1636 replies to this topic

[ForLyla]

Really sorry FH. Sounds like you had a rough go but how are you feeling these days?

Benzo withdrawal was bad and long but it was tolerable. Cymbalta withdrawal back to back with it just destroyed me. It's been 25 months of hell and the last 6 months of unimaginable hell. I'm really debating what I should do. I think maybe I should stay where I am and just wait for my body to get used to it. What do you think of that idea? My body has proven time and time again that it doesn't like any change and I was fine on cymbalta before I tapered it. Or will I just get worse the longer I stay at this updose? Maybe my body hasn't gotten used to the updose yet and I can drop back down? It hasn't been 3 weeks yet. I feel the same way I do after I taper but maybe worse. Heart pounding is back full force which makes me really upset. Feel terrible every day now. I'm starting to think that 3 week window for going back up is a legit rule.

[fishinghat]

I am doing fine, thank you for asking. If you ever have to do a benzo withdrawal afain, consider a water titration. It can be done with little to no withdrawal.

"I think maybe I should stay where I am and just wait for my body to get used to it. What do you think of that idea?"

I really like that idea. It may take even a couple of months or more to get comfortable but your body will slowly heal and recuperate.

That 3 week rule really has me stumped. I have known sooo many who have come down on Cymbalta and other ssri/snri and went back up within a few days with no issue BUT the brain is such a fickle thing. Some on other meds like mood stabilizers, Adderal and such have strange reactions sometimes to ssri/snri changes. So much to still be learned. One thing for sure that I have learned....I hate antidepressants.

[ForLyla]

Have you known anyone to go back up after a few months though?

I guess I'm so discouraged because I stayed at 22.5mg for 6 months. And although some symptoms abated like the heart pounding and nausea, I still felt like total crap. Probably for setback from insomnia from my newborn.

Do you think i set myself back for years or permanently from going back up? I'm worried about this shaking.

[fishinghat]

"Have you known anyone to go back up after a few months though?"

A great many and with good success. They stabilize well within a few days and then start tapering again.
I di a search on our site for people who had the shakes and I found 69 different people who mentioned that as a symptom. Several mentioned it lasted 2 to 3 months before disappearing. My journal showed taht mine lasted about 8 weeks. These folks all stopped shaking. You will be alright. As the stomach issues, shaking, brain zaps decrease then the emotional symptoms will increase but we will worry about one thing at a time.
.

[ForLyla]

That's exactly what happened though FH. My physical symptoms decreased before but then my mental symptoms increased. Now my physical symptoms are back with added shaking and my mental symptoms are terrible on top of it. Do you think I set myself back really badly? I wouldn't have thought that 2.5mg difference would be that devastating. 

[fishinghat]

"I wouldn't have thought that 2.5mg difference would be that devastating."

I recommend a one bead drop a day AT THE MOST for most people at that level. For a 300 bead 30 mg capsule that would be a 0.3 mg drop per day. It would take 83 days to drop 2.5 mg. Remember, there are those that can only drop 1 bead a WEEK. A 2.5 mg drop at once is very fast. It may easily take you a couple months to settle down.

[invalidusername]

What I think has occurred here is exactly what I am going through, and its a simple, yet nasty set of circumstances.

 

Your physical symptoms cause stress > stress causes anxiety/depression > anxiety/depression causes worry > worry causes physical symptoms

 

and so it goes on [cue The Magic Roundabout music]

 

The loop needs to be broken. I do not think the Cym can be completely to blame here. Having a child, whilst a wonderful thing, it well known to be one of the most stressful times in a persons life, along with moving house and getting married/divorced. 

 

Are you, or have you considered talking therapy?

[ForLyla]

IUN Ya I am in therapy but it doesn't do much good. I think you're right about your theory though. 

 

FH but I wouldn't have thought that going up 2.5mg would be the same as going down 2.5mg. I only expected a terrible reaction from tapering, not going up. So you think I'll be in this mess for at least a couple months? So do I just stay where I'm at or do I continue tapering again? I just don't know what to do. 

[fishinghat]

"I only expected a terrible reaction from tapering, not going up. "

I fully agree. I don't understand why you didn't improve.

"So you think I'll be in this mess for at least a couple months?"

I am afraid so. Just hang in there and try to avoid stress as much as possible. Don't overdo anything. It only makes things worse.

[invalidusername]

Meanwhile, I would consider finding another therapist. It took me four attempts to find the right one for me - and was it worth it.

[ForLyla]

I think I'm going to start tapering right away. I need to get off the drug and I'm just prolonging it. I'm having the shakes every day which I've never had before. Is this somewhat normal? Will this calm down or are the shakes here for good now? Could I have permanently damaged my brain?

What rate would you guys taper at? I'd rather it not take years to taper. One doctor suggested I go up and down in dose which I'll explain below...

