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Severe Withdrawal Since Discontinuing Duloxetine After Taper


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#1 glowbug

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Posted 20 August 2019 - 03:11 PM

First of all, I want to thank the owners of this forum and all of the people who contribute for helping me through this journey.

 

I started taking duloxetine a year and a half ago. I switched from Lexapro, which I had been on for a year, because the Lexapro caused me to gain twenty pounds (I literally never felt full on Lexapro and had some intense carb cravings) and because my neurologist suggested trying duloxetine as a migraine preventative. I cross tapered to duloxetine 60 mg, the recommended dose for migraine prevention. My mood was actually noticeably better on duloxetine than on Lexapro  (though I felt good on Lexapro too) but it did nothing to prevent my migraines, caused me to sweat an embarrassing amount (I already have excessive sweating and it got much much worse), and while I actually felt full after eating on duloxetine, the carb cravings became even more intense. I craved carbs the way I imagine a heroin addict craves heroin. I continued to gain another 15 pounds over the year and half I was on duloxetine because I could not resist the carbs, especially late at night. And after a year and a half the mood benefits also started to fade and I was becoming depressed because of my weight. Weight gain was the reason I resisted taking antidepressants for as long as I did (I have a history of anxiety mostly and a few episodes of depression). 

 

I made the decision to get off duloxetine at the beginning of the year and I started my taper in late April. I knew I was going to have to taper slowly because those few times I forgot to take the duloxetine I would have a very severe migraines within four to five hours of my missed dose, and I tend to be very sensitive to medication changes in general. I quickly learned that there is no way to officially taper slowly as everyone on this forum knows, which led me to bead counting. I read up on the different methods (counting vs. weighing, etc.) on this forum and I poured out a few capsules and counted the beads to see how many there were. They ranged from 190 to 240 so I decided I would decrease by 1% every day. The problem was when I tried this I always managed to lose some of the beads when I was in the process of emptying, counting, and refilling the capsules. I decided instead to just remove two additional beads from each capsule every day. The first day I removed two beds, the second day four beads, etc.. This worked for me. I didn't have any withdrawal symptoms with this method in the beginning despite there being a 50 bead variance in the number of beads. When I dropped below approximately 15 mg (could have been as low as 8 mg or 18 mg depending on how many beads were in the capsules) did notice that I was having some increased irritability and mild anxiety but nothing I couldn't push through. 

 

Last Thursday (5 days ago) I reached the end of my taper and I stopped taking duloxetine completely. The mild anxiety and irritability had increased in the week prior to stopping the meds but the day I discontinued completely I got very severe anxiety, irritability, rage, and weepiness. I had no physical symptoms, just the emotional ones so I worried I was having a relapse of my anxiety and depression, that how I was feeling was how a normally was, but on Saturday I started experiencing extreme dizziness, to the point where I have difficulty walking, standing, and sitting, mild to moderate nausea, and non-migraine moderate headaches. I'm sure this is withdrawal and not my normal anxiety and depression because of the extreme nature of my emotional symptoms (which have only gotten worse not better as the days go on) and the the physical ones. While I was quicker to anger before taking the meds I was never this much of a basketcase. I cry all the time now, am always irritated, and am so quick to rage. I feel crazier than when I was in the middle of my deepest darkest depression.

 

The reason I'm positing is because I don't know where to go from here. I can't function the way I am for much longer and my behavior is scaring my two young children, which makes me feel incredibly guilty, which in turn makes my anxiety worse and my crying spells more severe and more frequent. I don't know if I should try going back on the duloxetine and taper slower or if I should just try to ride out the symptoms. If do go back on, I don't know how many beads should I go back to. At this point I would just count the number of beads (instead of how many I was removing)  since it would be quicker and I would have plenty of extra beads in each capsule so losing them wouldn't be an issue anymore. And once I decide on a number do I just start taking that amount again or do I taper up? I don't think I would try going much higher than 50 beads to start with because I believe that's around the time I started experiencing the mild anxiety and irritation. I also have the option of asking my psychiatrist (who knows about my taper and is fully on board and monitoring me) to prescribe the 20 mg pills and tapering with those instead. I don't know how many beads are in the 20 mg. I'm guessing it varies by manufacturer and I don't know which manufacturer my pharmacy uses.

 

I'm also scared that it won't help and even if I taper slower I'll still have these awful symptoms when I discontinue the meds in another month or two and will have backtracked for nothing.  Staying on the meds longterm is not an option because the weight gain and sweating are unacceptable side effects and causing me to have social anxiety and depression. I have also considered trying an SSRI with a long half-life like Prozac and taper from one of them but I'm worried about the side effects while starting a new medication. I am very sensitive to medications and tend to get those rare reactions listed at the very end of the prescribing information (if mentioned at all). I was fine on Lexapro but the half-life isn't very long either so I don't know if there's any benefit to doing that. I'm just very confused about what I should do and need some advice. Thanks in advance.


#2 invalidusername

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Posted 20 August 2019 - 03:30 PM

Hi glowbug and welcome to the site.

 

I can see from your post that you have done a lot of homework and I am glad our little site here was of use to you this far... and you would have been perfectly welcome at any point during your withdrawal - we are here for support, banter etc - not just emergencies!!

 

So the thing here is, you did a relatively slow taper, but regardless of the speed of the taper, one should ALWAYS put on the brakes during the last 10mg or so. The brain will get used to the speed up til then, but thinking logarithmic, 2 beads represent a higher percentage of the medicine the lower it goes, eg 2 beads out of 100 is 2%, but 2 beads out of 10 is 20%... 10 times worse!! 

 

Therefore, yes - this is for sure the withdrawal and not a relapse. My advice would be to get some beads going again - and no - not 50 - this is way too much and will probably do more harm than good. We want you on just enough to be stable. If you have been 5 days cold, then I would suggest starting on 10 beads - give it 3 days to level in your system, and if you still feel like poo, add 2 more beads and continue this way and you should find a stable point. Then... again... yes, you need to go much slower from this point.

