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Withdrawal Getting Worse 3 Weeks In?


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#1 frog

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Posted 06 November 2019 - 09:33 PM

Hi everyone,

I just joined this forum seeking some much needed advice and support. I was on 60mg of Cymbalta for 4+ years for chronic pelvic pain that the doctor thought were some damaged nerves. I never felt all that amazing and healed and wonderful on the drug anyway and after going to physical therapy over the past year (which helped the pain way more than Cymbalta ever did) I was excited to finally get off this awful thing and see what it was like to just be myself again and what even that meant anymore.

 

I haven't had any Cymbalta for just about a month now and prior to that I had been tapering down since about late June. I wasn't following any particular tapering protocol (oh how I regret this now) and only thought to taper because I had been on Effexor for about a year prior to the Cymbalta and basically quit cold turkey and had a really rough time, though in retrospect the Cymbalta withdrawal has been far worse. In terms of tapering I basically alternated between 60s and 30s for a little while, then just 30s and then started weighing out the beads using a scale and dropping about 5 mg every week or so until I got to about 15mg and quit cold turkey. After reading everything on this site, this was definitely not the right approach but I didn't know better at the time.

 

In any case, the first week or so was tough but similar to Effexor withdrawal and I felt prepared for it: brain zaps, really irritable and angry, nothing I couldn't handle. Then things seemed to be getting better and I felt optimistic! But since about Friday I have been a complete emotional wreck. It started with some major depression, coupled with extreme fatigue (I live in San Francisco and even going up the stairs to our apartment was suddenly a big ordeal), trouble breathing properly, and a really irritable stomach. Saturday we attempted to go out for brunch which ended in getting the food to go and taking an Uber home because I was an anxious mess. After that I couldn't leave the house for 3 more days and struggled to even move between the couch and the bed much less do anything else. Starting yesterday I finally felt like the depression lifted, and I felt hopeful but my anxiety levels are still through the roof and my stomach is still a mess which is making my anxiety worse and making it really tough to feel comfortable leaving the house. 

 

I'm starting a new job next week (which underneath all this nonsense anxiety I'm actually excited about!) but that also means I don't currently have health insurance/a doctor to see. 

 

I considered going back on a lower dose of Cymbalta and bead counting but from what I've read, I fear that it'll just result in going through this all over again and maybe I just need to push through and wait it out, but I really have no sense how much longer it'll be this bad. I don't think I can go on in this state indefinitely. Anything over the counter I can take to take the edge off the anxiety and help with the stomach issues? 

 

You are all the very best for all your thoughtful advice and support <3


#2 invalidusername

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Posted 07 November 2019 - 08:40 AM

Hi frog and welcome.

 

Sounds very much like another member we have here - Polly. I suggest you read her thread for some discussion on your issues. Stomach and anxiety and the breathing. It is just the same as what she is going through...

 

https://www.cymbalta...ny-please-help/

 

I would urge you to try and push through the symptoms. The fact that you can see the underneath of the anxiety in being excited about your job is a good thing and means that it is the drugs doing this to you. It will be tough, but just keep telling yourself that this is not you causing this - it is purely the withdrawal...

 

IUN


#3 fishinghat

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Posted 07 November 2019 - 08:49 AM

Welcome frog.

"I considered going back on a lower dose of Cymbalta and bead counting but from what I've read, I fear that it'll just result in going through this all over again and maybe I just need to push through and wait it out, but I really have no sense how much longer it'll be this bad."

You have been off for a month now so going back on say 5 or 10 beads may help but going back to say 5 or 10 mg may bring on dizziness, brain fog and some vision issues. Whether to hang on is a personal question that only you can answer. How much of this can you handle? For how long and will it get worse? For most the bad part of withdrawal will last 6 to 8 months before you start getting periods of time where you feel better.

As far as what is available over the counter I would refer you to our ebook. It has comments from many previous members on what they tried, the positive and negative outcomes, medical research, proper diet, supplements for various symptoms and more. If you would like to post your primary symptoms that you are concerned about we can try and address them one at a time.

The ebook is free and can be found at …

https://www.cymbalta...tion-the-ebook/

#4 Polly38

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Posted 07 November 2019 - 09:05 AM

Hi Frog

So sorry you are going through these horrible withdrawal symptoms. I am in the process of tapering and having the stomach and breathing issues. I have been tapering slowly so I think they would happen whether you tapered or not.

I am on 15 beads today. Both symptoms were better yesterday but are back with avengeance today. I am pushing through and reminding myself that it will pass. It's the only thing I can do really. I was only on them for 4 weeks and so far it has been 11 weeks weaning off😫.

