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Origin Of Current Symptoms After Long Taper


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#1 Tom1711

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Posted 15 April 2019 - 03:40 AM

Hi folks. Thanks for operating this site. It's bloomin' enormous! I'm hoping someone can advise on how to differentiate between withdrawal symptoms and the return of an original mental health condition, and if anyone knows any average duration for symptoms after completion of a long taper. Also hoping people are not feeling too bad today...

Eleven days ago I reached zero duloxetine after an 18-month taper, following a couple of years on the drug here in Australia. I chose a very long taper (bead counting) because of major mental agitation caused by reducing the dose more quickly at a previous attempt. Nowadays I mostly use psychotherapy, mindfulness and exercise to manage anxiety so I had some optimism that I could survive as I dropped below the therapeutic dose (I was on 60mg). Nasty symptoms - feeling jittery, exaggerated startle response, mind going blank/stress responses to very minor stressors - started once I got to about 45mg and got worse again after I dropped below 30mg around five months ago. However I could still function at work and with study. The last few days/weeks have been far worse, however, and I've now had to take time off work with chronic headache, brain zaps, massive muscle tension, irritable bowel syndrome, nightmares, and even more frequent episodes of my mind going blank. The problem I have is that many of these symptoms are also symptoms of Generalized Anxiety Disorder, which I had a diagnosis of a few years ago. I'm not a big fan of the DSM but GAD is quite a useful way to describe my issues. So, how to differentiate between duloxetine withdrawal and return of GAD symptoms after 22 years on various antidepressants? Because of being off work I am starting to feel I can't justify being off meds, but I also don't want to give up after all this work if the symptoms are indeed withdrawals and there is some hope that they might remit reasonably soon. Hope this makes sense.

Tom 


#2 invalidusername

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Posted 15 April 2019 - 07:31 AM

Hi Tom and welcome to the family!
 
You are one of many that have come to us under these circumstances - and you have done so well to reach point zero. Seriously - well done. Leave aside your current issues - just recognise the acheivement for a moment. 
 
You sound like you have a grasp with the methods that you are using with your mindfulness, therapy and exercise, but you need to recognise that the days that hit after finally reaching the zero WILL be the worst. It is the first time without that half spoon of sugar, the first time without that final cigarette. I was only on the dreaded stuff for 10 weeks. I did a bead count over 12 weeks and still had a nightmare when it all stopped. 
 
The zaps will for sure be the withdrawal, the headaches and tension are also common culprits for your part of the journey. IBS can of course be brought about at moment of stress - as can nightmares, although these are also linked to withdrawal. The mind going blank is also very common - one of which I had repeatedly after I stopped, again, after only 10 weeks. It does pass.
 
Unfortunately, years of meds - and different ones at that - show to make things tougher at the stages of withdrawal. I think we need to talk supplements. Are you taking anything at the moment? If not, we can start you on a regimen of some things that will help take the edge of these symptoms.
 
My friends will be along as they wake up to welcome you and offer their own experiences and thoughts, but for now, my sincere welcome to you,
 
IUN

#3 gail

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Posted 15 April 2019 - 07:50 AM

Welcome Tom,

As I read your post, it came to me that you tapered by 15 mg increments. Am I wrong?

Tell us how you managed your tapering from 45 to 0. Asking because the last 10 mg take a long time to taper. They are the worst. I can also see that you continued tapering even if not stabalized.

Fishinghat hat will be in shortly. If you have the time, please give us some answers.

Whatever, all can be fixed, and you will be guided. Stay strong!

#4 fishinghat

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Posted 15 April 2019 - 08:09 AM

Welcome Tom

Job well done.

"...how to differentiate between withdrawal symptoms and the return of an original mental health condition, and if anyone knows any average duration for symptoms after completion of a long taper."

Things vary from one individual to another but …

Even the medical research argues on how to tell the difference from withdrawal and return of symptoms. Nit there are a couple of things that can clarify the situation. Brain Zaps are typically just from withdrawal. Also if you take a few beads and the symptoms get better then that is a sign it is withdrawal.

Those who do a long withdrawal USUALLY have 3 to 4 months of tough symptoms after the last dose and another 3 or 4 months of off and on symptoms. Then another 4 months of being over sensitive to stress. Having said that there are those who take 1 year or more to begin to see improvement. Not a pleasant thought. Those who do a rapid withdrawal can often take 1 to 3 years to see significant improvement.

I would suggest that you browse through the Thread "Summary of Cymbalta Withdrawal" in the Medical Support section. It is a summary of the things people have tried to help with their symptoms, medical research and other valuable info.

