Digital Scale Instead Of Bead Counting
Posted 21 November 2019 - 10:01 PM
Posted 22 November 2019 - 08:06 AM
Thanks for the info H - very useful.
As you can imagine, this has been a topic of hot debate for a long time here. The issue is that we can never know the ratio of duloxetine to coating, thereby making the weight of each bead a null factor. But it is the best we can go on, and it is the most logical to consider that smaller beads have less than average amount of duloxetine. However, equally likely is that the coating process can put more (or less) on each bead of duloxetine meaning you are merely measuring the amount of coating.
But the guidelines, of which every processing manufacturer must follow is placed at a 10% margin, Meaning that each CAPSULE - not bead, must have within 10% of the stated dose.
This is all we know....
Posted 22 November 2019 - 10:36 AM
Makes sense. It has been a sanity saver to go this route myself, using a scale. It is up to each person what they want to do of course. I have had great success. Thanks for the input iun.
You are absolutely right H. If it saves you the stress, then this is a very practical route to follow.
Could I ask you to share the link of the item you purchased for the benefit of the forum please?
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Posted 23 November 2019 - 12:07 AM
Its a jewelry scale." Smart weigh" brand. Currently listed at $29.99 U.S.
It is reliable but you should be respectful how you handle it as it is sensitive to some extent, as you would want it to be It measures to the thousandths in grams.
There are less expensive models for under $20 U.S. that may be perfectly suitable. This is the link for the one I have tried and tested for over a year and I trust this one.
Posted 24 November 2019 - 11:08 PM
I'm going to try the bead counting, but find myself a bit stymied by the actual physical logistics. The capsules I have don't just pop open so I'll have to cut them, then try to make sure I have all the little beads in one spot, then take out one extra each day? And scoop up the rest to swallow???
Posted 25 November 2019 - 09:18 AM
Those capsules should really pop apart but you may ne right. Who is the manufacturer of your Cymbalta?
Cutting the capsules may not be a good idea as that may scratch some of the enteric coatings and Cymbalta released into the stomach is destroyed as well as breaking down into naphthol, a rather nasty by product. I would recommend buying some empty enteric coated capsules from Amazon or such to put the remaining beads in. This product must dissolve in the intestines and not the stomach.
Posted 25 November 2019 - 03:36 PM
Hi Carolyn - nice to have you with us...
Not known a capsule to not pop apart... and Hat has a good point about the scratching of the beads. Perhaps you can turn it on one end so the bead collect at the bottom, and snip open the top with a pair of scissors. Rarely do beads fill the entire capsule, so you shouldn't be cutting near any.
A reduction of 1 bead per day is based purely on circumstances - your current dose, the length of time you have been on them, your reason for tapering etc...
If you can give us more details we will be able to give you a more accurate suggestion.
Posted 26 November 2019 - 09:51 PM
Posted 27 November 2019 - 08:26 AM
...and as a byproduct you wouldn't be getting the correct dose of the duloxetine (the medicine and non-trade name of Cymbalta). So your reasoning is sound, but you will only know for sure as to how much this has caused once the problem is rectified...
Posted 27 November 2019 - 10:20 AM
Posted 27 November 2019 - 03:19 PM
Following this thread. I feel like I might have had a similar experience?
I tapered using regular non-enteric caps and when I reinstated the 7 beads when the crazy anxiety hit I also did regular caps at least for the first 2+ weeks of that. My husband was helping make the pills, he thinks he started using the enteric ones right away when we got them but not 100%. Then I made a batch that I've been using since Sunday that I know for a fact had the coating and similar to you got a really strong resurgence of symptoms. I'm thinking it's just coincidental since I know part of the recovery sees a constant resurgence of bad symptoms that lessen in length and intensity over time
Posted 27 November 2019 - 03:33 PM
Frog, why did you "reinstate" 7 beads? I don't quite know what you mean. Were you off and tgen added them back to help withdrawl symptom management ?
Posted 27 November 2019 - 05:21 PM
Hat and myself spent a long time going over the details of this some time earlier in the year, and we found a few journal papers documenting the use of different compounds of encasing the beads. But the concern as Hat says is the issue of the conversion which can be dangerous for the stomach, let alone the change in chemical compound...
Knock yourselves out;
"a delay in gastric emptying will allow any duloxetine to be degraded to naphthol"
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Posted 27 November 2019 - 05:22 PM
I tapered for about 3 months at what I realize now was a bit of a breakneck schedule but it was still longer than what my doctor had suggested... I basically alternated with 60s and 30s for a while, then just 30s and then from there I started dropping by 5 mg every like.. 5 days or so? I was using a scale like you and measuring out that way. Though from what I've read it seems important to keep a more consistent dosage during tapering and with the way this stupid drug is designed, it seems like keeping the amount of beads consistent might be a better way than relying on the mg since the beads vary a bit in size and some of their weight comes from the coating and not just the actual medication. Anyway when I got down to 15mg I think I started getting some symptoms. In retrospect that was my body telling me to slow down and hold there until they passed but I hadn't yet done any research or read any of these forums so instead I just stopped taking them altogether. That was in early October.
