727 replies to this topic

[frog]

Thank you fishinghat. 

I saw on another thread either you or IUN mentioned that the empty capsules have to be enteric coated. I just realized that mine are not, they're just plain gelatin. I'm going to order some enteric coated ones, but wanted to know more about why it needs to be enteric? Have I not been getting the full effects (or any effects?) because I was just using the plain capsules? 

[fishinghat]

They do not have to be enteric coated it is just a safer way of doing things. The original capsules of Cymbalta are NOT enteric coated but the beads inside are. If the beads where to breakdown in the stomach it would release the Cymbalta into the acid of the stomach and much of the Cymbalta would be converted to naphthol which has some nasty side effects including bad stomach pain and much more. So just to be safe we usually recommend that members use enteric coated capsules.

[frog]

Oh that's very interesting because stomach pains, nausea, diarrhea, etc. have been a persistent issue for me throughout the taper but also since. I was attributing it to the overall high levels of anxiety I've been experiencing but looking back, it seems like things are much more delicate during the first part of the day which would coincide with when I take the Cymbalta. Then again my stomach was still a mess a couple of weeks ago when I wasn't taking any Cymbalta so who really knows. I will order the enteric capsules and see if I notice any difference.

 

Thanks for the tip! I feel like I've gotten to a stable and manageable point with the awful anxiety to where I can mostly resume life as I wait for things to continue to improve (who knew 7 measly beads could make SUCH a difference.. this drug really is terrifying) but the one thing that still sends me spiraling and makes me anxious about being anywhere except home or the office is my stomach. Things seemed better last week so I stopped the Imodium and Pepto (I'm scared of taking them too much) and a few days later my stomach was right back to being messed up. 

 

Did your stomach issues resolve on their own after a month? 

[fishinghat]

Mine lasted around 4 to 6 weeks before fading away.

Our bodies are so complicated. Cymbalta controls serotonin which is one of the most common neurotransmitters in the GI tract. As Cymbalta levels lower the serotonin levels begin to fluctuate and the GI tract becomes inflamed and very upset.

Just another piece of the puzzle.

[frog]

Checking in. This week doesn't seem to be much different from last week. I'm not getting AS HIGH of levels of anxiety as last week but I think it's just because I'm settling into more of a routine at work. Stomach troubles continue and yesterday and today I've had numerous occasions where I've suddenly felt like bursting into tears for absolutely no reason. Fortunately I've been able to hold the tears back until I get home where my poor husband gets to deal with me crying randomly. I feel discouraged because this week doesn't feel any better than last week and I'm scared thinking that this is how I'll be feeling for months and months to come. I'm also terrified at the thought of the Ash no longer being effective as I've read it can lose its potency over time, because I really feel like it's been a lifesaver. 

When should I start considering starting the taper down from the 7 beads? By continuing to take it am I keeping myself trapped in this withdrawal feeling? Or should I keep going at 7 beads until I feel completely fine again and only then drop a bead? 

[fishinghat]

This is going to require a lot of patience. Do not keep dropping. If you think this is bad well...it would probably get a lot worse if you keep dropping. It may take you several weeks to really settle down where you can drop again. Getting a set routine is a good thing. Nothing new and try to avoid stress as much as possible. Stay hydrated and get plenty of sleep.

Oh Yea, and ne patient lol.

[frog]

But but but... being patient is not my strong suit even in the best of times lol. 

I've been on the 7 beads + Ash for just about 2 weeks now so I'll evaluate again after another week. The timing really could not be worse with the holidays upon us for stress management. Fortunately we're not leaving the city for Thanksgiving but we're flying across the country (with a layover!) for Christmas so I'm really going to need optimal stress management by then. 

It still seems so confusing to me that these awful mood symptoms hit a full 3 weeks after I stopped taking Cymbalta. Everyone else seems to experience symptoms either alongside their taper or immediately after stopping. Any thoughts about that? 

[invalidusername]

Not necessarily true. It all depends on the resilience of the individual. Many factors to consider. This time is often referred to as the "honeymoon period". The point at which one feels as though they are out of the proverbial woods, only to find that the symptoms catch up with them. 