 

Please ask if there is anything you would like explained further or any other questions. Others will be along later I expect, but for now, well done for getting this far and for coming to the right place...

 

IUN 


#3 fishinghat

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Posted 20 August 2019 - 04:46 PM

I agree with IUN. This is withdrawal. Ir is very interesting how closely this resembles my withdrawal which was very mild until I got down to 1 bead. I would say there are several options.

 

Go on an ssri like Zoloft, Lexapro or Prozac But they may or may not help and you would still have to taper off of them.

Go back up around 10 beads (that is 5% of the original number of beads approximately. If you don't stabilize there within a few days then try 20 beads.

There are various supplements that may or may not help as well as a couple of prescription meds.

 

There are also things to avoid in withdrawal like sugar, caffeine, energy drinks and much more.

 

Let us know if you are interested in any of these approaches an d we will provide more details.


#4 glowbug

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Posted 20 August 2019 - 11:58 PM

Hello IUN and fishinghat. Thank you for your quick responses. I have taken your advice and taken 10 beads this afternoon. I will take another 10 tomorrow morning, which is typically when I take my duloxetine. I knew when starting my taper that reducing by 2 beads towards the end of the taper would be a much higher percentage than it had been in the beginning, and I had actually been planning to reduce by only one bead once I got down to around 10 mg and maybe even stay with the same dose for more than a day, but I really wasn't experiencing terrible withdrawal symptoms and I was so eager to be off that I pushed along when I should have slowed down. I let my desire to be rid of the duloxetine side effects cloud my judgement. 

 

I am planning to take 10 beads for a few days and see if I stabilize. If not, I'm unsure if I should just add 10 more beads or if I should do what IUN suggested and add two beads and see how I feel. If I take that rout, how long would I give the two additional beads to work before adding two more? This may be unnecessary but I do like to have a plan that I can just jump into if the 10 beads aren't working. 

 

What other supplements can possibly help to mitigate the withdrawal symptoms. I am interested in at least trying something. 

 

Reading back my original post I don't think I was clear that if I did switch to Prozac (which I've never taken so don't know how it will affect me) or Lexapro (a longer half-life than duloxetine but still not that long) I would being doing it because both of them seem to be easier to taper off of. This is my least favorite option because I really don't like the idea of switching meds, but I am not closed off to the possibility if I can't get off duloxetine any other way. I'm hoping that going up to 10 beads (or even 20 if I have to) will get me stabilized and functional, and then tapering more slowly from there will help me avoid some of the withdrawal symptoms or at least have them be at a manageable level. 

 

Once I find a number of beads where I am stable and no longer a basketcase, how long should I stay on that dose before tapering. And once I do start the taper, how should I go about doing it? Reduce by one bead instead of two? Reduce every other day? Every third day? Every week? I know the answer is probably dependent on the individual but how do I know what schedule to start with?

 

Any advice would be greatly appreciated. I'm so glad to have some support from people who have been through this themselves and with others.


#5 invalidusername

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Posted 21 August 2019 - 07:10 AM

It really depends on how bad you are feeling after settling on your 10 beads. Give it til the weekend and if you are still feeling really bad, then go with the 10 bead Hat suggested, if not stay put or go 2 beads. Listen to your body and then decide.
 
What are the main symptoms of the withdrawal that are causing you the most discomfort? We can suggest some supplements to aid...
 
Once settled on the 10 (or whatever) beads, which I would suggest you maintain for a few days, I would then suggest a bead every three days. Give yourself a month to come off slowly. There is no prize at the end of this race!

#6 fishinghat

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Posted 21 August 2019 - 06:57 PM

Like IUN said. Listen to your body. Once you have been stabile long enough you will know when you are strong enough to start weaning. Start weaning slower and then even slower.


#7 fishinghat

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Posted 21 August 2019 - 07:00 PM

I will get back to you on the supplements. Sorry, long day. Need some rest.


#8 fishinghat

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Posted 22 August 2019 - 08:25 AM

Ok glow bug, lets take a look at some of the options for you.

The following information is from the document Summary of Cymbalta Withdrawal in the Medical Support section. That document contains considerable other information as well as safety information on these and other supplements. If you decide to try any of these please let us know and we will try and give you as complete information on the supplement as we can.

Items Proven to Help Many with Cymbalta Withdrawal symptoms.

8/8/18

Part 1

Dramamine
Helps with lightheadedness, jolts, dizzy spells, sleep, nausea, brain swooshes, calming, motion sickness, brain zaps, Sloshy head, and anxiety.

Active Ingredient
Dimenhydrinate - an antihistamine - Do not take with other antihistamines (such as cetirizine, diphenhydramine, hydroxyzine).
Caution - some members state that "dramamine did..." but as listed below there is a difference in ingredients and dosing for different kinds of dramamine. Please follow label directions. Dimenhydrinate is available in 98 products approved in the USA other than dramamine so please check label ingredients before using with other products. Nearly all nausea, cold, flu, sleep aides and dizziness medicines contain antihistamines and are incompatible with each other. Check ingredient list closely. These drugs Will NOT contribute to Serotonin Syndrome.
Note - If taken on a regular basis, it stops working
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Bonine -
Active ingredients (in each tablet) Meclizine HCI 25 mg.