Please feel free to come back any time to vent, ask questions or just visit.

#5 Tom1711

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Posted 15 April 2019 - 05:48 PM

Thanks very much for the welcome, encouragement and advice. I'll check out the Summary of Cymbalta Withdrawal section. I am inclined to agree that the brain zaps in particular are withdrawal, particularly as they've emerged mainly since I took the last dose. I would be interested in looking into supplements, IUN, yes, thanks for the offer. I'll see what's on the site but I am also open to suggestions. In answer to Gail's question: I reduced by approximately one bead a day throughout the taper, except when I felt I needed to stabilize, at which point I stayed on that dose for a few weeks before continuing to reduce. However I may have made a mistake towards the end because I think when I got to about 100 beads I reduced by two a day: I was starting to feel I would never reach the finishing line and just wanted the drug out of my system. 

I've been considering going back on fluoxetine for a while, on the grounds that it is easier to come off that (I've tolerated it pretty well in the past), but haven't decided yet. A lot depends if I can get back to work and study. 

Anyway thanks again for you support so far, it helps.


#6 invalidusername

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Posted 15 April 2019 - 06:05 PM

Tom...

 

Sounds like you did everything really well - quite possibly the quick exit from the last 100 beads is a culprit. If anything the brakes should certainly have been pulled before getting too low. Nevermind. We'll see you through.

 

You don't mention much in the way of psychological effects - anxiety, depression? Are you no longer having any GAD symptoms? 

 

The physical symptoms are all part of the frontal cortex putting its pieces back together again after being scrambled by the Dulox. As you may be aware, whilst mucking about with the serotonin areas, all closely related parts can be adversely affected which is why people suffer headaches, zaps, balance issues and so forth. So the go-to supplement for aiding the restoration of your gray matter would be Omega 3. Make sure you get a minimum of 2000-3000mg of combined DHA/EPA, otherwise it will do nothing. I'd give this a run for a few days first and go from there.

 

If however you are having the psychological issues, then we can add something for that at the same time. Plenty to work from. Hat has an extensive knowledge of nootropics, aminos and such - or I can guide with more of the herbal side.


#7 AliYogini

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Posted 15 April 2019 - 07:29 PM

Tom, I came off of cymbalta 3mos ago after about a 15mo taper. I was only on 30mg for 9 mos.(and that was as fast as I could come off). The last 8 mg of the withdrawal were the worse for me.

I am still having withdrawal symptoms although they are milder now than before and not constant. With the exception of the nightmares I have had everything you listed. I did not have any of those symptoms before the cymbalta so I know it was not due to any prior issues returning. Although I know everyone's experience with this drug is different..

#8 Raven72

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Posted 15 April 2019 - 09:49 PM

Welcome to the Family,

My friends seem to have things under control. We are here for you if you need us.

Raven

#9 fishinghat

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Posted 16 April 2019 - 07:31 AM

Tom, one thing you might want to add to your considerations is taking one bead from time to time to reduce the severity of the withdrawal symptoms.

#10 gail

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Posted 16 April 2019 - 09:24 AM

Hello Tom,

Thanks for your answers, I'm sorry that I misinterpreted your post.
Everything you did was top notch. I understand the wanting to get over it quickly.
Surely, you weren't aware of those famous last 10 beads or so.

What is done is done. Keep posting, anytime you feel like it, as you can see from all the posts, we are a family here.

#11 KathyInFL

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Posted 16 April 2019 - 03:14 PM

Tom, welcome! What  tremendous accomplishment! 

 

I was on C for about 12 years and tapered off for almost 2 years, ending this past December.  I have the same question, how do I know what I'm feeling now is not the return of depression? I wanted to go back on something to feel better but my p-doc and people here have convinced me to wait a few months, haha they are sneaky! Maybe in a few months all the withdrawals will be gone? I'm hoping so! 

 

Read up on supplements, clean eating and exercise. I wish it was easier. 

 

You found the best place on the internet for C withdrawal! 


#12 fishinghat

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Posted 16 April 2019 - 03:25 PM

Hey Kathy, have you been reading my posts on Ravens thread "All the Feels"? I have been making periodic posts on things that can be done to help with depression. I will continue to post there off and on for a couple more weeks.


#13 invalidusername

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Posted 16 April 2019 - 03:50 PM

Stop trying to butter us up Katherine!!

 

We know we are the best on the splinternet - but you are not going back on pills yet!!

 

But yes, very similar talk going on with the dear Raven at the moment. Depression seems to be doing the rounds at the moment...


