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Weaning From 20 Mg. 2 X A Day. Seems I Did It Wrong, Now What?


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#1 RTE0163

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Posted 18 March 2019 - 07:10 AM

I found this site after my GP started weaning me off Cymbalta.  I was originally prescribed 20 mg 2 x a day. I started weaning down to 20 mg. 1 x day. Then 20 mg. every other day. Then every 2nd day. I am currently doing every 3rd day. I feel dizzy and a bit depressed prior to taking it on the third day. However, it is winter in Ne PA and I usually feel anxious waiting for sun and warmer weather to arrive! I also have been dealing with the stress of my husband recently being diagnosed with Parkinson's Disease. So....even though I'm trying to remain positive about his PD, and wondering what the future holds, I can see as I'm typing this, that maybe it is not JUST the withdrawl of Cymbalta causing my "moods". . I am ready to try every 4th day, however after doing my research It seems that the med is out of my system after 12 hours. So at this point, should I even bother? I am afraid to completely stop, however it doesn't make sense if it is out of my system already. Any advice is greatly appreciated. 


#2 fishinghat

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Posted 18 March 2019 - 08:20 AM

You are absolutely right RTE.

Even the FDA warns against the alternating day routine as it jacks up your blood levels and then lets them crash again. You repeat the same withdrawal all over again. If it were me I would try and stabilize at around 8 mg per day and then bead count down from there.

I would also say that most people who are in your type of situation would be climbing the walls by now. If you can stabilize around 8 mg then you may be able to bead count fairly successfully.

#3 invalidusername

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Posted 18 March 2019 - 08:21 AM

Hi RTE0163,

 

Welcome to the site - I am glad you have found us here. First up I can say with some confidence that the way you are feeling WILL be largely caused by the administration of your meds. Letting the levels of Cymbalta drop, and then spike so frequently will cause mayhem in your system. There is no doubt about how to get around this, and that is to reinstate a dose every day. You didn't mention how long you have been on Cymbalta for? Can you also state how long you were on 20mg every day, then how long you were on every 2nd day and how long you have now been on every 3rd day?

 

As a rule, I would take your dose of 20mg every 3 days, which would give you ~7mg/day. Therefore, you need to start taking this dose EVERY day. If this still doesn't balance you out, then maybe a little more until you stabalise, but just going back to a daily dose WILL give you some noticeable stability. 

 

In order to do this dose, you will need to bead count. Are you familiar with this method? If not, we can help. This is something that your doctor was clearly not aware of given their suggestion you have been following to date.

 

Finally, I am sorry to hear of your husbands Parkinson's diagnosis. My father has been living with it for the last 6 years, so I know a lot about it. Whilst it is of no immediate comfort, there have been some amazing advances in the field recently, and there are even potential cures currently being trialed. Granted they are a way off being rolled out to general patients, but there is a lot going on with some excellent results. Meanwhile, our thoughts are with you.

 

IUN


#4 fishinghat

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Posted 18 March 2019 - 08:25 AM

Wow, IUN. We are exactly on the same page. Cool

#5 gail

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    5 months on cymbalta, scary side effects, to get help and to return the favor if I can.

Posted 18 March 2019 - 09:08 AM

RTEO, welcome to the forum,

Our guys gave you excellent advice. Nothing to add to their replies, do come back as many times that you wish. We are here for you.

#6 RTE0163

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Posted 18 March 2019 - 09:29 AM

Thank you for the responses.

 

IUN...I have been on Cymbalta for about 15 years. I did 20 mg. once a day for a month. I did 20 mg. every other day for about a month. I am currently doing every 3rd day and it has been three weeks. As you said, I do notice the dizziness and mood swings when it is time to take the med. The rise and drop of Cymbalta. This is all making sense now. 

 

I do understand how to take apart the capsule and that there are beads inside. Since there are 4 beads inside each capsule, I assume there are 5 mg. in each. Your suggestion of 8 mg., and the suggestion of "fishinghat" at 7mg., has me wondering wether to do 5 or 10 mg. 

 

Thank you for your thoughts on my husbands PD diagnosis. He's 58 yrs. old and started on medications in Dec. He is doing much better with the meds. He has a great Movement Disorder doc, Neurologist, in Philadelphia at a teaching hospital. We travel there every 3/4 months to re-evaluate. Physical Therapy and speech therapy are very important to him having "good" days. Good Luck to your Dad!