Meclizine
Taken for headaches, nausea, dizziness, brain zaps.
Meclizine (an antihistamine) is available in 104 products approved in the USA other than Bonine so please check label ingredients before using with other products.
Will NOT contribute to Serotonin Syndrome.
Caution - Tell your doctor about all medicines you use, and those you start or stop using during your treatment with meclizine, especially the antidepressants bupropion, duloxetine, fluoxetine, paroxetine, or sertraline.
Using meclizine together with duloxetine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating.
Common side effects include blurred vision, dry mouth, constipation, dizziness, drowsiness, headache, vomiting, or tiredness.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems (such as asthma, emphysema), high pressure in the eye (glaucoma), heart problems, high blood pressure, seizures, stomach/intestine problems (such as ulcers, blockage), overactive thyroid (hyperthyroidism), difficulty urinate, liver problems, kidney problems.
Sarah noted "Dramamine II (not the original Dramamine) contains the same active ingredient as Bonine. Some places also sell generic Meclizine and I have found it at CVS. Some very closely related drugs are buclizine, and cyclizine.

Some brand names that contain meclizine, buclizine, or cyclizine are:
Bonine
Bonamine
Dramamine II
Marezine
Marzine
Meclicot
Medivert"
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Rugby Travel Med

Meclizine HCI 25 mg and they contain the artificial sweetener Aspartame, also contains Phenylalanine 0.28 mg per tablet (can cause anxiety and nervousness in some people).

Truck Princess commented that "I have found that taking the Rugby travel sickness med 25mg took away ALL my withdrawal symptoms for the majority. I don't get any brain zaps, dizziness, head swooshing, none of that. Also with the Rugby it's 24hrs so you only take one or two. The Rugby I took because of the nausea was so bad and just discovered it really got rid of most of the withdrawals and I didn't get the crying spells like you and others have."
This may partly be due to the fact it also contains Phenylalanine which other members report as helping their symptoms. (See below)
Caution - Many of the above products contain Lactose, a concern if you are lactose intolerant. They may also contain artificial colors that may irritate the nervous system and artificial sweeteners that can irritate the stomach in some people.
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Imodium AD

Members report it is very effective for dry heaves and diarrhea.

Fishinghat - If the dry heaves are bothering her you might try a half dose of Imodium. It helps relax the GI muscles but don't use it if constipation is an issue. In the case of constipation you can have her suck on a peppermint lozenge. This relaxes the esophagus/stomach but does not affect the lower intestines and does not aggravate constipation or diarrhea. Be sure it has real peppermint not peppermint flavoring. I have occasional esophageal spasms (a weaker form of dry heaves) and they work well for me. I buy mine at a health food store for about $3 for 10 lozenges.
When I went through mine I lived off of Imodium and Pepto for the digestive issues.
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Pepto

Upset stomach and diarrhea

Fishinghat - I know I lived off of pepto, Imodium and antacids. I had some good success with Pepto. I used it for occasional relief as too much can cause constipation, black stools and ringing in the ears.
Many members report using it successfully for stomach issues including nausea, cramping, and diarrhea.
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Diaper Rash Cream

Itching

Pitbullmama- The diaper rash cream actually helped soothe the itch some.
Runni - Anyway, back to itching I found that Calamine Lotion was helpful, Pure Aloe Vera gel was very cooling and also cream that can be bought for diaper rash in babies is especially good.
Vickif - hey even diaper rash cream works(by generic it cheaper)
AproDerm Emoillent cream
Katherine - (Red Face Rash) If anyone else is suffering from this I just wanted to give hope that this side effect only lasted a few days and that I eased it with AproDerm Emoillent cream,
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Advil LIQUID BLUE GELCAPs Cocktail
Used for pain

Heartfeatherss - Try taking 4 ( yes 4) Advil LIQUID BLUE GELCAPs with a Coke. It has to be the blue gel caps and it cannot be a diet Coke. My neurologist told me to do this and I was so miffed, thinking he was just not understanding how bad it hurt... but dang! It works!! Hope this gives you relief. Contains ibuprofen and dihydramine. Should not be taken with other amines like Benadryl.
Indian J Exp Biol. 2003 Nov;41(11):1322-4.
Influence of acidic beverage (Coca-Cola) on pharmacokinetics of ibuprofen in healthy rabbits.
https://www.ncbi.nlm...pubmed/15332505
Note - This sure sounds like it puts a lot of Advil into the system. The articles I read from migraine users all say the same thing it must be coke a cola and name brand Advil liquicaps.
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Dextromethorophan

FiveNotions - I didn't check, but my bet is that Tylenol Cold contains DMX -- "dextromethorphan" .... it's a serotonin agonist (enhancer - reuptake inhibitor) ...
Nyquil contains a lot of it, which is why someone taking Cymbalta (duloxetine) or any other SSRI shouldn't use Nyquil ... there are case studies about the combo causing severe serotonin syndrome ...
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Zantac

Acid control, upset stomach and fights anxiety
Contains Ranitidine is an H2 histamine receptor antagonist that works by blocking histamine and thus decreasing the amount of acid released by cells of the stomach.
http://www.cymbaltaw...tion#entry66071
Zantac (Ranitidine) For Anxiety And Depression
FiveNotions - I've stumbled onto the discovery that Zantac, which I'd been taking for severe acid reflux, seems to help my post-crapalta anxiety ... did some research, and found a number of old (really old) articles that seem to confirm this ... here's one of the freely available ones ...
jimmcg - Now, with a week on the Zantac, I feel much more in control of these feelings. I may wake up worrying about something in the middle of the night, but, unlike before, I can talk myself through it and go back to sleep.
Caution : but be aware that new research is showing that extended use of Zantac, and / or use of the highest dose, may cause liver damage.
https://livertox.nlm.../Ranitidine.htm

Drug interactions -
Zantac (Ranitidine) may significantly increase the blood levels of loperamide (Imodium). This can lead to serious and potentially fatal complications such as irregular heart rhythm and cardiac arrest, especially if you use more than the recommended doses of loperamide.
Zantac CAN be taken with Benadryl. They are different types of antihistamines. Drugs.com
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Diphenhydramine, (over the counter) also known as Benadryl, is an antihistamine and as such is not only used for allergies/colds but also as a sleep aide. It does have a mild anxiolytic effect. May lower blood pressure and cause irregular heartbeats. Your body does build up tolerance to it after a few weeks. This medicine has many drug interactions.
Begins working in 15 to 30 minutes
Peak levels - 2 to 2.5 hrs
Half Life – 4 to 6 hrs
Use by members for anxiety relief and to help sleep is too numerous to mention.

