27 replies to this topic

[Daley]

I have now had 2 failed cross tapers since starting in December 2018. First cross taper from Cymbalta to Prozac was too fast and caused terrible withdrawal when stopping Cymbalta. The second cross taper over a longer period was unsuccessful as well. During both cross tapers I felt very unwell with taking 2 drugs at the same time even on low doses. I have now stopped cross tapering and have stabilised on Cymbalta 30mg and have made a decision to stop Cymbalta first before considering any other antidepressant.

 

Can I have some help as to where to start? I’ve read about bead counting on this website but I don’t know how to open the capsules and what sort of taper schedule I should be on. I really need step by step instructions. Any help would be appreciated.

[fishinghat]

Welcome Daley.

 

First of all you will need to open one of your capsules and count the beads inside. The capsules will simply slide apart. The beads inside are usually very small so you need to open the capsule over a dish or a black T-shirt. The black T-shirt is said to work very well. Once you find the number of beads inside we will be glad to recommend a weaning schedule.

[invalidusername]

Hi Daley,

 

Unfortunately, two drugs together - over any length of time - can cause adverse effects sufficient for you to turn back to the first drug. I am in the throws myself with Lexapro and Celexa. Some people simply cannot tolerate a cross-taper, but it is a shame that you have to go through such trials to find this out. 

 

You did mention how long you were on the Cymbalta for? But as Hat says, once we have a bead count, we can go from there.

[Daley]

Hi Fishinghat and IUN, thanks very much for your quick replies. 

 

Fishinghat, I've opened the 30mg duloxetine generic capsule and there are 200 beads. I have counted them twice to double check. Thanks for the tip about using the black T shirt to count the beads on. One thing to mention about the beads is that some of them look like they are stuck together but they are not able to be separated so I have counted them as one bead only. Is that ok? 

 

IUN I've been on Cymbalta 60mg for about 5 years. The dose was increased to 90mg and then 120mg for a short period of time towards the end of last year but I was not able to tolerate the higher dose and my Psych decided to cross taper me onto Prozac which was a miserable experience and unsuccessful. I have stabilised on 30mg Cymbalta for the past week.

[invalidusername]

Right you are - 5 years is plenty time and a small wonder that you were having difficulty, but a right pain nonetheless. 

 

Some of the generics you will find the beads morphed together, and there is no real way of knowing how much of the ball is medicine and how much is the protective coating. Where people are that sensitive, these would be binned! 

 

So we are working with 0.15gm per ball, so I would say that a safe place to start from given your severity and length of time would be the one ball per day. This puts you on a trajectory on a 6 month taper, which might sound like a long time, but believe me when I tell you this is not slow!! Hat may suggest slower, but as we are talking 30mg here, I think we would be safe with the 1 bead. If after a couple of weeks you are tolerating this well, you can always step it up to 2 beads, but as sure as eggs is eggs, you will need to put the brakes back on as you approach the final few beads. As a rule, the last 10mg can be the worst, so when you get to the last 50/60 beads you need to tread cautiously. 

 

Hat will respond in the morning after his beauty sleep.

[fishinghat]

I am now beautified!!  (It would take more than sleep to make me beautiful). I agree with everything IUN has said. Of course the old axiom applies, the slower the better.

[Daley]

Thanks IUN for your detailed reply and thanks Fishinghat for your input.

 

So I am going to start bead counting on Monday.  I don't mind going slow. 

 

Is it ok to prepare a weeks worth of capsules at a time? If that is ok, can I store them in a plastic container? The only reason I ask is that as you know the capsules are in a blister pack which I think protects them from light. I'm probably overthinking this ...lol.

 

Thanks again for your support. I'll keep you posted.

[fishinghat]

Actually you are right Daley. It is ok to prepare a weeks worth ahead of time. (as long as you know which one had one bead removed, and 2 beads removed and 3 beads removed...). OK to store in a plastic container but they must be kept out of the sunlight and away from heat.

[invalidusername]

Its a very good idea - and exactly what I did. I bought a canister from eBay - you know the ones with the days of the week on? Messing them up is not something you want to do.

 

https://www.amazon.c...ay&sr=8-10&th=1

 

Four bucks from Amazon? 

[Daley]

I have a pill organiser with days of the week on it so that's what I'm going to use to store my prepared capsules. Thanks for the suggestion.

[invalidusername]

top banana

[Daley]

Hi again,

 

I’ve just realised that the generic brand of Cymbalta 30mg that I have commenced tapering with on Monday is not my usual generic brand. I had gone to a different pharmacy a few weeks ago and did not think about it. I refilled my script yesterday at my usual pharmacy and now have my usual generic Cymbalta brand which I have taken for many years.

 

I started my 2-4-6 schedule on Monday using this other brand which has 200 beads. I will be on this other brand for 2 weeks before resuming my usual brand

What should I do with my taper when I recommence my normal generic brand which has 220 beads? Should I just continue with the 2-4-6 schedule or should I adjust the taper for the extra beads in this brand? I don’t know if I am overthinking this but would appreciate your thoughts.

[invalidusername]

10% extra beads will be fine, but what you will need to do is adjust the starting point on the other brand when you get it. I can work this out for you if you can tell me when you will be starting to take the usual brand again, but essentially, all you need do is add 10% to the number of beads you are taking out when you switch. 

 

So... if after 2 week you are removing 28 beads from the non-usual, 28 x 110% gives you 30.8. Always round down, so you have 30 beads to start from, then just carry on from there.

 

Make sense?

[Daley]

Thank you IUN, that makes perfect sense. I'll be ok now when I switch back to my regular brand. 

 

It's so good to have help with this taper.

