63 replies to this topic

[hatecymbalta1]

Hello there

I’m in distress and need help. I have been trying to get off cymbalta for over 2 years. I’ve had 3 failed attempts. Most recently I did a fast taper using the generic capsule that I have which has four big beads each are 5mg. I did a fast taper in May -July (2 month taper) and my symptoms showed up 3 months later. Severe symptoms. So in desperation I reinstated a month after the symptoms showed up by 10mg. It’s been 5 weeks now and I’m not doing well. I don’t know if I should wait a little longer or change to a different antidepressant.

Please I really need your help.

Thank you.

[invalidusername]

Hi Mary...

 

... and whilst it might not seem like it for you, I wish you seasons greetings. And we will help you as best we can.

 

The "big bead" examples are not the best to operate a taper from... and you have answered your own question above as the phrase "fast taper" appears twice. Guess what I am going to say?!

 

You do have the option of switching to another AD to counteract the issues of the Cymbalta, but ideally you would switch to a brand of Cymbalta which uses the smaller beads and do a far slower bead count method. There should be no harm in switching between the two. The problem is, these big beads are not designed to be cut in half either as there is no guarantee that you will get equal amount of the active ingredient of Duloxetine in each half. It is possible to dissolve the beads, but there are issues due to the coating, which is why I suggest the smaller beads.

 

Has this been suggested before, as I have seen you have posted previously, but I do not remember discussing with you - memory isn't so good at the moment!!

 

IUN

[hatecymbalta1]

I have tried twice to switch to the small beads and to no avail I could not stabilize and it threw me into severe withdrawals. I’ve tried thus using the big beads to do a fast taper. I’m thinking to switch to celexa which I was on for 14 years before cymbalta and would be a much easier drug to taper. Do you know of others who have been successful with switching to a different antidepressant. Thank you.

I have tried twice to switch to the small beads and to no avail I could not stabilize and it threw me into severe withdrawals. I’ve tried thus using the big beads to do a fast taper. I’m thinking to switch to cell a which I was on for 14 years before cymbalta and would be a much easier drug to taper. Do you know of others who have been successful with switching to a different antidepressant. Thank you.

[hatecymbalta1]

I did not know you could dissolve cymbalta beads. How would you do that.

[invalidusername]

OK - so the switch to small bead has been tried and failed - I am sorry to hear that, but this tells us that you are very sensitive, so it is something to work with.

 

The active ingredient, duloxetine, need to dissolve only when it reaches the intestines such that it survives the lower GI and reaches the liver which will then disperse the duloxetine accordingly into your system. This is achieved by have an acid-resistant coated capsule. If you were to dissolve the big beads, this would mean dispensing with the capsule, thus the duloxetine would be released in the stomach way before it needs to be and the efficiency would be compromised. So this is unfortunately not an option - but IS with other drugs and is known as water titration. 

 

If you are feeling stable enough on the Cymbalta at present and it is the withdrawal that is the hurdle, then a cross-taper to something like Prozac would be a way forward. The withdrawal from Prozac post-switch will be - or should be - a walk in the park compared to the Cymbalta. 

 

Another alternative, which might be more complicated would be to powder the big beads and dispense smaller doses of the powder into the acid-resistant capsules, thus giving you a slower taper. You would need a pestle and mortar (or similar) to crush the beads and micro scales to measure the weight of the dose. There is a possibility that you would get slightly uneven doses doing it this way, but it is an option. What you would need to do is empty a load of big beads out of the capsules, crush them to make a powder, then measure out 9mg of powder and put this back into one of the capsules, and do this until you stabalise... then move to 8mg, 7mg and so on. This would achieve the same effect of bead counting, but the drops would still be a little larger between doses, unless you measure out decimalised doses such as 9.8mg, 9.6mg etc. This is possible, but would try the nerves of even the most patient of people I would imagine!!

 

Let me know if that makes sense and if I can be of any further help.

 

I expect Hat will be along later to comment.

[hatecymbalta1]

How do I know how many milligrams of powder to get 9mg. And what kind of capsule do I need to get?

[hatecymbalta1]

The powder way seems confusing how do I weigh that

[invalidusername]

I agree, it can be confusing, but it can be done.

 

I use a lot of natural powders as I cannot tolerate medicine very well, so I need to measure doses this small and I use these scales;

 

https://www.amazon.c...e/dp/B00EPO9M2Y

 

They look cheap, but they work perfectly and measure down to 1/100th of a gram. Very accurate.