Diphenhydramine should NOT be taken with hydroxyzine. Drugs.com

serendipity - I found Benadryl to produce hangover effects, and cause palpitations when taken long term. Even if you wake up in the middle of the night, and can't get back to sleep, even a teeny amount (say, 15mg) can induce sleep again.
Schmb - Benadryl worked on a limited basis for me, because sometimes it makes me jittery, and that only made the zaps much worse, so just use some caution in case you are sensitive to it.
FH - One caution on Benadryl. It is famous for bad reactions with other medicine so check your compatibility closely. The maximum dosage of Benadryl is 25 to 50 mg every 4 to 6 hours and do not surpass 300 mg in a day.
Benadryl Total
Medicinal ingredients:
•Acetaminophen, 500 mg
•Diphenhydramine Hydrochloride, 25 mg
•Pseudoephedrine Hydrochloride, 30 mg

It contains diphenhydramine which is the active ingredient in regular Benadryl and also pseudoephedrine which is common in most cold medicines. The Diphenhydramine helps with sleep and anxiety and the pseudoephedrine helps block the action of adrenaline which produces a calming effect.
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#9 fishinghat

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Posted 22 August 2019 - 11:33 AM

Well glowbug, I keep tryin g to post the rest of the info but it will not let me. I can only post short sentences right now. Sorry.

#10 fishinghat

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Posted 22 August 2019 - 11:35 AM

Part 2

Omega 3

Dose - Omega 3 is recommended at 2000 mg/day EPA and DHA for anxiety, give or take a couple hundred depending on what research you read. It has been shown that only the EPA and DHA components effect anxiety. Any other omega 3 fatty acids don't do anything for anxiety. Life Extensions, Mega EPA/DHA, is distilled (molecularly purified) so you don't get any impurities with your product plus it contains no mercury. Some even provide a certificate of analysis if requested. They also have ones that are enteric coated now that will not irritate the digestive track and has no fish burbs to them.

http://www.cymbaltaw...elps#entry67706
This thread contains a detailed discussion on use of Omega 3.

Also this thread....
http://www.cymbaltaw...elps#entry68036

Fishinghat - Omega 3 fish oils can be very high in mercury depending on the type of fish used. Some have tested at over 300 ppm mercury. There are brands out there that are mercury free or low mercury guaranteed. Something to think about. If you have thyroid issues they usually contain high iodine concentrations also. One member had an episode of high iodine toxicity I couldn't find a iodine free product. If your thyroid is fine then this should not be an issue.

FH - Cod liver oil you buy in the store may be high in mercury and pesticides. The liver is the pollutant filter for the body. Cod livers are from the top of the food chain and pollutant levels are usually significant. Be sure to get one that is purified and verified mercury free. But I don't believe there is one verified pesticide free. Great care must be used in selecting one. It also contains fairly significant levels of vitamin A and D and toxic doses are known to occur. Routine blood analysis for Vit A and D should be done every 6 months if using Cod Liver Oil or any Fish oil.

#11 fishinghat

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Posted 22 August 2019 - 11:38 AM

Part 3

Ginger

Helps with nausea and stomach issues.
25 positive remarks and 4 negative.
Tips from members...
FN - ginger tea (really strong), ginger ale (old home remedy for sure), and ... candied ginger, raw ginger.
Even it sounds disgusting, eating Ginger raw is the most effective way cured my nausea in 5-10 minutes
AH - Ginger root works very well for nausea. I have 550mg ginger root capsules, and this has helped with a lot of the nausea and stomach upset. I'd totally recommend buying the ginger root in capsule form at the health food store. Mine was $8.99 for 100 capsules, and I will take 2-3 whenever my stomach is upset. And of course we can't forget ginger tea. It is soothing, relaxing, and will also help your stomach feel better.
ta2ed - You can try ginger root... Wont make you tired.
Betty - I'd recommend trying ginger ale -- not Canada Dry but the real strong stuff, sometimes labeled Jamaican ginger ale or ginger beer. It's sold in four-packs here, in the health food or imported section of the store. I've had "irritable bowel" problems for years and have found this is real medicine, with no downside I can see! It also works for nausea.
Anna - I thought I would give just smelling ginger a try. I put 2-3 drops of ginger essential oil on a cotton ball and my nausea pretty much disappeared almost instantly.
Latte - ginger candy for nausea - I swear by it, particularly the Gin-Gin brand
Amberd - I tried ginger tea, but it only gave me indigestion on top of it all.
Vinvin - The Fierce Green Apple Gatorade, Dramamine and Boylan's Ginger Ale seem to help out as well

Travelcalm Natural
Travacalm Natural contains 100mg of dried ginger root extract that offers faster relief in conjunction with 400mg of root powder that helps sustain the soothing effect. Each tablet contains: Zingiber officinale (ginger) 500mg as root powder 400mg and dried root extract equivalent to 100mg of root powder.
EOTR - I am taking 'Travelcalm' Natural - costs $4.50 for 10 tablets and ......it works!
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Bragg's Apple Cider Vinegar