 

Granted 3 weeks is to furthest end of the spectrum for this to occur, but as I said, it is very subjective. Not only can the chemistry take longer to catch up, but you may also have traces of the cymbalta in fat reserves (not insinuating anything about your weight!). This can occur regardless of your weight, BMI and so forth. And the aforementioned resilience. 

 

For sure, it is a shame that it has hit, but this is how the cookie crumbles. Hang in there. It has started, but will get better.

[frog]

Thank you for your encouraging words IUN. Getting to see a psychiatrist has been harder than I expected and I'm starting to feel like by the time they have an opening, I'll be feeling better and won't need their help anyway... (outside of this Cymbalta stuff I'm fortunate to not have issues with depression and my anxiety while higher than normal is manageable without drugs)

 

Scary to know that it could be because the cymbalta was just hiding somewhere inside my body lulling me into a false sense of complacency. I'm pretty average weight but definitely don't have the fastest metabolism.

 

This is the end of week 3 since the emotional symptoms hit which makes a total of 6 weeks since I came off Cymbalta though the last 3 I've been taking around 1mg/7 beads a day. Every day is slightly different for example the past two days I felt like crying at random, prior to that my issue was relentless anxiety for two weeks, today I had a random couple hour window at work where I felt lightheaded in a zombie like state (could be low blood sugar though maybe as my stomach issues are my biggest physical symptom), but last night after work for no apparent reason I felt the calmest I have in the last month. Not like I was "managing" the symptoms where I can feel them bubbling below the surface but I'm able to mentally control them, but truly calm as if I had no cares in the world. The way I used to feel before this nightmare. I've read so many posts on here and I know you will likely say that this is great news and it means my brain was able to accurately calibrate its chemicals for the first time in a while. But I also know this isn't the end of it, and my brain will likely continue screwing up before it gets it right again. How much longer will it be before I have more good days than bad days? As good as the better days feel, the bad days really knock your confidence fast!

[fishinghat]

How long until you start feeling better?  For most it would be another 4 to 6 months but that varies considerable. It could be a couple weeks or a year. Sorry I can't be more specific.

[invalidusername]

Absolutely - as Hat says. Too many variables. It is all subjective....

[frog]

Hello again, 

It's been about 2.5 weeks of taking some beads again and I'm having a hard time stabilizing. I think things have improved in their severity but not significantly enough that I can keep going like this indefinitely. I also stopped taking Ash a couple of days ago. I wanted to see if it was making anything worse (I've read that it raises your serotonin). Today I'm having a lot more anxiety but is it because I stopped the supplement, or just another wave of withdrawal, or heightened anxiety because of Thanksgiving coming up? Impossible to know. Should I take Ash again? Do I bump up another bead? I've been trying to find a psychiatrist to see, but I don't even know what they would really be able to do for me. Seems like most of them are unfamiliar with Cymbalta withdrawal anyway

[invalidusername]

If you want to rule out the Ash, then start taking it again. If the anxiety is still there, you know it is not doing its job. But if it WAS working, then this would have caused your anxiety levels to increase. Adding another bead will only be a further trip to come down, and should be a last resort otherwise it will be a slippery slope to getting back to your dose and back to square 1. 

 

P-docs, for the most part, will know the square root of sh*t about how to do this. If you are looking for the best place to help with Cymbalta withdrawal... you have already found it

[frog]

I took one Ash a few hours ago (400 mg with the formulation I have; previously I was taking two at a time as advised on the bottle for 1 serving twice a day: before work and after work) and things calmed down tremendously. Nice to know I have something that kicks in so fast when things are rough. I'm also under extra stress right now with family coming into town, my brother-in-law staying with us for a couple days, etc. So I think maybe any other week I wouldn't have this strong of a reaction but I basically have no stress coping mechanism right now... thanks Cymbalta. 

 

Most experiences I've read people my age (32) and circumstance (not having a history of depression or severe anxiety) seem to come out on the other side in 2-3 months. I'll be at a month at the end of the week so I still have a ways to go. I'm trying to stay positive and optimistic that things will keep getting easier as I get closer to the 2 month mark. I think not having any concrete idea of how soon it'll start to pass has been the most frustrating thing about all of this for me. 

[fishinghat]

Nice work you two. Job well done.