I just wanted to to know you are not alone and to hang on in there. I know of someone who came off cold Turkey and said her stomach was awful for 2 weeks after and then went away.

Please feel free to message me and keep us informed of your progress.

Polly

#5 frog

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Posted 07 November 2019 - 01:01 PM

Thank you so much for your responses. Polly it's so awful that you're going through this. I read through your whole thread, I had trouble with shortness of breath for a few days but then I started taking Flonase (I have some random indoor allergies that I've never been tested for but will occasionally rear their heads) and I think it's been helping with that. Either that or it just passed on its own. That's encouraging that someone only dealt with the stomach issues for a brief time. I know we are all different but hearing other stories helps (though also sometimes is scary!). Are you also dealing with stomach issues? 

 

I think solving the stomach thing would really improve things for me. It's essentially IBS-like symptoms and I think it's really aggravating my anxiety which is already high and I think in turn the anxiety is affecting the IBS even more, a vicious cycle really. I already had some milder IBS issues prior to discontinuing the Cymbalta due to having had to take a lot of antibiotics in the past, and it got worse during tapering (I didn't realize at the time that they were connected). Then it seemed to be back to normal and now it's really bad again to the point that I'm too scared/anxious to leave the house for more than say 10 minutes. Yesterday I tried to walk to the nail salon to my husband (about 20 minute walk), my stomach was already starting to churn, driving my anxiety up. Then all of a sudden I just got extremely lightheaded and had to sit down and we called an Uber and went home :(

 

Fishinghat are you saying it might be a good idea to try 5-10 beads and that it might it take the edge off the anxiety? I would say that currently the anxiety and the stomach issues are really working in tandem to make me absolutely miserable. I've already cancelled various plans due to anxiety and I can't even imagine what Monday will be like when I have to go off to my first day at my new job. I don't know how you all are holding down jobs at all really because I don't even know how you're leaving the house... I hope to get to that point very soon. It scares me to hear that it could be 6 to 8 months before I feel better! I really don't think I can hang in there that long. These current symptoms have been around for nearly a week and I'm already losing it. 

 

IUN I did read the ebook, lots of interesting information but I got a little confused looking through all the supplements. I couldn't really figure out what in particular might be helpful for the anxiety. And I couldn't figure out if Imodium is helpful or hurtful? Getting the stomach issues under control I really think is going to be step 1 to lowering the anxiety and being able to cope with it for now. 

 

As of last night I seem to also be starting to see some insomnia which is really unfortunate. I took a 5mg melatonin tab hoping it would help, but I think I slept for about 2ish hours and then was wide awake with my heart rate going and spent the rest of the night tossing and turning and maybe sleeping a total of another couple hours. Seems like it's maybe the anxiety at work preventing my heart rate and thoughts from slowing down enough to fall asleep. 

 

Any more advice would be greatly appreciated. I'm really struggling through this right now. 


#6 fishinghat

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Posted 07 November 2019 - 03:27 PM

"Fishinghat are you saying it might be a good idea to try 5-10 beads and that it might it take the edge off the anxiety? I would say that currently the anxiety and the stomach issues are really working in tandem to make me absolutely miserable."

They do indeed work in tandem. There is a layer of nerve tissue in the wall of the stomach that provides direct input tp the brain. This layer of nerves is often referred to as the second brain.

Here is what member and some of my drs have recommended for upset stomachs.

1) NEVER drink anything cold or hot when your stomach is acting up.
2) Pepto or kao pectate to coat the lining of the stomach and let it calm down.
3) Moderate heat from a heating pad on your stomach.
4) Imodium Ad if you have diarrhea or your stomach is churning. A whole tablet for diarrhea is fine but I only recommend a half tablet for stomach churning as too much can cause constipation.
5) Eat smaller meals but more frequently.
6) Ginger for nausea.
7) NO antacids within 2 hours of taking any medicine as they may affect the absorption of that medicine.
8) Peppermint lozenges (or other forms of peppermint) to calm the stomach. peppermint relaxes smooth muscles like what lines the stomach.

In some cases it may take less than that to help. Don't take too big a jump upward in dose as that can cause some issues and will be just that much more to wean in the future.

Oooops. Gotta run. Will be back shortly.

#7 frog

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Posted 07 November 2019 - 03:42 PM

Those all sound like great advice even just for general upset stomach. 