Used for detox, fibromyalgia, arthritis, zaps, fatigue, shakes, muscle aches and pains.
Tfaff - I'm trying to " detox" by eating well, finding foods that help detox the liver. I drink that apple cider vinegar/ honey/cinnamon mix that came up in another post here.
Fivenotions - I took myself off completely a few months ago and went back to home remedies (ginger tea and ginger slices, as well as Bragg's vinegar) ... the home remedies work pretty well (not perfectly) for the acid reflux ... but the "stomach worms"/anxiety every so slowly started to ratchet up ...
Another "home remedy" that really helped me (still does, I'm still taking it) is Bragg's Apple Cider Vinegar ... it's also available in most health food stores, as well as from the internet (Amazon, and Bragg's directly) ... can be put in water, with honey, etc.... during early withdrawal, I drank it straight ... my food cravings were totally weird, and at the time it actually tasted great just like that ... blech ... there've been studies (which I now can't find, typical) that indicate it's a food that naturally increases serotonin levels ... it also cured my arthritis ... (Grandma knew more than I gave her credit for!)
The Bragg's ACV, which is unpasteurized and has what they call the "mother" in it...weird term, but that's the stuff that would otherwise be pasteurized out ....what starts to form when apple cider begins to go "hard" ....

Here's the link ...
http://bragg.com/

I started taking it early in withdrawal ... totally by self-discovery ... I was having an amazing craving for vinegar tasting stuff...like dill pickles...actually, the juice they come in...so I did some googling...

It was very helpful to me with the withdrawal ... seemed to help with the zaps, my constant tiredness and the body "shakes" I got .... now, I've found that it's pretty much cured my arthritis...
Fishinghat - By the way some have had very good success with Bragg's Apple Cider Vinegar for their fibro. There is some medical research that supports this. If you do a search on this site you will find several discussions about it. Be aware it is acidic so it can upset the stomach. The reason the Bragg's is the only Apple Cider Vinegar that works is that it is unpasteurized and therefore has all the original components. If you have any questions about the Braggs let me know and I will try to answer them.
Lady Nancy - I could not resist the urge to search and found several references to Bragg's Apple Cider Vinegar which is an unfiltered and unpasteurized apple cider vinegar. Many are unable to take it due to stomach issues in which case a good alternative is Malic Acid/Magnesium in pill form as it works the same.
The dose for the Bragg's is two teaspoons in a cup of water. It is much stronger than regular Apple Cider Vinegar which is probably why it causes stomach aches for some even with some sugar or honey added. I know that I would not be using sugar at all if possible as it actually adds to joint pain and feeds the inflammation. .
Fishinghat - A little caution on the vinegar, which has been shown effective, added vinegar ingestion by women has been linked to increases in vaginal infections due to changes in blood and vaginal pH.
katrand - I also add Bragg's apple cider vinegar to my orange juice every morning to aid in absorption of my thyroid meds and supplements.
TFL - Are you taking anything for the joint pain? I found that Apple Cider Vinegar (Braggs is the best - natural!) is a great help - you can mix a couple of spoonfuls in a cup of warm water with 1 spoon of honey and some cinnamon - almost tasty! I have arthritis and fibro and this really helps - give it a couple of weeks...
BJinFl - I have tried ACV, fishinghat, thank you. Unfortunately, I have one of those stomachs that can't stomach anything.
Fishinghat - For fibromyalgia I would try Braggs brand Apple Cider Vinegar. The dosage is 2 tablespoons in about a cup of cold water once a day. There has been some medical research that this juice has benefit for fibro and arthritis pain. This brand is the only one that works because it is the only one that is unfiltered and not pasteurized. Many find this solution to be too acidic for their stomach to handle, if you have that problem then buy some malic acid/magnesium tablets at your local health store. Malic acid and magnesium are the active ingredients in the Apple Cider vinegar.
Gail - ....each capsules contains 500mg apple cider vinegar powder, 300mcg potassium and 4mcg bore.
Fishinghat - He said to use a 50/50 blend of Braggs (sp) apple cider vinegar and water on the area on her back where the nerves are pinched. It may take a couple months to make a difference but will reduce the arthritis and the pain greatly. He recommends it to many of his patients as a way to reduce there use of pain meds for arthritis. I asked him if he has ever heard of using it on fibro and he said that the ACV worked better on the fibro than it did the arthritis.
http://www.ehow.com/...bromyalgia.html
This article explains the basics of using ACV to treat Fibro. I found maybe 50 articles or so that say basically the same thing and many forums that say it works.

http://www.ncbi.nlm..../pubmed/8587088
This research article demonstrates that malic acid is very beneficial in treating fibro. AND malic acid is one of the main ingredients in ACV. It is suggested that there must be magnesium present for it to work and there is magnesium in ACV.

Bragg Organic Apple Cider Vinegar is the type most often mentioned on the forums.

Gonnamakeit - Well, I decided to give this a try and started this morning with this recommended by Whycee a while back: "A cup of hot water, 1/2 teaspoon of cinnamon, two tablespoons of apple cider vinegar and a teaspoon of honey every morning" minus the cinnamon as I'm allergic and I have to say that it seems to be working! I had two servings this morning and this is the first good day since last Friday and I even woke up with my period in full force AGAIN--it just ended Sunday (apologies to the men!) and even those cramps are so much better.
FiveNotions -
Drinking to Cure: Apple Cider Vinegar and Cherry Juice for Arthritis?
http://www.healthlin...juice-arthritis

This isn't an article, but a collection of links to info about the ACV arthritis connection...also, we had an interesting discussion here a while back about tart cherry juice as a remedy for withdrawal... https://www.cymbalta...l=+tart+cherry

The healing powers of vinegar
http://www.dailymail...rs-vinegar.html

http://www.anyvitami...inegar-info.htm

Serotonin/tryptophan connection mentioned . . .
http://health.usnews...e-cider-vinegar