At first my symptoms were pretty expected and mostly manageable. The brain zaps I was prepared for and the foggy/cotton brain feeling. The anger/irritability was pretty intense but even that was manageable. It was also all improving over the course of a few weeks and then suddenly in early November almost a month after I stopped Cymbalta I got completely bowled over with crazy anxiety, nausea, crying. It was weird because the day before it all started I had gone to a spin class (for the first time since probably May?) and had a really intense workout. It was almost like that triggered everything? I know Cymbalta can hide away in your fat for a while especially if you have a slower metabolism so maybe the workout released some of it? Hard to say. Either way I was in really bad shape and that's when I started posting here and was advised that I was outside the window of safely reinstating at the 15mg where I originally stopped but I could try a very small dose of just a handful of beads to take the edge off. I've been taking 7 beads every morning for almost 4 weeks. Days like today and yesterday make me want to try to bump up the beads but it's hard to say if it would even have any effect and of course the more I tack on, the more I eventually have to taper off of when I'm feeling better again. I think they're helping because I definitely see a difference in mood as the day progresses compared to when I wake up and the first few hours at work. On the other hand I feel frustrated because I still haven't stabilized and am still seeing a lot of ups and downs. I had a few pretty good days here and there over the past few weeks but then there's periods of time like this that just really knock your confidence and optimism in the process.
I'll let IUN and fishinghat give you advice about your situation, but from what I understand depending on the brand of Cymbalta you use, some companies put the enteric coating on the beads and not on the capsules in which case you're probably ok using non-enteric capsules. I would also say that per my own experience, if you're having bad symptoms at a certain dosage, I would NOT recommend dropping as that is what I did and I think it was my body telling me to slow down. I would take it as a sign that you're still adjusting to this dose. Especially when you're down to such a small amount, it seems important to take it really slow. I don't know when you did your previous drop but sometimes it can also take a little time to see any bad symptoms emerge so that could also be what's happening. I say stick to the 20 beads for a couple more days and see how you feel.
Posted 27 November 2019 - 05:55 PM
FH- please can you elaborate on how this occurs, what are the physical effect we would experience from this? The napthol. How was this discovered to be? It is fascinating science! Thank you for your input.
Will see what I can come up with tomorrow on the naphthol conversion. I do know that the original discovery was made by Eli Lilley during the clinical trials. People were not consistently getting results from Cymbalta, not even close. They started checking the pH of the test subjects stomach and found some were more acidic than others (not unusual) and then did lab tests on exposing Cymbalta to acids and discovered the conversion to naphthol. I will see if I can find more details tomorrow.
Posted 27 November 2019 - 05:57 PM
Hrk, let me know if I got that wrong!
Posted 27 November 2019 - 06:06 PM
Posted 27 November 2019 - 06:08 PM
Sorry Hrk that's why I defer to fh and IUN for advice. Didn't realize you had gone up in dose and THEN started getting symptoms. I thought the only change was the capsule type.
Also Hrk I'm curious about your dose split? Fishinghat and IUN would love some input also. This was less of an issue on my better days but on these tough days I feel like I take my 7 beads around 7:30/8 finally feel solid relief around 1-2 and then that 12 hour half life hits and around 7pm I've been a mess again. Does it make any sense to take 7 beads in the AM and 7 in the PM? Or do I cut my current amount in half and do say 4 beads x 2? Is this totally going to screw me up?
Posted 27 November 2019 - 06:19 PM
This is the issue - changing more than one variable at a time. There is every chance that the dose change could have influenced the changes. If an enteric capsule was used, this would break down in the intestines and release the beads which would then do the same. It is not so much of a problem WHERE in the intenstines this occurs as inevitably it will reach the liver. HOWEVER, if released in the stomach and the pH is above a certain amount and there is a delay in gastro-emptying as detailed in the FDA release, then this is when there is more of a problem.
Therefore, overdoing the enteric coating is not a problem. Underdoing it is
Hope that makes sense... and Hat please elaborate or re-word as you are better at explaining this stuff. My research supervisor is always saying this to me... "You and I understand this, but no-one else will!!". I tend to make too many assumptions!!
Posted 27 November 2019 - 06:21 PM
Posted 27 November 2019 - 06:30 PM
Frog, there are a number of proteins and receptors involved with Cymbalta metabolism because of this some do better with taking it in the AM and some in the PM. Normally I recommend splitting the dose if the person is worse starting about 1 or 2 hours after taking the Cymbalta and then slowly get better as time passes. The converse is true also. If some one feels better after taking the Cymbalta and worse as it wears off then again I will recommend splitting the dose. By splitting the dose it provides a more stable blood level of Cymbalta and reduces swings up and down some.
This was very similar to what was occurring with Polly when she got to the lower bead count. In the end I advised her to go 3x at 8 hour intervals which helped... but any more than this and it will weaken the potency of the dose beyond that which is required, but can be a game-changer during the last few days of withdrawal.
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