 

Today has been the worst day so far. Depressed, anxious, jittery and crying at the drop of a hat, plus the stomach issues. I don't feel like I can start off a new job like this and am seriously considering just getting back on the Cymbalta until I'm feeling more settled in my new job and have a psychiatrist to work through all this with. Trying to get an appointment with a psychiatrist today and just pay out of pocket (sigh) and get some advice and direction. If not I think I'm just going to try 5 beads... Is that better than just going back to the last dose that felt fine on before I quit cold turkey (18-20 mg in my case) or is that asking for trouble at this point because I've already been off for a month? 


#8 Polly38

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Posted 07 November 2019 - 04:55 PM

Hi Frog.

Thanks for the tip about the allergy med. We don't have that one in the UK but I'm wondering whether an antihistamine like Cetirizine may help (we don't have dramamine over here either and that's supposed to be good). I am definitely struggling with the stomach issues. It feels like I have a lot of gas in my upper stomach and the pain goes into my arms and shoulders. Does yours feel like that? That then makes me feel anxious but I just try and ignore it. I have also been having random sweats as well.

I had 3 months off sick from work earlier in the year but have been back a couple of months. I still feel anxious from time to time but feel better at work as I used to sit and dwell on things when I was off and used to try and avoid going out. Hopefully, the new job will give you something to focus on. Keep telling yourself it is temporary and it will pass and this horrible poison will be out of your system soon!

Good luck for next week and please feel free to chat on here or message me. The people on the forum are so supportive and knowledgeable and it's so good to know I am not mad and am certainly not alone.

Take care.

Polly

#9 fishinghat

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Posted 07 November 2019 - 05:38 PM

Sorry I got side tracked.

"I don't know how you all are holding down jobs at all really because I don't even know how you're leaving the house... "

It is sad but these long withdrawals have cost many members their jobs and their marriages. That is such a shame.

"I took a 5mg melatonin tab hoping it would help, but I think I slept for about 2ish hours and then was wide awake with my heart rate going and spent the rest of the night tossing and turning and maybe sleeping a total of another couple hours."

Studies have shown that the most effective dose of melatonin is 0.7 mg sublingual (under the tongue) and should never exceed 4 mg as it actually interferes with sleep. Any excess melatonin is converted to serotonin which can cause the heart pounding and racing as well as be a stimulant. Those members who have used it successfully (including me) report that if you wake up after a couple hours you can repeat the sublingual dose and go back to sleep. The sublingual dose goes directly into the blood stream and takes effect rapidly. Because of that it is processed quickly and there is no sluggish hangover in the morning. I also use it in a very small dose to control anxiety during the day. I don't take the full 07 mg because I don't want to sleep. I take around 0.1 or 0.2 mg which is just enough to take the edge off.

#10 fishinghat

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Posted 07 November 2019 - 05:47 PM

"If not I think I'm just going to try 5 beads... Is that better than just going back to the last dose that felt fine on before I quit cold turkey (18-20 mg in my case) or is that asking for trouble at this point because I've already been off for a month?"

That is asking for trouble. Most find that going back up a large amount after being off for more than a week can cause dizziness, vision issues and bad mind fog and only helps slightly with the symptoms. And if 5 beads is not enough you can always go up a little but more the next day.

#11 frog

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Posted 07 November 2019 - 05:50 PM

Thanks that's actually very helpful information. 

 

I think I will try the 5 beads then. I need to get through the next couple of weeks at my new job without this unbearable anxiety and if taking a little Cymbalta again is necessary then so be it and I can deal with the weaning again when I feel more comfortable at my new job. Should I be expecting any adverse side effects on 5 beads? Or do most people just get the relief they're seeking? 


#12 fishinghat

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Posted 07 November 2019 - 05:50 PM

Polly, you are looking for a product that contains one of the following compounds,,, dimenhydrinate, meclizine or diphehydramine. Do not take two of these at the same time as they are not compatible.

Also...

Cetirizine HCl 10 mg (antihistamine)
https://www.ncbi.nlm...pubmed/23673913
Cetirizine linked to depression.

#13 fishinghat

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Posted 07 November 2019 - 05:52 PM

Thanks that's actually very helpful information. 
 
I think I will try the 5 beads then. I need to get through the next couple of weeks at my new job without this unbearable anxiety and if taking a little Cymbalta again is necessary then so be it and I can deal with the weaning again when I feel more comfortable at my new job. Should I be expecting any adverse side effects on 5 beads? Or do most people just get the relief they're seeking?


Normally there is no bad effects from such a small increase. Just based on what I have seen here in my nearly 7 years is a small to moderate improvement.