This is an interesting discussion about ACV from the Social Anxiety Forum....
http://www.socialanx...a-relief-47323/
Wagtail - I think it was Fivenotions that recommended the apple cider vinegar , so I decided to try it . I can't say if it's a coincidence or not , but I do feel better since I've been taking it ... Less s/e's & more energy .. I'm happy with that !..:-)
Carleeta - Holy Moly...Apple cider vinegar...wow...I use it daily with Iceberg lettuce...I use it on my fish and on my potatoes. .Also, I mix apple cider with fresh caused garlic and fresh ground black pepper, place it in a small bowl and dip pieces of meat (steak, pork chops) on it and eat them...I also soak crispy friend pork rinds in the bowl mixture and eat them...I guess I use apple cider vinegar a lot. It's possible this is what keeps me going forward...I like that it does burn fat also... So great to know it's helping you out with your cymbalta withdrawal....
JBhibbard - Drink lots and lots of water. Have you tried the apple cider vinegar detox? I believe it helps.
Andreamarie - For supplements I'm taking B Complex, Omega 3s, and apple cider vinegar.
Whychee - A cup of hot water, 1/2 teaspoon of cinnamon, two tablespoons of apple cider vinegar (Braggs) and a teaspoon of honey every morning.
plezhelp - i cannot say what will work for you but i continue to try different things = being open to change as the *** side-effects change too! the best thing i am still doing is tepid Epsom-salt baths with baking soda, and apple cider vinegar - which has helped a lot with the itching; i have no idea which one of those things are the best/better 'healing' but know that they are all currently helping me.
happyzappynot - I found that adding a teaspoon of cider vinegar to a glass of water helped my gut.
andie - I have bought some omega 3 6 9 and taking apple cider vinegar. everything has been very bearable so far so good xx
Nmood2talk - I started taking apple cider vinegar over a week ago to help with metabolism and weight issues - it does - more energy than ever - less appetite but amazing result is how I didn't know it helped get off Cymbalta - I tried before because when I didn't have money for meds at times I had terrible brain zaps(like electric shocks in my head) and terrible nightmares- and the pain in my legs got so much worse -
the apple cider vinegar has worked 3rd day off minimal leg discomfort - no brain zaps - no nightmares - have felt better than I can remember ever - look up apple cider vinegar on Web MD and other places - don't drink straight as it will irritate throat - harsh to teeth - look to see if any side effects - says it could interact with meds ... just research it - but I'm telling you - it's an answer for me so far when I thought there were no answers - apple cider vinegar - look it up - nothing fancy although they say organic is better - got mine at the dollar store and like I said took it initially for weight loss - which it is curbing my appetite and making me feel so much better and I'm losing weight but the off Cymbalta without terrible withdrawals was the unexpected unbelievable finding - look it up - research it - and let me know
IamwhoIam - Prepare a mixture of apple cider vinegar and honey. Consume this mixture; this home remedy is highly effective in relieving vertigo.
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#12 fishinghat

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Posted 22 August 2019 - 11:40 AM

Part 4

Melatonin

FH - a research article where it was shown that taking 3 mg of melatonin under the tongue (sublingual) helps with anxiety. Place it under the tongue until dissolved and gone. In case you are not familiar with melatonin it is the chemical your body produces in the evening to make you sleepy and ready for bed.
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Gatorade

Many members found Gatorade to be considerable help in fighting most withdrawal symptoms, especially the green gatorade.

Kindorf - Also I have been avoiding caffeine so I cut out my coffee and sweet tea.
I replaced then with fruit juice, ( mainly apple juice ) water and Gatorade. Today no stomach cramps I think they are done. No diarrhea, Lord I hope that is gone.

Judy - I knew that Gatorade helped with the light-headed, "floating brain" feelings.

watchdog - Drinks LOTS of GREEN gatorade..... don't know what the deal is, but it helps.

wiraz - Drink at least one G2 Gatorade a day – stay away from the full sugar version, leads to a higher chance of diarrhea. I drink one 32 oz bottle every day plus tons of water!!

caroline - Vit E also for head and joints and then Gatorade's G2. I didn't want the sugars so I went with the G2

Rafael - I have mild brain zaps but I believe the omega 3 Fish Oil and Gatorade are helping.

Sandlion - I took fish oil/other Omega 3 and also found that Gatorade helped -- maybe it's the salt replacement after all the nightsweats.

guppie - I'm a month off the drug so only minor zaps now and then. Whoever gave the gatorade advice is a genius. That treats them instantly (make sure you get the low calorie gatorade since regular is high calorie). Brain zaps are minor. I grab a gatorade and that gets rid of those for a bit (electrolytes).

Alisha - gatorade-had one of the big bottles yesterday and it did seem to help,

Vinvin - The Fierce Green Apple Gatorade, Dramamine and Boylan's Ginger Ale seem to help out as well

Summary - Many members mentioned drinking Gatorade for the electrolytes after diarrhea, night sweats and when having brain zaps. G2 was often mentioned because it has no sugar (not true, see below). Also, it was suggested that one should not just rely on Gatorade alone for hydrated but should also drink plenti of water. Green Gatorade is highly recommended by some members. Vitylite and Powerade were also mentioned a couple times for electrolytes. I would also recommend Isopure as it comes with and without sugars and proteins with a similar amount and type of electrolytes as Gatorade.

G2 Gatorade - It has the same amount of sugar as regular Gatorade and nearly all the same ingredients and electrolytes.

Gatorade Fierce Green Apple Sports Drink - This may be the "green gatorade" that members spoke of. It contains malic acid, the active ingredient in apple cider vinegar which has proved so helpful to other members. Other ingredients are the same.