#7 invalidusername

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Posted 18 March 2019 - 09:48 AM

Oooh - 15 years, so you are a fellow AD veteran! So all the more reason for you to be taking it slow, and the reason for you feeling like you do.

 

And you have the big bead variety. Odd as these don't come up so often, but you are the second person in the space of a few days to report this. Your math is of course correct that you will have 5mg per bead. Ideally you would break one in half. I do not know if this is possible or not. However that said, you will need to get hold of the smaller beaded variety to successfully taper to the finish line. You should find that your pharmacy will be happy to oblige it sourcing them for you. But for now, if you can break a bead in half to get 7.5mg then go for that starting today. If this really doesn't work, then I would go for the 10mg as I feel the 5mg would be a little too far to drop. 

 

The last 10mg can be a real stinger, so for now stabalise on the above dose for a good couple of weeks, and while doing that, source your smaller bead meds. Please check in with us as often as you can - we like to hear how it all goes - even daily is good as it helps us with how to suggest moving forward.


#8 RTE0163

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Posted 18 March 2019 - 02:39 PM

My pill splitter was able to cut the bead in half. I started today with 7.5 mg. per capsule one time a day. I will head to my pharmacy for the smaller bead capsule. 

 

Thank you for your help, and I will keep with this dosage for a few weeks. I will keep in touch to let you know how this is going for me.

 

Thanks again!


#9 fishinghat

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Posted 18 March 2019 - 04:00 PM

Looking forward to your next post. Take care RTE.

#10 invalidusername

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Posted 18 March 2019 - 05:06 PM

Top banana - well done. You are back on the straight and narrow.

 

Also looking forward to see how you get on.


#11 RTE0163

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Posted 22 March 2019 - 09:57 AM

Ok...so I am much more "balanced now". I am sticking with the 7.5mg per day for now.  I'm not having the depressing lows or shakiness that I was previously experiencing. I did find that my Pharmacy deals with another manufacturer for duloxetine with micro-beads as opposed to the 5mg. beads in the ones I have now. However, I must contact my doctor to send an order to the pharmacy for this other type of capsule. I'm wondering if this is necessary or if I could just wean down to 5, then 2.5 and then stop? I would have to tell my doctor that I took matters into my own hands and am following this protocol instead. I get anxiety having that conversation, lol. Just kidding really, I will do it if you all think that it would be better. You all are so knowledgeable and can really related to the difficulty in doing this. 


#12 fishinghat

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Posted 22 March 2019 - 10:16 AM

"I'm wondering if this is necessary or if I could just wean down to 5, then 2.5 and then stop?"

Very unlikely. At these low doses you must go very slowly.

#13 invalidusername

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Posted 22 March 2019 - 10:45 AM

Thank for the update and absolutely what Hat said. You must go slow at this point. 

 

Taking things into your own hands is what we all do at some point. I for one have been self-medicating for the last 6 months because it seems that I have a much more vested interest in my own health than any medical "professional" does...


#14 RTE0163

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Posted 27 March 2019 - 08:05 PM

Still on 7.5 mg. every day. As I said last week, I feel more balanced.

 

However...my body feels like I just got hit by a truck. I keep taking my temperature thinking I am getting the flu, but that is not the case. It is the only way I can describe how I feel. My body is sore, my clothes on my skin just hurts. It's like my skin is hypersensitive. I previously was a gym rat. Loved working out, Zumba, cycling, yoga...I tried my spin bike today and couldn't get through my usual 45 minute workout. I just don't want or feel up to doing anything. I am keeping up with Yoga a couple of times a week but I must take Alleve prior to the class to get through. Is this withdrawal or is something else going on???

 

I also plan on staying with this dose (or giving up and increasing the dose) for the next few weeks as I have a vacation to Florida coming up 4/3 to 4/17. I am afraid to change anything as I don't want to ruin my (and my husbands) vacation. My next doctor appt is 5/3, so I thought I might drop down to the 5 mg. then. 

 

I really don't want to give up, but these body aches are making me depressed and I just want to lay on the couch.


#15 invalidusername

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Posted 27 March 2019 - 08:42 PM

Hi RTE...