 

You then to use the capsules that the beads came out of, and then when the supply for those run out, you need acid-resistance capsules - also known as enteric capsules. There is lot of information on the site about this topic as we have covered it with many users, but you can find these from pharmacies, amazon, ebay etc...

 

IUN

[hatecymbalta1]

I would crush. 10mg bead and put in a scale and get the weight and then how do I know what 9mg would be does it weigh in milligrams I’m so confused and I do have a scale but it was used for the beads can I use that How do I know how much 9mg weighs can we talk on the phone I don’t understand

[hatecymbalta1]

I have a Gemini 20 scale

[fishinghat]

Nothing wrong with that scale. Many have used that model. Lets take an example. Lets say you weight a 10 mg bead and it weights say 43 mg. That means it is 4.3 mg per mg of Cymbalta. So for 9 mg you would take 8 times the 4.3 mg and get 38.7 mg of powder would give you a 8 mg dose. If you decide to go this route you can weight out one of the 10 mg beads and we can do the math for you.

I am concerned with your trying to wean directly from Cymbalta. You mentioned that symptoms hit you 3 months after you stopped the wean. That is very rare and makes me think it might be better to switch to another antidepressant and wean off of that. Many members have done that in the past. The favorites are Prozac, Zoloft and Lexapro but others can work as well. I must state at this point that if you switch the new antidepressant may or may not work even if you used it before. I had to try 4 different ones before I found on that worked. You may be lucky and get the right one on the first try. The final decision is yours and you can bet whatever you decide we will be there for you all the way.

[invalidusername]

The Gemini is perfect - better than my scales. You would first weigh the capsule, and then add powder, weigh, add more, weigh etc, until you reach the 9 grams. It really isn't as difficult as it sounds. Once you have done it the once, it will all make sense. 

 

Whereabouts are you from? 

[invalidusername]

Good point Hat - this is why I ask if Mary is at a place where she no longer feels she needs an AD - or whether she (assumed!) is wanting to get off it for reasons other than feeling better....

[hatecymbalta1]

Okay I put the capsule with the two 5mg beads on the scale and it weights 0.098

[hatecymbalta1]

Okay and now I put the 2 beads on the scale and it weighs 0.045.

[hatecymbalta1]

My first dose would be 9mg and if 10mg weighs 0.045 how much would I calculate the weight of 9mg

[hatecymbalta1]

And if I can do the powder with cymbalta I would rather go off this because I’m already on it and won’t get any more withdrawals because I’m already on it just tapering off it

[fishinghat]

9/10th of 0.045 grams which equals 0.0405 grams.

By the way that is still a pretty big drop but a lot less than what you did before.

[hatecymbalta1]

I’m totally confused as to your calculations . This is very confusing to me I have such brain fog

How much powder would I put on the scale to 9mg and then I would put the powder in an acid resistant (enteric coated capsule), right

Thank you fishing hat

[hatecymbalta1]

And why would 9mg be a big drop. I’m totally confused. Can you show me how you got that calculation please

[invalidusername]

Mary... I can understand this is difficult with the "cog fog". No shame in feeling lost by this all, so I will explain as best I can for you.

 

Let's say you had a cake and 10 people all wanted a slice. You need to divide that up into 10 equal portions. Now as we know a full circle is made up of 360 degrees. So in order to get 10 equal slices, we have to divide the 360 degrees by 10. So 360 ÷ 10 = 36. So you would need a way of measuring 36 degrees which would be difficult, but not impossible!

 

So now lets say that cake got smashed to a pulp and was just crumbs - but the 10 people didn't mind - they all still wanted their equal share of the cake! OK...

 

Now the cake becomes a question of WEIGHT rather than SLICES. So, you weight the whole cake as crumbs, and let's say it weighed 500 grams. So again, we do the math as before. 500 ÷ 10 = 50. So each person gets 50 grams worth of crumbs. You get your scales and put the whole cake on. The scales read 500 grams as we know. So you get a spoon and start taking crumbs off until the scale reads 450 grams. What you have taken off is 50 grams, so that is one portion that you give to your first guest. Then you take more crumbs off until the scale reads 400 grams (450 - 50), then you have your second portion etc.

 

Hope you are with me so far.

 

Now let's switch the cake for your powder.