Isopure Zero Carbs - No sugar, with some calcium. Contains Malic acid
Isopure Mass - With sugar and proteins, with calcium, Contains Malic acid
Isopure zero carb with proteins - no sugar, contains proteins. With calcium Contains Malic acid

Sparkybird - I’ve found that Pur Aqua Sparkling Frost in any flavor has malic acid. I discovered it by accident. It is only 50 cents at Aldi’s. It is only 10 calories a bottle.
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L-theanine

L-theanine is an amino acid precursor to glutamate (involved in the synthesis of GABA) and glutamine. It can cross the blood brain barrier. It is only produced by plants and fungi and a component in some teas. It inhibits glutamine transporters and glutamate transporters, and thus blocks the reuptake of glutamine and glutamate. Theanine increases serotonin, dopamine, GABA, and glycine levels in various areas of the brain. Caution – Most plants that contain L-theanine also contain caffeine and it can be a significant contaminant in L-theanine supplements. It is synthesized from glutamate using the enzyme glutamate decarboxylase and pyridoxal phosphate (which is the active form of vitamin B6) as a cofactor. This process converts glutamate, the principal excitatory neurotransmitter, into the principal inhibitory neurotransmitter (GABA).
http://en.wikipedia.org/wiki/Theanine

Member's comments
(puritan's pride) 200 mg capsules 2- 3/ day. I have been taking this prior to Cymbalta detox. It helped me reduce my dosage of clonazepam. Within 20-30 mins I feel more calm. I do believe it is helping keep the anxiety in check.
Tinabee - For now I have started taking fish oil and a supplement called Theanine Serene that is supposed to help with anxiety. I know it sounds silly since I've only taken the anxiety supplement for a couple days but I really feel like it has helped.
200mg L-Theanine in the morning with a full glass of water on an empty stomach, you can take again in late afternoon 100 to 200 mg if needed (make sure it is suntheanine - it helps with headaches and pain as any painkiller I had just did not cut it)
Member's comments were generally favorable.

http://www.cymbaltaw...page-2?hl=helps
Page 1 and 2, detailed information on L theanine and its usage.
Research
The research shows that all green tea leaves contain both L-theanine and D- theanine BUT only the special processing used by the manufacturer produces pure L-Theanine and is the choice of many of the research biologists.


Five of the six products contained significant amounts of D-theanine. Only one product, SunTheanine, appeared to contain only the L-theanine enantiomer. D-theanine is not used by the humnn body. Suntheanine is the pure ingredient and that is what you want.

Key Points
Theanine increases serotonin, dopamine, GABA, and glycine levels in various areas of the brain.
Scientific Information
A National Standard monograph that reviews current research on theanine reports that it is likely safe in doses of 200–250 mg up to a maximum daily dose of 1,200 mg. Theanine is used to help with anxiety, blood pressure control, mood, and cognition.
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#13 fishinghat

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Posted 22 August 2019 - 11:43 AM

Part 5

Prescription Meds

Clonidine

Clonidine (Catapres, Kapvay, Nexiclon, Clophelin) is a classic blood pressure medicine BUT it is very effective on anxiety. It is an alpha adrenergic antagonist which means it stimulates the alpha adrenaline synapses located in the frontal lobes of the brain. When these synapses are stimulated by the clonidine the brain thinks that it is due to adrenaline and it tells the adrenal gland to produce less adrenaline. It is a little slow to kick in, about an hour and a half. It has a 12 hour half life. Most drs prescribe 0.1 mg twice a day. One to be taken about an hour before bedtime and the other in the morning. Because it decreases adrenaline it has a strong calming effect which helps a person get to sleep and stay a sleep. It is not unusual for people to have a little drowsiness from clonidine until they get use to it (1 or 2 weeks). It does NOT work faster sublingual (under the tongue) like benzos. These have no withdrawal but your blood pressure may spike for a couple weeks if you cold turkey. Due to the lowering of blood pressure and sleepiness it is common for the patient to start with ½ tablet at bedtime. Once the patient adjusts to the medicine they begin a ½ tablet in the morning. As sleepiness and blood pressure stabilize they are slowly worked up to the 2 tablets (0.1 mg each) a day.
Begins working 60 to 90 minutes
Peak levels – 3 to 5 hrs
Half Life – 12 - 16 hrs
There are too many research articles on clonidine's anxiolytic properties to list here.
FH - I started clonidine but it was a relief to me NOT to be able to feel my heart pound through my chest. As long as your bp is OK you shouldn't have a problem.
That is why the slow start up. This gives your heart a chance to adapt to the new med. I did the same slow start up and my bp stayed within normal range. Just keep monitoring your bp and you should be OK.
FN - clonidine worked wonders for me

Hydroxyzine, (Vistaril, Atarax) - is an H(1)R antagonist, is very effective against anxiety in most people but some get no help from it at all. It is not addictive nor does it have withdrawal but it also can lower blood pressure some but that usually goes away with time. This medicine should be started slowly to give your body a chance to adjust to the blood pressure effect. Normal dose is 25 mg four times a day but can go as high as 400mg/day.
Begins working in 30 minutes or less
Peak levels - 2 hrs
Half Life – 15 to 20 hrs
Do not take with cimetidine as it increases hydroxyzine levels in the blood.

https://www.mayoclin...se/drg-20311434
(Mayo Clinic)
For oral dosage forms (capsules or suspension):
⦁ To help control anxiety and tension:
⦁ Adults—50 to 100 milligrams (mg) 4 times a day.

Atenolol is a beta 1 adrenergic receptor antagonist, also known as a beta blocker. It does not pass through the blood brain barrier which limits its side effects compared to other beta blockers. It has been linked to a higher risk of type 2 diabetes. It may cause drowsiness and lower blood pressure. Typical dosage around 25 mg four times/day. Dosage should be slowly increased.
Begins working in 30 minutes to an hour
Peak levels – 2 – 4 hrs
Half Life – 6 - 8 hrs
SF - So now I am on one. It is called Atilonol (Atenolol?) and calms down your heart rate too.