 

Glad you are still feeling balanced, but you need to give it a little longer to feel a bit more stable - but what you are feeling is certainly normal. And not being able to keep up with the fitness is normal - this was addressed earlier by Hat and myself;

 

https://www.cymbalta...s-left/?p=82483

 

I would advise against going up on the dose, as it may cause more issues. You have another week and I would have thought this would be enough. You do always have the option of taking a few extra beads while away, but really - just that. Jumping up too high is NOT a quick fix. But Florida should bring you lots of other stuff to occupy your mind - and you can pop in to see our Kathy and Liz :)


#16 RTE0163

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Posted 28 April 2019 - 08:55 AM

Well that was HELL for a while. I have been back from Florida for a couple of weeks. However, to get a plan going forward I will update you on my progress, or lack-thereof. I started on 7.5 mg on 5/18 and stayed there due to vacation and hoping to level out. I had two episodes of the HELL I mentioned. Body aches, extreme fatigue, feeling like I was getting the flu, etc. The 1st episode lasted about 2-3 days. That was doable. The second episode lasted about 2 weeks. I was convinced I had fibromyalgia and doing my google search had me convinced my doc would just prescribe Cymbalta again. I was depressed, and angry. However after that nightmare passed, about 4/10, I finally started feeling "normal". I am back to my old self, working out, enjoying life. I am preparing to drop the dosage again. If I keep the capsule with 4 beads inside, I will have to go from 7.5 to 5 mg. I see that this is more than the 10% recommended. I fear that if I do this I will suffer the same withdrawal as I did when I dropped from 10 to 7.5. 

 

So my questions are...1. Is the withdrawal inevitable if I drop from 7.5 to 5?  2. If I switch to the capsule with the micro beads, how do I determine what 7.5 mg is and what the drop would be?

 

I also forgot to mention that I saw my doctor after the second episode of HELL as I call it. He was totally on board with the Cymbalta Withdrawl Syndrome. He told me he "just" was made aware of this Syndrome through some medical reports and articles he was reading. He told me I do not have fibromyalgia and he is convinced that the symptoms I described are classic withdrawal symptoms from the Cymbalta. I felt better knowing that he is on board, even if he is years behind the people here! I directed him to this site and he was "enlightened" about the bead counting. 

 

I can't thank this site enough for your help and support. I will await response and recommendations before I drop the dosage. Not gonna lie, I'm scared.
 


#17 fishinghat

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Posted 28 April 2019 - 09:09 AM

"So my questions are...1. Is the withdrawal inevitable if I drop from 7.5 to 5? 2. If I switch to the capsule with the micro beads, how do I determine what 7.5 mg is and what the drop would be?"

More withdrawal is probably inevitable.

If you switch just count the number of beads inside and we can do the calculation for you.

#18 invalidusername

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Posted 28 April 2019 - 01:46 PM

Why not simply go for a one bead route? If you are that worried, which I completely understand, then just go for the slowest possible option.

 

Very well done for all you have got thru so far. You should feel very proud of yourself...


#19 RTE0163

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Posted 28 April 2019 - 06:11 PM

Thank you fishing hat and IUN. I most likely will go with the one bead, I'm worried thinking back to how bad I felt and having to carry on with my responsibilities. I babysit my 1 yr old grandson 2 x week and that was a struggle. I will enlist help if I need to this time. 


#20 RTE0163

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Posted 25 June 2019 - 09:57 AM

"I did it!" She says cautiously. I just had a doctors appt yesterday and reported two weeks off of Cymbalta. I last reported here that I was at 7.5 mg per day. I was able to cut the beads in my capsule into quarters. Therefore, I was able to drop down 1.25 mg at a time. I spent 6 weeks doing this for fear of having symptoms at bad times. For example, during my daughter and two toddler grandchildrens' 2 week visit at my house  :blink: - and other life events I didn't want to risk being sick for. I am cautiously optimistic and continue to be sure to keep up self care techniques that help me. Exercise and yoga are my go to activities. 

 

A great big THANK YOU to fishing hat and invalidusername for your support and guidance!!


#21 fishinghat

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Posted 25 June 2019 - 10:28 AM

WOW, RTE that is great and very unusual. That would and has taken many of us months and months to do the last 7.5 mg. Thank you so much for coming back and sharing that story with us.

#22 invalidusername

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Posted 25 June 2019 - 03:47 PM

Absolutely - I'm obviously with Hat here - very unusual indeed!

 

A brave move that has paid off. Wonderful to hear when such things comes together. Very happy for you RTE :)


#23 RTE0163

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Posted 07 July 2019 - 07:12 AM

May have spoken too soon. I felt great two weeks ago, however depression has kicked in. Or, peri-menopause along with depression. I know...I did this Cymbalta weaning at an awful time of life. Any ladies in this stage of life that can offer some advice?