#14 frog

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Posted 07 November 2019 - 06:01 PM

Hi Polly! I didn't have any pain like that which sounds awful. I basically just had shortness of breath so often I felt like I couldn't get a full deep inhale in. Flonase is just what I had on hand that has helped me in the past with allergies because my allergies are entirely nasal (insane amounts of sneezing, foggy brain) and a lot of times I get post nasal drip as well which I was thinking was not doing me any favors in the breathing department. It's also entirely possible that my feeling better was just coincidental. Who knows! That's what's so frustrating about all of this unfortunately but you take the wins where you can.

 

Fishinghat thank you so much for ALL the information. It truly makes a difference. I just took 5 beads. How quickly would I feel the effects if any? 


#15 fishinghat

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Posted 07 November 2019 - 06:33 PM

It takes about 2 hours to feel anything and reaches its peak in 4 hours.

#16 frog

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Posted 07 November 2019 - 06:48 PM

Fishinghat, this is a more scientific (maybe) question, but I like to know how things work, it sometimes helps me deal with them if I can unpack the mechanics. Is my anxiety caused by low levels of seratonin due to my brain not yet having compensated properly for what the Cymbalta was providing? If so wouldn't having the excess melatonin converted to seratonin be a good thing adding more seratonin into the system? Or can high levels of seratonin also be responsible for anxiety? 


#17 fishinghat

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Posted 08 November 2019 - 09:40 AM

The discussion over low/high serotonin during withdrawal is one of much conversation by reasearchers. Some research says it decreases and others say it increases. This conflict of opiniom is upheld by our members experiences with 5htp and sam-e. Both are converted to serotonin in the brain. Some members find some relief with them and some find it makes things worse and most find little difference. And really it makes little difference as antidepressants change the shape of the symapses which react to serotonin. Once the med is removed these symapses they can no longer react with the serotonin so how much is present is sort of irrelevant. Studies have shown that people can develop EITHER anxiety or depression when serotonin levels are off. The main thought on this is that serotonin production is complicated and effected by many many variables, especially genetics.

Now having said that, the main problem with anxiety is due to the over abundance of unused norepinephrine with the removal of the Cymbalta. Cymbalta controls the use of norepinephrine as well as serotonin. Norepinephrine is then converted to adrenaline and the anxiety goes through the roof. There is an excellent document in the ebook titled Chronic Adrenergic State that explains how anxiety develops physiologically. If you have any further questions do not hesitate to ask.

#18 invalidusername

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Posted 08 November 2019 - 04:00 PM

One thing to add to that is the question of the blood brain barrier, of which is not a consideration for the Cymbalta (and other such SNRI/SSRI), whereas the supplement based formulas/amino does require the BBB to function in the way the capsule require. Much like a lot of other psychotropic paraphernalia, it will be a long time before we fully understand, but it is known that not everyone is aware of how this works. There are talks of such symptoms as "leaky" BBB, which would mean 5-HTP etc will not work correctly. 

 

As Hat said, there is a vast conflict of opinion on this, as the best thing we can go on is experience. And just like I said to the (ignorant) p-doc that told me to stay away from forums... but how does the data from the forum differ in the result from a published article? It doesn't. This forum is by far the best data that anyone could hope for regarding Cymbalta. Period. 


#19 frog

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Posted 09 November 2019 - 03:50 PM

Interesting. It really is all so complex with so many variables and so little understanding that now it seems even more irresponsible to have doctors prescribing these things so easily and thoughtlessly. 

 

I started taking 5 beads a couple days ago, 6 yesterday and 6 this morning. It seems to be taking the edge off SLIGHTLY but not as much as I would like. I also started taking ashwagandha as of last night. Supposedly 800mg per serving. I took one last night and one this morning. It's also helping, but I'm still left with the super anxious tummy and nausea that's making it REALLY hard to eat which of course means I have little energy at a time when I sorely need it and makes it hard to attempt to go outside for more than say 10 minutes before I start feeling lightheaded and dizzy. I'm eating ginger candy, I'm taking 1 imodium a few times a day (which is a half dose in this case as a full dose is 2 capsules). It's all HELPING but I still feel pretty crappy and can't eat. A week ago I was eating constantly! I love to eat!

 

Should I add another bead? I guess I don't know how much or what kind of relief I'm really expecting. And the lack of energy has really got me stuck in a loop. It's hard to not just want to try to build back up on the Cymbalta and get to feel "normal" again. 

 

My husband (who has been nothing short of amazing) has been trying to make an appt for me to see a psychiatrist so at least I have a doctor as part of my support system, but I don't yet have any doctors here (and no health insurance of course...) and the UCSF psychiatry clinic of course doesn't appear to employ a receptionist. You just leave a voicemail and hope for the best. UGH. 


