - and specifically, can provide more guidance on how, ultimately,  to best come off both Duloxetine & Alprazolam completely. Of course, I will be weighing her recommendations against the sublime, wise recommendations make by FH, IUN and others on this site. I am my own CHO!  (Chief Health Officer)

 

Also, There is a new study that was published in JAMA recently regarding the link between long-term usage of anticholinergic drugs and an up to 50% greater risk for dementia. For those who do not know, "Anticholinergic" drugs work by blocking the effects of acetylcholine, a substance that transmits messages in the nervous system. Benzodiazepine antidepressants (most notably for me, Xanax/Alprazolam), are the anticholinergic drugs that seems to have the greatest increased risk (30%-50% greater risk). And, although SSRIs & SNRIs like Cymbalta/Duloxetine are not part of this study because they have "low" or "minimal" anticholinergic effects - that doesn't mean they has zero anticholinergic impact. In fact, one piece of journal literature I read explains that Effexor  and Wellbutrin has even lower anticholinergic impact than Cymbalta/Duloxetine.

 

CNN.com featured this as a news item yesterday: the link is:

 

https://www.cnn.com/...tudy/index.html

 

If you read the article, keep in mind one important point - just because study findings cannot be represented as "causal" doesn't mean they aren't indeed causal. In fact, in my opinion, they most likely are causal - they just cannot be presented as such, because the studies are observational in nature in a uncontrolled setting - where many other mitigating factors could, in theory, have some causal impact. The medical research community rarely provides proof of causation in their studies - it just isn't possible and/or practical in the world we live in. However .... we, as actual patients, should err on the side of extreme caution and assume causation as a likely occurrence.

 

This research adds important insight into the likely ramifications of these reckless medicines. We shouldn't choose to conveniently ignore what the research is trying to telling us - it is there to educate us, protect us and give us the power to make more informed decisions. It is trying to tell us what Pharmaceutical companies will not - that these drugs are dangerous and reckless, and should only be a "last resort" for those whose depression is super-extreme (e.g., psychosis, suicidal tendencies), or possibly, if you feel you've reached the very end of your rope in terms of hopelessness. But, I feel strongly these drugs are not for the rest of us....

 

And now, I will press on with my headache, anxiety and dizziness and fear of seizures..... feeling confident that I am making the right decision to come off these dangerous medicines ..... knowing one day this will all be worth it ....

 

-Vin

[fishinghat]

The full article is at...

https://www.ncbi.nlm...les/PMC2697587/

[fishinghat]

Anyone interested in this subject should read...

https://mentalhealth...ticholinergics/

It is a very good overview of what medicines have this effect and why.

[fishinghat]

This is a list of anticholinergic drugs and its relative risk.

https://ephor.nl/wp-...ergic-drugs.pdf

[invalidusername]

Interesting update Vin - will be very interested to read how you get on with this super-duper pharmacologist. We need more of these and it is a shame that so few people are aware that such people have a far greater working knowledge than a majority of gp's. Most people think of them just working in a shop like a post office or newsagent, but truth of the matter being that they are very well educated men and women of whom are only too glad to speak to people about their drug issues and concerns.

 

Mine is from the far east somewhere, I am not good at specifying where exactly, but I would trust his opinion greater than that of my GP.

 

Please keep us all posted Vin.

[Vinpin]

Will do, IUN:

 

FH: I mentioned in my post that Cymbalta/Duloxetine has a "low" (or "minimal") anticholinergic effect, as per one source I found.... yet, some other sites listing anticholinergics don't include any SSRIs or SNRIs at all. Do you have any insight into this? Is it a difference in how one might define "anticholinergic"? Or possibly, does is possibly have to do with the lack of knowledge of whether SSRIs/SNRIs have the actual chemical makeup of an anticholinergic?

 

Thx,

 

-Vin

[fishinghat]

OK Vin. I have been trying to post this since yesterday evening and couldn't even get on the site. N0w I am on but it still won't post so I am going to try and load it one small section at a time.


An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. (Wiki)


So the strength of a compounds anticholinergic acidity is based on its affinity for the acetylcholine receptors.

"Duloxetine has no significant affinity for dopaminergic, cholinergic, histaminergic, opioid, glutamate, and GABA reuptake transporters, however, and can therefore be considered to be a selective reuptake inhibitor at the 5-HT and NE transporters."