8 replies to this topic

[Khamla64]

Hello Everyone,  I am so pleased to find this forum.

 

I am a 54 year old female with a long history of major depression. Cymbalta user for 10 years. I suffered excessive sweating when I first started taking it but otherwise have not had major side effects. Based in Australia.

 

Currently very well and under my doctor's and psychologist's guidance am slowly tapering my Cymbalta dose. I have been taking 60mg morning and night which is quite high - so that's why I am tapering at the moment. 

 

I started about 2 weeks ago. Taking 30mg in morning and 60mg at night every second day - continuing usual dose every other day.

 

it is summer here and it is hot and humid in my city. Since the third of fourth day of tapering I have  experienced increased sweating at night around my neck, the back of my neck and scalp.  I have also developed hives / heat rash  type of tiny bumps / urticaria on the back of my neck and my scalp. It gets raised and red and itchy and then calms down if i use a cold compress. Cold showers/ rinses help too.  Avoiding any sweating or exertion helps too. pretty difficult to do in the middle of summer. 

 

I have used antihistamines which help a little but am trying natural remedies and just trying to keep cool.

 

I would appreciate any information about histamine reactions when tapering or how Cymbalta may inhibit or alter histamine functions.

 

Thanks so much  

 

 

 

 

[fishinghat]

Welcome Khamla64


First of all the every other day thing is a bad idea, You raise your blood levels one day and lower them the next. This repeats miniwithdrawals over and over. I would recommend the bead counting method.

Bead counting, is where you open the cymbalta capsule each day and remove a few beads, usually 2 or 3 (1%). So the first day you remove 3 beads, the next day 6 beads, the next 9 beads etc. This provides for a slow steady withdrawal. If symptoms get to bad you just hold at that dosage for a while until you stabilize. Then start dropping again. Be aware that for most the last few beads give the worse withdrawal. Be prepared to slow down when you get to the very end. Now this is just an example. Some can only remove 1 bead a day and others 7 or 8 beads a day. You will have to play with it a little bit to find what works for you. This doesn't mean you won't have withdrawal but it will be lighter and you will have some control over it.

As far as the histamine reaction, I will do a little digging. I know many drs recommend hydroxyzine when taking Cymbalta or during withdrawal and there seems to be little issue with that but I will check the medical journals. Be back soon.

[fishinghat]

Considering that Cymbalta does not react with the H1 histamine receptor I would not expect any interference with an antihistamine reaction mechanism

 

Cymbalta histamine reactions
https://www.ncbi.nlm...pubmed/21366359
An increase in gastric pH produced by histamine H(2)-receptor antagonists or antacids did not impact the absorption of duloxetine.

https://www.ncbi.nlm...pubmed/19480470
It (Cymbalta) has a low affinity for neuronal receptors, such as alpha(1)- and alpha(2)-adrenergic, dopamine D(2), histamine H(1), muscarinic, opioid and serotonin receptors, as well as ion channel binding sites and other neurotransmitter transporters, such as choline and GABA transporters.

https://www.ncbi.nlm...pubmed/12211418
In humans, duloxetine has a low affinity for most 5-HT subtypes and for muscarinic, histamine H1, alpha1-adrenergic, alpha2-adrenergic and dopamine D2 receptors [444103].

https://www.ncbi.nlm...les/PMC2626928/
Duloxetine lacks significant affinity for muscarinic, histamine H1, alpha-1-adrenergic, dopamine D2, 5HT1A, 5HT1B, 5HT1D, 5HT2A, 5HT2C, GABA, glutamate and opioid receptors
 

[invalidusername]

Hi Khamla64 and welcome.

 

First up I want to reiterate 'Hat's mention of every other day - please do not do this. It will, I guarantee, make things more difficult. There is plenty of evidence to support this. Doctors think that you can do this with any anti-depressent, but it is not true due to the half life. As 'Hat has said, it messes up the blood levels.

 

Regarding the reaction you are having, the sweats are exactly what I had - and many others. The urticaria is again quite common, and what 'Hat has digged out will do you well for ways forward.

 

Just another note as you have also been taking natural remedies. Please be careful with how much dose of anti histamine you take as they have a tendency to quite easily elevate pulse rate and cause tachycardia, which if you have not had an episode, is quite scary! Just be sure to mention to your doctor or pharmacist if you go this route.

 

IUN

[fishinghat]

Actually IUN it depends on the antihistamine and which histine receptor it works on. There are 4 histine receptors, h1, h2, h3, h4,

 

Some antihistamines are agonists (stimulate the receptors) and some block the receptors. Hydroxyzine is one that lowers bp and Benadryl can lower or raise it depending on the individual.

 

Also decongestants typically do not raise blood pressure in most people but in about 6 to 8% they raise bp considerably. That includes phenylephrine and pseudoephedrine. They are not related to antihistamines.

[invalidusername]

Ah - yes, and I am one of those 6 to 8%. But that should come of no surprise to you

 

But yes - need to consider the antagonists separate from the blockers - thank you for pointing this out 'Hat.

 

Still unsure how the h3 and h4 would affect me, but fortunately I do not need to find out for the time being...

[Khamla64]

Thank you both (fishinghat and IUN) so so much.  

 

All of this advice and information is extremely helpful. I am so glad I asked questions here. 

 

I am having a discussion with my GP today and feel much more informed about how to approach the tapering. it seems very few doctors actually now how best to approach tapering as the every second day dose decrease was suggested to me by my GP.

 

I am sure to have further questions.

Khamla

[invalidusername]

You are more than welcome Khamla, and feel free to stop by and ask any further questions you have.

 

Just to make sure you understand the half-life - if a drug has a half life of 6 hours (around that of Cymbalta) and lets say you took this dose at 1pm.... by 7pm that day, there would be 50% left of it in your system. After another 6 hours, there would be 50% less again, so 25% by 1am... and so it goes on. Therefore, after 24 hours, the level in your system has reached around 6%! This is why every other day is not a good idea unless the half life of any given drug is a mean of around 24 hours or more.

 

Go educate your GP

 

IUN

[KathyInFL]

Hi Khamla! I read with interest that you got hives on the back of your neck, I do too and I'm completely off the C. A few months ago hairdresser asked me if I changed anything lately and I didn't, so it must have been from the C. I think the hives are gone right now, at least I haven't thought about them at all until I read your thread.

 

I had horrible sweating on C, but now that I'm off, I don't sweat uncontrollably anymore. I live in Florida and it's still quite warm (80's) so the real test will be in a few months when it gets hotter again. But I'm so happy the major sweating is gone, hopefully it will lessen for you too!