Buspirone (Buspar) is a serotonin 5-HT1A receptor partial agonist and a dopamine antagonist at the receptors. It functions as a weak anti-anxiety medication similar to diazepam in strength (a weak benzo). No withdrawal or tolerance issues. Dosage should be kept low if taking a ssri and/or snri or St. John's Wort as it may cause serotonin syndrome. DO NOT take with grapefruit or grapefruit juice. May lower blood pressure. Typical dosage is 10 to 20 mg three times per day.
Begins working 3 to 7 days after begin dosing
Peak levels - 1 hrs
Half Life – 2 - 4 hrs
https://www.ncbi.nlm...pubmed/22998742
Buspar (15mg) and Melatonin (3 mg) yielded the best anti-depressant effect of any combination concentration tested. (See Melatonin below)
https://www.ncbi.nlm...pubmed/25156283
Buspar and melatonin in combination is anxiolytic.
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Dos and Don'ts

DON'T ...
take Omeprazole (Prilosec)
Significant drug interactions.
omeprazole ↔ citalopram
Applies to omeprazole and Celexa (citalopram)
Talk to your doctor before using citalopram together with omeprazole. Combining these medications may increase the blood levels of citalopram and increase the risk of certain side effects, including an irregular heart rhythm that may be serious or life-threatening.
Caution - Omeprazole causes the increased absorption of nearly 500 medications. It should NOT be taken with.....
Benzos, Atenolol, Celexa, Lexapro and many other ssri and snri, st. john's wort, etc.
take St. John's Wort, 5HTP, tryptophan, SAMe, Dextromethorphan (a cough syrup/cold medicine) with an antidepressant - Serotonin Syndrome.
Don't take Stimulants (Make anxiety worse)
Caffeine
Over-the-counter cold preparations contain phenylpropylamine and pseudoephedrine*
Sleep deprivation
m*********
Magnesium*
MSG
Alcohol
Stress
amphetamines
ecstasy
nicotine
Ginseng
L-Tyrosine
B Vitamins*
aspartame
Coconut Oil
Taurine
DHEA
Ginkgo
Iodine
Arginine
Sugar
Kava
* - Only some people have this reaction.

Things containing caffeine..
Coffee, Espresso, Cappuccino, some Teas, Low calorie, non-cola soda containing aspartame, Low calorie colas containing aspartame or saccharine, Energy drinks, Some types of alcoholic drinks.
Chocolate ....Baking, Dark, Sweet and semisweet, Pudding, Cereals, Fudge , Milk chocolate, Syrup, Mousse, Soymilk, Fat free cookies, Cookies, Cake, Frozen Yogurt, Ice cream, Frosting, and Shakes .
Java Pops, Chai Mints, Green Tea, Warp Mints, Penguin mints, and cinnamons. Caffeinated Energy Strips, Caffeinated Fruity Lollipops, HyDrive Energy Chews, Caffeinated Nixie Tubes, Foosh Energy Mints, Atomic Energy Bites, Buzz Bites, KickBricks, Energy Chews, Reload Energy Strips, Movit Gummies, Caffeinated jellybeans, Morning Spark, Oatmeal, Sumseeds (caffeinated sunflower seeds), Lightning Rods (beef sticks), Engobi "Energy Go Bites" (crispy snacks), Jolt Gum, Blitz Energy Gum, Think Gum Stay Alert, Vibe Black, Black Go Fast!, Dozens and dozens of herbal supplements.
https://www.caffeine...ffeine-database
List of energy drinks with caffiene. (over 100)

Don't take Depressants (Make depression worse)
Oxalic acid is found in members of the spinach family and cabbage, broccoli, brussels sprouts, chives and lamb's quarters are high in oxalates, as are sorrel and parsley. Rhubarb leaves contain about 0.5% oxalic acid.
Can cause depression, lack of minerals, kidney stones, and more. Cooking does not affect oxalic acid. People with kidney disease, a history of kidney stones or suffer from depression should avoid these foods.
other depressants:
Aspartame
Gluten
High Fat Dairy
Sugar
alcohol
Trans fats
Sodium
Caffeine
Pesticide residue on foods
GHB
exposure to organic solvents (paint, varnish, stains, cleaning solvents, paint thinner, etc).

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Do
take 500 mg of vitamin C per day or 300 mg of NAC - (N-acety cysteine) an antioxidant
learn Cognitive Behavioral Therapy or Mindfulness
sleep as much as possible
Keeping a Journal - Don't trust your memory during withdrawal.
Stay hydrated

 

The End
 


#14 glowbug

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Posted 23 September 2019 - 01:17 PM

Thank you so much for the information on the supplements. Sorry for disappearing but life has been hectic, made more so by getting off the Cymbalta. An update. Last week I finally weaned off of the Cymbalta. Going back to 10 beads stopped all of the physical symptoms and greatly lessened the emotional ones but they did not disappear. I decreased by one bead every three or four days until I was off. Most of the symptoms I feel are manageable except the extreme rage. I just feel so angry most of the time and even when I don't any little thing can set me off. I'm ashamed to admit that I've lost it (verbally, not physically) on my kids a few times when I haven't been able to keep it under control. I'm worried my memory of who I was before antidepressants is faulty and that I was always this angry. I know I had more of temper but I don't remember being like this. I really don't want to get back on the meds due to the side effects but for my children's sake I can't be angry all the time either. Could the withdrawal really cause this rage and if so how long does it take to stop feeling this way? 


#15 fishinghat

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Posted 23 September 2019 - 02:12 PM

Hi glowbug

My rage lasted about 2 months after coming off and changed to anger and then irritable before fading away. It is embarrassing to say but I left dents in my boat, yard, trees, etc where I would hit things in anger, No reason just anger. Scary I know but it does go away.

#16 invalidusername

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Posted 23 September 2019 - 03:48 PM

Oh, I remember that part very well last December. Part of what I do in my line of work involves teaching and I can't tell you how many times I had to excuse myself to scream into a cushion, punch the air or similar. I was asking the exact same question back then when I heard of Hat's boat :) 





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