 

When I think about my mission to get off Cymbalta it had to do with low libido. I can't live this way either. I just want to sleep this day (Sunday) away and get my doctor on the phone tomorrow. I apparently need something to help me deal with life. As I said earlier, mid-life. my just retired husband recently diagnosed with Parkinson's, taking care of things for my mom (dad passed away two yrs ago), babysitting my grandchild, and hormonal crap. I cry at the drop of a hat. My doctor told me I have to "push myself to exercise" which I never had to do. He ended my last session and told me that I am a tough cookie and I can get through this. He said he'd rather see me doing yoga and exercise than start on another anti-depressant. Easy for him to say, I Don't want to leave the house for fear someone will say..."hey! how you doin'?" and I'll just burst into tears. My husband and kids are concerned and said they miss ME.

 

I don't know if I should start the cymbalta again or try another anti-depressant. 


#24 RTE0163

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Posted 07 July 2019 - 07:29 AM

AND...the body aches started again yesterday.. Lord knows it's not from exercise but probably from laying on the couch too much. I sleep like its my job.


#25 invalidusername

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Posted 07 July 2019 - 08:21 AM

Hi RTE...

 

Just catch us up here - exactly how long did you stop the 1.25mg, or are you still on this dose? Either way, what you are feeling has to be expected - it is very much par for the course. I would advise against jumping straight into another AD at the moment. It is early post-withdrawal days. Your brain is still recovering and learning to be independent without the Cym. There are going to be ups and downs for sure for a while. 

 

You have got a lot on, and all of this is taking its toll on you. What you are doing is very stressful - it is going to make you tired. It has only just hit me this weekend (after 3 years!) that trying to care for my wife who has social anxiety, OCD and depression is going to play havoc with me. I have been expecting to fully recover and wondered why I can never get past a certain point. I was reading articles yesterday about just how many partners DEVELOP mental health as a result of looking after a partner with mental health. So what chance do I have?!

 

Give yourself time to rest, and yes your body will ache as a byproduct, but try to break the rest time up so you move frequently enough to give the muscle groups some movement. I know it isn't easy... Most of all, be kind to yourself.


#26 fishinghat

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Posted 07 July 2019 - 08:34 AM

One thing to consider is that often during Cymbalta withdrawal it screws up your hormone levels. Many of our members have had this issue. Low estrogen or testosterone can cause depression and menopause type symptoms. You might consider having your dr check your levels. It may help/


#27 RTE0163

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Posted 07 July 2019 - 09:35 AM

My last dose was 6/18. 

 

My hormone levels were last checked in Jan. and are balanced (with the help of a progesterone cream) and where they should be for a woman in peri-menopause. 

 

My thinking today is that life is passing me by while I suffer through this withdrawal or depression or both. So if medication is what I need to cope and enjoy life, why not. I don't see a stigma with needing meds to cope. I don't want this to consume my life. I want to enjoy life again. I feel like I opened a can of worms doing this. Sorry for the Debby downer me today.


#28 invalidusername

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Posted 07 July 2019 - 09:55 AM

"I don't see a stigma with needing meds to cope."

 

Absolutely not, but another withdrawal will prevail, and so it goes on. But in your case, I think you are right in that you have unfortunately undertaken the withdrawal at a difficult point in your life. Exactly what I did. Stopped Citalopram right in the middle of Immigration Court proceedings for my wife (what was I thinking?!). Just wouldn't want you to suffer the sensitivity that can come with chopping and changing too much.

 

"My thinking today is that life is passing me by while I suffer through this withdrawal"

 

If I had a pound (or dollar) for every day...!!


#29 fishinghat

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Posted 07 July 2019 - 12:43 PM

I fully agree RTE. I for one will probably be on some meds for the rest of my life but I think I can get by with less than right now. If that is what you need then so be it.

 

Has the dr given you anything for the withdrawal? there are prescription meds that can help you get through this.


#30 RTE0163

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Posted 07 July 2019 - 02:44 PM

IUN, I totally agree. I don't want to start and have to stop/withdraw too much. When having days like today, I just want to feel better ASAP. 

 

fishinghat, I have not been given any meds for withdrawal. I understand the withdrawal while dropping down the dosage, but now that I'm off completely, I thought it would be out of my system by now. Which I why I am thinking I'm actually depressed (needed the Cymbalta) as opposed to these symptoms being withdrawal. If that makes any sense.

 

Thank you both for helping me think/talk through this.





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