[invalidusername]

I took one Ash a few hours ago (400 mg with the formulation I have; previously I was taking two at a time as advised on the bottle for 1 serving twice a day: before work and after work) and things calmed down tremendously.  

 

Marvellous... there's your answer then

[frog]

Thanks guys. I don't mind taking Ash if it's helping things (it makes me sleep like a log I've found) I'm just worried that A. it'll make me feel like I'm getting better when I'm not (like in this case) or B. it'll lose its effects. IUN I read you saying that it stopped working for you

[invalidusername]

There is a chance that it will lose its potency after a few weeks. This is very common and most people take a tolerance break - some take the weekend off each week, whilst others will go a few weeks and then take a week off. Again this is all dependent on the person and a little experimentation is called for to see what works. 

 

I think had I have done this myself, it would have worked for me, but I needed something that was going to maintain my system at the time, but this is true of a number of things. Receptors can easily get used to the levels that are consistently thrown at it, so you either give it more, or take a break...

[frog]

GAH it worked so beautifully yesterday during the day and then I started getting bad anxiety again the evening and took another Ash and... nothing. I also couldn't sleep all night. Every time I felt like I was drifting off my brain would jerk me awake suddenly with a hot flash and my heart rate going, like mini panic attacks. I hope this is just another "phase" of my brain figuring things out and it'll pass? I took my 7 beads and 2 more Ash this morning. It's keeping a lid on the anxiety I think but just barely. Is this just all part of the windows and waves of feeling better and then feeling worse again? 

 

Also on another forum they keep pushing this idea that pretty much anyone who doesn't taper at an extremely slow rate has PAWS so now they've got me worried that I'm dealing with PAWS here. Could that be the case given that a bunch of my symptoms came on a few weeks after the initial ones after I quit? 

 

I know you guys try to be realists, but I feel like I really need some positive recovery stories of people who quit in the same way I did and recovered in a few months

[fishinghat]

"Also on another forum they keep pushing this idea that pretty much anyone who doesn't taper at an extremely slow rate has PAWS so now they've got me worried that I'm dealing with PAWS here."

In essence that is true. It has been my observation the slower the withdrawal the shorter the time to recover afterwards. The processing of this drug by the body is very complicated and varies tremendously in people. I know one lady (sister-in-law) that cold turkey off Cymbalta twice and never had a withdrawal symptom. I also know two others who weaned over 3 weeks and had no withdrawal. It just doesn't hold a pattern.

[frog]

Boy are they lucky!

Actually about a year before I started up Cymbalta I quit taking Effexor (was taking it for a year for the same reason: chronic pain) and I also did a super super quick taper off of it from what I remember. Similarly to this time it was kind of a stupid time to quit (I had just moved back home from living in another state, was breaking up with a bf, etc.) I remember being more emotional during that time but it could have just easily been the circumstances of that time. I had one middle of the night 'I think I'm dying' panic attack and another lesser one the night after and that was that. I didn't really have any other effects. 

I actually tapered slower this time off the Cymbalta but I also took it for longer. Wish I knew why this time was different!

[frog]

So is any withdrawal that doesn't resolve within a few weeks considered to be PAWS? 

I know PAWS is sort of a vague term but is it treated any differently than just acute withdrawal? 

[fishinghat]

There is no set standard for how long you most endure before it is considered PAWS,

[invalidusername]

....although some do do put a time frame on it. It is more for a professional to decide.

[frog]

Hi guys, me again... 

I'm feeling stuck. The 7 beads are doing.. something. And I do think my stress management systems are coming back online, but incredibly slowly. In the past two days I went to Thanksgiving yesterday which had me out of the house for a good 6 hours and went out to lunch with my husband's parents today and made it through the whole meal. On the flip side of the positives, it was an internal battle to get myself out the door, and in both cases I definitely spent most of the time feeling off and not able to be as present as I would like to be as I was up in my head most of the time doing a lot of talking myself down through both outings. Thanksgiving was actually cut slightly short because I suddenly felt very overwhelmed and overstimulated and needed to go home to give my brain a rest. I'm very fortunate in that everyone around me already knew what was going on and was incredibly kind and comforting, but it was still not how I imagined things going. 