#14 KathyInFL

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Posted 16 April 2019 - 05:40 PM

Hey Kathy, have you been reading my posts on Ravens thread "All the Feels"? I have been making periodic posts on things that can be done to help with depression. I will continue to post there off and on for a couple more weeks.

 

Yes I am dear Fish, I love your advice!

 

 

 


 

Stop trying to butter us up Katherine!!

 

We know we are the best on the splinternet - but you are not going back on pills yet!!

 

But yes, very similar talk going on with the dear Raven at the moment. Depression seems to be doing the rounds at the moment...

 

haha I haven't gotten back on the pills yet!!


#15 Tom1711

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Posted 16 April 2019 - 05:52 PM

Thanks again to everyone who has offered advice. Kathy - I know exactly what you mean about not knowing whether to go back on a medication. Each time I feel I don't have any alternative, and must go and ask for a prescription for Prozac, I then feel a bit better and decide to carry on attempting to weather the storm. Be kind to yourself, whatever you decide.

I'll try to get some Omega 3 DHA/EPA combined today. I think there are some beads still knocking around somewhere so I'll consider taking one or two every now and then in case that helps, as suggested by FishingHat. In answer to IUN's question, it's a tough one because I do have GAD symptoms but no way of knowing if they will get better with time as my brain gets used to not relying on anti-depressants for its neurotransmitter levels. If they don't it's a bit up in the air as to whether I can function well enough through non-medication methods. 

I'm going into the office this morning to do a bit of work so I'll see what happens in terms of stress-related reactions.


#16 invalidusername

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Posted 16 April 2019 - 06:55 PM

Tom - you make a sound point about the psy effects. I always approach my little experiments from a similar standpoint. Are the symptoms from the pills, or are they me? Are the pills helping or hindering this particular symptom? Are the side effects exacerbating my symptoms? Yada yada yada.

 

All this stuff that the "professionals" should be doing, but we end up doing it ourselves! Obviously we have a vested interest in maintaining our health to best of our abilities, but I can't help thinking of all of those who cannot reach the point of working it out for themselves. The amount of times I have corrected doctors is a joke. I am not kidding.

 

They don't like it either. 

 

First p-doc I saw misdiagnosed my seizures and put me at risk. I collated paperwork and placed them on his desk for him only to push them back to me saying he didn't want to see them. The mark of a true professional. I put in an official complaint and he refused to see me again. The NHS in a nutshell...


#17 Tom1711

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Posted 19 April 2019 - 02:26 AM

What do you good folks think is going on now? It's two weeks since I reached zero duloxetine after a long taper, but in recent days I've been taking a few beads in the morning to see if my symptoms abate (they haven't). I basically have flu-like symptoms, but nothing else. The flu-like symptoms are constant headache, eyeball-jolting/zaps when moving eyes or head, flushed face, shivering under a duvet when it's 28C, fatigue, and excessive sweating. Lots of things cause flu-like symptoms, from mosquito-borne infections to STDs, so I'm thinking I need to get tested for them to rule them out. I've started taking a big dose of DHA + EPA Omega 3 as recommended (thanks!) but I guess it's too early for that to have much effect (about three days now). I need to establish what's going on because I can't go to work at the moment.

Tom 


#18 gail

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Posted 19 April 2019 - 07:07 AM

Hello Tom,

Every single thing you described are symptoms of witdrawal.

Anxiety can play tricks on you making you believe that it's something else.

But, if it makes you feel better, it is ok to get a consult.

Even with slow taper, the first four months can be rough.

Others will come soon.

#19 fishinghat

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Posted 19 April 2019 - 08:16 AM

I agree with Gail although I am a little surprised that and extra bead or two didn't help. If they are not bringing relief I would stop them. Normally an extra bead every few days helps some. It is just a waiting game now. The brain zaps and flu like symptoms should start to fade away in a few weeks and will be replaced with more of the anxiety/emotional symptoms.


#20 invalidusername

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Posted 19 April 2019 - 09:04 AM

Can't add to that, but in perfect agreement. It seems like it is simply not possible for these things to continue, but I can assure you that this is the nature of the withdrawal. So difficult to accept.

 

If it helps, I am in a similar boat in so much that I cannot work. I switched out Lexapro for Celexa 7 days ago, and it has all caught up with me over the last 48 hours. I know it will pass, but its the not knowing. One thing I do know, and that is there will be no more changing of meds now. If the Celexa doesn't do the job, it will be augmentation therapy. My system simply cannot cope with switching between these pills.

 

Worse yet is that I am looking outside to a bright sunny day and loads of people outside enjoying it and I am stuck in bed. Wouldn't mind if it were raining!! Sigh....





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