Start 25mg and drop to 22.5mg
Week 1 Take 25mg 6 days/week and 22.5mg 1 day/week
Week 2 Take 25mg 5 days/week and 22.5mg 2 days/week
Week 3 Take 25mg 4 days/week and 22.5mg 3 days/week
Etc.. and just continue that way.

How does that sound?

[fishinghat]

Not a good Idea.

You NENER alternate doses with Cymbalta or any other antidepressant with a short half life. Cymbalta has a half life of 12 hours. When you drop that dose to 22.5 your blood levels drop. BUT when the next day comes you take 25 and the blood levels go back to normal. The next time you drop to 22.5 you repeat the same withdrawal all over again. The wean really needs to be done evenly (bead counting) and slowly. I know it is a pain but I am afraid the alternating method is going to be unbearable.

As I mentioned in another post somewhere, 69 members have complained about the shakes in past posts. All have recovered and most that mentioned a time frame said they lasted 2 to 3 months. Mine lasted about 8 weeks.Very common.

[invalidusername]

Absolutely. This is without a doubt a sure way of making things worse.

 

We have seen people come to us having tried this method a number of times, and in every case there have been issues. This isn't opinion, it is based on sound reasoning as Hat has explained... and damn it, doctors should know this.

[ForLyla]

Ok thank you. So what is a good rate, about 5%/month? IUN it feels like I have Parkinson's and I remember your story. Is Parkinson's something I need to worry about with this drug? I googled it and found one article.

[invalidusername]

Essentially, the slower you can manage, the better - as Hat will corroborate I am sure. But you are right, you need a plan otherwise you will feel like you are going nowhere.

 

Having seen my father come down with Parkinson's after 20+ years on Prozac, it led me to look into the correlation and read as much as I could. As I said before, this is what led me to try coming off my Citalopram, which ironically became the precursor to my issues now. I can say with some sincerity that you will have needed to have taken these meds for a significant amount of time for the risk to be posed, otherwise instances of Parkinson's would be cropping up all over the place for people who have taken these meds. However, my conclusion is that these meds can cause such problems, but the criteria is that you need to have taken the meds for a long time and be of an older generation - neither of which apply in your case, so I would urge you not to worry.

[fishinghat]

IUN is right. The risk of a neurological problem developing from Cymbalta is small but possible. In fact there are some drs who put patients on Cymbalta for Parkinson's, Alzheimer's, etc. because it does seem to help the neurological symptoms at first but usually doesn't last long. That would be an off label use.

For a drop rate...

"I recommend a one bead drop a day AT THE MOST for most people at that level. For a 300 bead 30 mg capsule that would be a 0.3 mg drop per day. It would take 83 days to drop 2.5 mg. Remember, there are those that can only drop 1 bead a WEEK. A 2.5 mg drop at once is very fast."

Boy did I screw up the math on that one or not. I do recommend a 1 bead drop a day for a 300 bead capsule so that would be 30 beads a month or around 10% BUT it must be a bead a day NOT a single 30 bead drop. That would be overwhelming. Obviously as you wean you may have to decide to go slower or faster depending on how you react.

Sorry about the error.

[invalidusername]

For a 300 bead 30 mg capsule that would be a 0.3 mg drop per day. It would take 83 days to drop 2.5 mg.

 

Watch that decimal point at the end there my friend!!! Think you want 25mg there, rather than 2.5mg

 

You got to love Cymbalta maths!

[ForLyla]

Ok thanks I'm just not used to the shaking. I'm literally holding my brush and can barely brush my own hair. Also, feels like I'm shaking on the inside - a very weird feeling I haven't really had before. Can you guys relate to that feeling?

Currently my doses weigh .133 ... they use bigger beads. I kind of like the idea of dropping 1% a week and see how that goes. Think that's ok?

[fishinghat]

I agree. That should be a good starting point until you get down to around 0.040 mg then you will need to consider going slower.

[invalidusername]

Oh my goodness - yes, I know all about the "internal shakes". When I first had them, I thought it can only be me, but it is a common phenomenon. The shakes are often referred to as essential tremors;

 

https://www.nhs.uk/c...troduction.aspx

 

Lots of people with any kind of withdrawal - meds, drugs, alcohol - they all get them. The internal ones are by extension of those. But just like brain zaps, the symptoms are difficult to explain, but they are suffered by many.

[ForLyla]

How many of you guys had to have your gallbladder removed?

[invalidusername]

Hang on.. let me check.

 

Yes, still there....

[ForLyla]

Lol what about others? IUN how long have you been on Cymbalta again?

[invalidusername]

I was only on the stuff for 10 weeks before withdrawal. No drug should take twice as long to withdraw than the time on it...

[fishinghat]

I still have my gall bladder. I was on Cymbalta for 4 or 5 years.

See note below.