#20 fishinghat

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Posted 09 November 2019 - 05:37 PM

Your idea to go up slowly on the beads as well as one supplements at a time is a wise one. Your right, these things are not cures they simply help. I would go up one more bead tomorrow and hold there for 3 or 4 days before deciding on what to do next.

#21 frog

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Posted 12 November 2019 - 01:41 AM

Update:

Today was my first day at my new job. I was obviously totally bugging out this morning and barely slept last night. I even tried taking a little melatonin during the night when I was just lying there but got nothing. Oh well. Odds are even if I wasn't dealing with this medically induced anxiety, I would have been anxious about today anyway. The disappointing thing was that I was really hoping that I would get there and be too busy and preoccupied to be anxious, but that was far from the case. Up until about 2pm I was jittery, panicky, nauseous, the works; just doing everything in my power to keep it together. Then around 2pm it was like a curtain was lifted and I felt like a normal person, like I might have been if I weren't going through all this. I did start feeling pretty crappy and irritable the second I got home, but I think it was just the result of being so keyed up and tense all day long and finally being home. I ended up closing my eyes on the couch and just lying there like that for a few hours as I felt everything wash away from me. 

I took 7 beads of Cymbalta in the morning + 800 mg Ashwaghandha. And then 800mg again tonight after dinner. We'll see how tomorrow goes, but having debilitating anxiety for the majority of the work day isn't really going to fly going forward. Should I up the beads? Does it make sense to maybe take the 7 beads twice a day instead of once? I'm wondering if by the time 24 hours has passed there's very little left in my system and that's why I'm left feeling so crappy for half the day? 

 

On a positive note, I'm proud of myself for making it there today and getting through what would be a big day regardless considering just a few days ago I couldn't make it to the nail salon without breaking down and taking an Uber home. I just hope each day is a little easier than this one because boy this one was tough. 


#22 TmanB

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Posted 12 November 2019 - 05:41 AM

Good job for hanging in there Frog ... I know it is tough, but we need to push ourselves sometimes. Always giving in to our anxiety and feelings would make us a pushover and the anxiety will always win ... These are difficult moments when you start a new job and are dealing with great anxiety, but you did the hardest part ... the first day !!! It will only get easier from now on as you get used to the environment, the people, the work, etc ... So hang in there !!!!


#23 fishinghat

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Posted 12 November 2019 - 08:35 AM

So right now you are taking 7 beads of Cymbalta each morning?

#24 frog

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Posted 12 November 2019 - 11:16 AM

Hi fishinghat yes I started with 5 beads mid last week and now at 7 as of yesterday. 


#25 invalidusername

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Posted 12 November 2019 - 12:59 PM

Might not be a bad idea to up a bead or two, but it will take a couple more days for the levels to balance out.

 

Well done for hanging in there. I can only imagine how difficult it must have been for you to get out of bed and tackle this first day...


#26 fishinghat

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Posted 12 November 2019 - 01:17 PM

I agree with IUN. It will get better.

#27 frog

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Posted 12 November 2019 - 09:01 PM

Thank you guys for the encouragement. Truly.

Today was magically a lot better. I felt very little anxiety all day and was even able to eat some lunch! Not sure what was different about today because it was really a 180 from yesterday. I did take some Omega 3s and Vitamin D this morning which I didn't do yesterday. I'll hold tight at 7 beads and see what happens tomorrow. Hoping for another easy day. 

Regarding the beads, not that I'm anywhere remotely to the point where this matters, but when the time comes how do I go about dropping the Cymbalta again? 7 beads can't be more than like 1mg but I'm so scarred from the initial experience that I want to do whatever it takes so I can get to 0 and not have to deal with any side effects. 

 

I hope you both had good days today as well! 


#28 fishinghat

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Posted 13 November 2019 - 08:07 AM

How fast did you drop before? I would say to drop much slower. If you were dropping 1 bead a week I would go to 1 bead every two weeks, as an example.

#29 frog

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Posted Yesterday, 10:06 PM

Unfortunately I never got down to the phase of dropping by 1 bead. When I was tapering I was dropping about 3-5mg a week from 30 to 15 and then I just quit entirely from there. I take it I should just go with a bead a week when I start. 

 

Is there anything I should be aware with discontinuing Ashwagandha? I've been taking 800mg twice a day. 


#30 fishinghat

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Posted Today, 09:03 AM

That sounds like a good plan .

 

There are no issues stopping Ash that I know of.





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