[fishinghat]

Right on IUN. Smooth sailing to you Daley.

[Daley]

Hi again,

 

I have been slowly tapering 30mg Cymbalta for approximately 8 weeks now and am down to 15mg. I have mostly been okay with this taper except for the past 3 nights I am experiencing brain zaps. I take my morning Cymbalta dose at 6am and the zaps are starting around 7pm in the evening. When I take my morning dose again at 6am the zaps stop until the evening. The zaps I am experiencing at the moment are not as severe as full blown withdrawal which I have experienced in the past but I am getting upset that they have started.

 

I am wondering what to do next. I am worried about what may come next regarding withdrawal symptoms. Any thoughts would be appreciated.

[fishinghat]

Hi Daley

Time to pause and stabilize. When you start dropping again drop about 50% slower. Just my opinion.

[invalidusername]

The zaps are coming on at the point of the half life - so this can be expected. Is textbook.

 

If this has just started happening, then as Hat said, I'd give it a a few more days to make sure there is nothing more sinister round the corner.

 

The last 10mg is known to be the critical point, but no harm is slowing at this point. You might be able to go the same dropping pace until you get to 10mg, but then you really do need to but the pace by half. Your body will then tell you how to proceed from there. Chances are there will be a point towards the last few beads where you might need to slow further. Just don't get impatient and keep listening to how you feel and you will be fine

[Daley]

Hi again,

 

Thanks for your replies FishingHat and IUN. 

 

A new symptom this morning is that I feel light headed like I am going to faint when I move quickly. It has gotten slightly better a few hours after taking my morning dose of Cymbalta but is still there. The evening zaps continue but are I guess manageable compared to full blown withdrawal zaps and resolve when I take my morning dose of Cymbalta. It’s all causing me anxiety wondering what will happen next.

 

I will remain on 15mg and hopefully stabilise for a few weeks. I might have to check in a bit more often as I need a bit of support at the moment with my anxiety. Thanks again.

[invalidusername]

Hi Daley,

 

The light-headed feeling is most likely an effect in the inner ear. There are a number of serontonin receptors in the vestibular systems which sends signals to the brain about our balance. When you start removing the level of serotonin it is used to, these signals can get mixed up. Alternatively, it might be related to blood pressure which can drop during withdrawal in some cases. If you are feeling dizzy, it will most likely be the former, but if you find yourself weak and/or visual disturbances, it might be worth checking BP. Either way, hang in there and it should pass. Just keep an eye on it. But for now, stay on the 15mg.

 

Check in as often as you wish - always here to help you!

[gail]

Daley,

Do check in as often as you like, you will never be a burden.

Do remain at 15 till you have stabalized. No hurry, no marathon. Love.

[fishinghat]

That dizziness when turning the eyeball or head quickly is a classic early symptom of Cymbalta withdrawal.

[Daley]

Hi again,

 

Thanks IUN, Gail and Fishinghat for your replies. 

 

A couple of days have passed since my last post. I’m feeling a little bit better. The zaps have slowed down and the lightheadedness is settling as the day progresses. I don’t feel normal though. Very hard to describe. I am staying on 15mg for the time being. I don’t feel in any hurry to reduce any further. I am feeling fatigued and I have low concentration but I can manage those symptoms.

 

I’m taking Omega 3 fish oil but I was reading here that I need to be on a high dose. The dose I am taking is 2 capsules in the morning (one capsule has EPA 180mg and DHA 120mg). I’m wondering whether I should be taking more capsules a day? 

 

Many thanks for all your kind support and reassurance. 

[invalidusername]

The things we feel during these times is very often difficult to describe - but rest assured that plenty of people will be feeling the same thing! Just stay put and it will level out in a few days. The brain is correcting itself 24/7 - just needs time.

 

That omega 3... unless you are close to 2000mg combined EPA/DHA, there will honestly be no benefits. 

 

You are taking 2 capsules of 180/120 twice a day giving you 1200mg, so you will need to at least add another 2 or 3 capsules from this brand - either added to the morning and evening, or take a third dose during the day - but this can easily be forgotten, so I would suggest the former. I know it sounds a lot, but the studies are there. 

[gail]

Hello Daley,

IUN is right about Omega. I take Omega joy, 650 EPA 100 DHA, 3 capsules a day. Total 2250.
I'm about to grow fins, plus my wings that are growing(lol) an angel with fins!!!!

Real normal not to feel normal, one morning you will wake up to the true you. Again, TIME AND PATIENCE. love.

[fishinghat]

"I am staying on 15mg for the time being. I don’t feel in any hurry to reduce any further."

brilliant move!!

IUN - "That omega 3... unless you are close to 2000mg combined EPA/DHA, there will honestly be no benefits."

Right on!!

[Daley]

Hi again,

 

I have been tapering Cymbalta generic now for about 3 months. The last time I posted I was in June. Since then I have continued my taper and have now reduced to 14 beads or approximately 2mg Cymbalta. I have mostly been okay but recently I have had a dull headache and light headedness. Because of this I have stayed on 14 beads for the last 2 weeks. The lightheaded feeling has settled but still have a dull headache but I think I am ok to continue tapering and have prepared this week’s capsules reducing 1 bead each day. I am also taking high strength fish oil liquid.

 

I would like some advice on how to proceed with my taper. Although I can manage with a dull headache I also feel a little “off”. I don’t know how else to describe it. At present these symptoms are not severe but I was wondering how people proceed with the last 2mg to 0mg. 

[fishinghat]

The dull headache is a telltale sign you are still having some withdrawal. To reduce at 1 bead a day would probably be a little risky at this point. I would suggest 1 bead every 3 or 4 days and see how it goes.