[fishinghat]

I am sure your dr has told you about this but having your gall bladder removed has been linked to
depression.

https://www.ncbi.nlm...pubmed/26053886
PLoS One. 2015 Jun 8;10(6):e0129962. doi: 10.1371/journal.pone.0129962. eCollection 2015.
Increased Risk of Depressive Disorder following Cholecystectomy for Gallstones.
Abstract
BACKGROUND:
Prior studies indicate a possible association between depression and cholecystectomy, but no study has compared the risk of post-operative depressive disorders (DD) after cholecystectomy. This retrospective follow-up study aimed to examine the relationship between cholecystectomy and the risk of DD in patients with gallstones in a population-based database.
METHODS:
Using ambulatory care data from the Longitudinal Health Insurance Database 2000, 6755 patients who received a first-time principal diagnosis of gallstones at the emergency room (ER) were identified. Among them, 1197 underwent cholecystectomy. Each patient was then individually followed-up for two years to identify those who were later diagnosed with DD. Cox proportional hazards regressions were performed to estimate the risk of developing DD between patients with gallstone who did and those who did not undergo cholecystectomy.
RESULTS:
Of 6755 patients with gallstones, 173 (2.56%) were diagnosed with DD during the two-year follow-up. Among patients who did and those who did not undergo cholecystectomy, 3.51% and 2.36% later developed depressive disorder, respectively. After adjusting for the patient's sex, age and geographic location, the hazard ratio (HR) of DD within two years of gallstone diagnosis was 1.43 (95% CI, 1.02-2.04) for patients who underwent cholecystectomy compared to those who did not. Females, but not males, had a higher the adjusted HR of DD (1.61; 95% CI, 1.08-2.41) for patients who underwent cholecystectomy compared to those who did not.
CONCLUSIONS:
There is an association between cholecystectomy and subsequent risk of DD among females, but not in males.

https://www.ncbi.nlm...pubmed/27601483
BMJ Open. 2016 Sep 6;6(9):e007969. doi: 10.1136/bmjopen-2015-007969.
Does preoperative depression and/or serotonin transporter gene polymorphism predict outcome after laparoscopic cholecystectomy?
Abstract
OBJECTIVE:
To determine whether preoperative psychological depression and/or serotonin transporter gene polymorphism are associated with poor outcomes after the common procedure of laparoscopic cholecystectomy.
DESIGN:
Patients undergoing laparoscopic cholecystectomy were genotyped for the serotonin transporter gene 5-HTTLPR polymorphism and assessed for psychological morbidity before and 6 weeks after surgery. The main outcome was postoperative depression; secondary outcomes included fatigue, perceived pain, quality of life and subjective perception about return to usual.
RESULTS:
Full genetic and psychological data were obtained from 273 out of 330 patients consented to the study (82% female). Significantly fewer people with preoperative depression (Beck Depression Inventory (BDI) score >5) had returned to employment (57% vs 86%, p<0.001) or made a full recovery (11% vs 44%, p<0.001) 6 weeks after surgery. Independent predictors for subjective return to usual after surgery included preoperative depression, body mass index and postoperative pain scores. Independent predictors of postoperative depression included preoperative antidepressant use and preoperative depression. SS genotype was associated with use of antidepressants preoperatively and higher anxiety levels after surgery. However, it was not associated with other salient postoperative psychosocial outcomes.
CONCLUSIONS:
Depressive psychological morbidity preoperatively, pain and body mass index appear to be important factors in predicting recovery after this common surgical procedure. There may be a place to include preoperative brief psychological screening to enable targeted support. Our results suggest that the serotonin transporter gene is unlikely to be a useful clinical predictor of outcome in this group.
TRIAL REGISTRATION NUMBER:
ISRCTN40219584.
Note - If the serotonin transporter gene is not involved with this type of depression than ssri/snri would probably be worthless and might explain your treatment resistant depression.
 

[ForLyla]

How long were you on cymbalta FH? I had one "expert" tell me that everyone has their gallbladders removed while taking this. So obviously that's not true, except 1 person out of 5 I talked to did. Maybe it does increase your chances somewhat.

Thats the last time I pay money to book a consultation with someone. She had a couple good suggestions pertaining to diet but also spouting off conspiracy theories by the CIA so not sure what to believe lol.

[ForLyla]

Btw I had a pretty good day yesterday.I felt maybe 70% normal if i had to put number on it. My heart pounding went down and the shakiness was a lot better. Today its not so good again. This might be coincidence but i think cbd opens windows for me about 48 hours after I take it. I've taken cbd 3 times now and always a couple days later having a window.

[fishinghat]

Forlyla, I was on Cymbalta for around 4 or 5 years.

I don't know of a link between being on Cymbalta and then having to have your gall bladder removed BUT we have had members sure have trouble with depression after having their gall bladder removed.

The up and down cycles are a standard routine for Cymbalta withdrawal but I can't say that the CBS withdrawal isn't effecting that as well.

[invalidusername]

No idea about gall bladder either, but I would keep going with the CBD oil if you are seeing some improvements. Perhaps take every other day and see if this maintains those windows? It is perfectly safe. Make sure you stick to the same brand for now as well.