 

So I've really been tossing around the idea of reinstating to 5mg or 10mg. I quit cold turkey at 15 or 18 which was when I started feeling some withdrawal too coincidentally (dummy!) but since it's been over a month and a half since then I feel like I probably don't need to go all the way up to that to notice a difference. I'm feeling like if I had a crystal ball to tell me that in say... 3 weeks I'll be feeling noticeably better, I could probably keep pushing, but it's getting harder and harder to stay positive and optimistic. This whole week I also started having a new side effect that's really affecting my sleep. I'm basically experiencing sleep starts as I'm about to fall asleep. From what I understand my 'awake' systems and 'falling asleep' systems are coming into conflict so as I'm relaxing and falling asleep my brain kind of jolts me back awake. Has anyone had this happen? Prior to this week I was actually sleeping like a log through the night. The best sleep I've had in ages really. 

 

Anyway sorry for the lost post. If you guys were in my position what would you do? Do you think my improvements are a sign that things are moving along at a good pace? Should I reinstate at 5mg? If so how should I do that? Count the total beads in a capsule, divide by 60 and multiply by 5? Do you know people who have gone back up after a month and had it work? I'm wary of it causing more anxiety instead of helping to even things out. 

[Lovey]

Frog, i think you are doing great. Why don't you give yourself the rest of the weekend and maybe thru Monday to really get over tge Thxgiving hangover of emotions and stress. Holidays are very demanding and stressful for a majority of people, despite what Hallmark commercials would suggest. Rest rest rest. Its your call but this is my best advice to offer.

What mg are your capsules? Do you know the number of beads? I can help you figure out what 5 mg would be.

[frog]

Hi Hrk! 

Thank you for the kind words. I normally look forward to holidays so it's been sad to be basically dreading them. So far I've noticed that the more I'm able to push myself to do things the better I feel afterward (though not usually during...). After going out for lunch today and then having my husband's parents come over later in the day for a couple hours I ended up having a decent day overall. I like the idea of waiting a few more days to get back to whatever "normal" is before deciding. 

 

I think I read in one of your posts that you updosed at one point? If I have that right, how long were you on a lower dose before going back up? Did you experience any bad effects from jumping back up? 

 

I have 60mg caps right now but I also have a prescription for 30s at the pharmacy. It's been a while since I counted the beads so I'll have to do it again. I think it was like 270 or something like that??? 

 

Hope you're having a good day today!

[fishinghat]

Frog, I totally agree with hrk. You are doing great. Things will slowly, and I mean slowly, get better over the next couple months then you can get back to weaning.That

[frog]

Thank you fishinghat. Hearing you say that things are moving along well is encouraging! I've also been using 3 months as a relative goal but I'll be honest at only 1/3 of the way through now that feels really far away at the moment. Also currently my husband and I are supposed to fly across the country for Christmas in 3 weeks. I am very stressed out with travel even in my best times and I don't have much confidence that in 3 weeks I'll be feeling so dramatically better that I'll be able to handle not only dealing with the airport (i can probably muscle through that) but a 5 hour flight on top of it. And of course do it all again 5 days later. No one's going to be mad at me if we end up having to cancel the trip but I really want to be able to do it and I really don't want to make my husband miss Christmas. That's part of why I was thinking of bumping the dose: to get to a place where I can get through the holidays and deal with the wean in January when things are quieter. Thoughts? 

[invalidusername]

The sleep starts you describe Frog are termed as hypnic jerks and is related to the myoclonus family of symptoms of involuntary muscle twitches. I get these sometimes like you when I am just nodding off to sleep, sometimes during meditation - which paradoxically is NOT relaxing (!) - and I also get them when I am fully with it. Sitting there with a client and either a leg, or occasionally my whole body, has a big ol' twitch. Very embarrassing.

 

These started during my Cymbalta withdrawal last November, but they have reduced significantly. They come back and are consistent with stress levels, but during "normal" operation, they are very few and far between. We are talking less than 2-3 minor twitches a day.

 

Tough call on the Christmas trip and ultimately only you can decide. Maybe a double dose of Dramamine will help you through the flight! If you are one of these people that find the anticipation worse than the actual event - as I am - then I would do my best to treat it as an exposure and have the Xanax on standby. Once the trip out goes well, the return trip will be much smoother. My anxiety has got so much better in the last 6 months, but trips away are one of the last things to conquer...