 

Your powder weighs 0.045 grams - a very small cake!! You need to take the one slice out of that to be left with 9 slices. So you take off enough for the first slice, and you will know when you have cone this as your scales will read 0.040. What you have left on your scales are the nine slices... OR the dose you need as your first tapering dose.

 

Now the better way to do this is to know how much one "slice of cake" weighs, so you don't always start with the whole cake. In this case, each slice weighs 0.045gm. So you would need to measure in multiples of this. Your taper would be based on this, so...

 

1st dose - 0.045gm

2nd dose - 0.040gm

3rd dose - 0.035gm

4th dose - 0.030gm

5th dose - 0.025gm

6th dose - 0.020gm

7th dose - 0.015gm

8th dose - 0.010gm

9th dose - 0.005gm

10th dose - none!!

 

How long you stay on each of these doses is one we need to work out for you, but before we do, can you please tell me if that makes sense!!

[hatecymbalta1]

Hi God like,

Wow thank you. I got your analysis of how this will go. Are each drops 9mg, 8mg, 7mg and so on. I’m assuming the percentages as I go lower will be more than a 10% decrease wig get may be a bit of a drop but I can see how it goes. So I will put the two bead which are enteric coated in bowl and crush and put that powder o scale and remove so my first dose weighs 0.040gm and put that powder in capsule. I would imagine I would make up 2 weeks of that does and see how my body handles it and if I’m okay can make my next drop 0.035gm.

Now I have to buy the capsules. Which capsules should I purchase. Can you send me a link of the capsules from amazon please.

I’m thinking the lower I go my scale might not weigh that low but not sure.

Thank you so much for your help. Your description was Vert helpful and clear to understand.

Thank thank so much.

[invalidusername]

Yes - you got it exactly. The drops become more as you go, which is why you might end up going slower towards the end. You start by eating 9 portions of the cake (which is 10 portions), so this is quite a lot. But by the end, you have gone from eating two portions down to one portion which is HALF a drop, so yes, it does get difficult and this is why you have had such a hard time. Really glad my cake example helped! It's a new one - so it was just for you Mary

 

A quick search found these;

 

https://www.ebay.com...0.c101111.m2109

 

I am in the UK so don't know the best place in the US to find this stuff.

[hatecymbalta1]

Are these drops more than 10%. Do you think I will be okay. Can you calculate the percentage for each drop. I’m scared the drops will be too big and throw me into further withdrawals.

Also I found these gel caps. Will they be okay to use.

https://www.amazon.c...s/dp/B06XGM6HK9

Thank you so much for your help. Also would you crush a bunch of the beads and keep them in a plastic cup and put in fridge or just make them daily?

Again thank you so very much. Merry Christmas to you

[invalidusername]

Yes - the link you have found is just fine for the purpose.

 

Regarding the drops, given that we are measuring the powder, there isn't much less we can go. The drops do increase, but as you will be going slower this time around, you will find the symptoms easier. You can also split the dose over 24 hours - that is to say, you can can take 2 capsules every 12 hours instead of 1 capsule in 24 hours. This often helps people when the dose gets low. So here if you were measuring out your 6th dose at 0.020gm, you would measure 0.010gm instead and take them 12 hours apart. So you still get the correct dose over 24 hours, but the blood levels are more stable because you don't let the blood level drop quite so much between doses.

 

There are also plenty of supplements which help - so don't worry too much. You are in the right place to get the best help

 

...and a very Merry Christmas to you too.

[hatecymbalta1]

I need some hope have you ever seen anyone reinstate after 3 or 4 months after stopping cymbalta. I’m reading so many scary stories that I will never get better. Omg I’m so scared. It’s been 5 weeks back on and maybe now I’m feeling 5% better but I really am filled with being paralyzed with fear and have such a lack of emotions. Please tell me I will start to feel better.

[fishinghat]

Reinstating after 4 or 5 months isn't something I normally recommend. You are already about half way through the worse part. Also reinstatement at that point may worm but it may not as well. If after 4 to 6 days you don't feel a lot better then it probably will not make a significant difference as your blood levels have already reached their peak for that dose. Having said that there have been a few that did respond to reinstating after that long but not many.

[invalidusername]

You had 3 months off the drug and then reinstated, and now it has been 5 weeks, right?

 

Can you detail exactly what you felt at the 3 month point that caused you to go back on the Cymbalta?

 

And any other symptoms that you felt during this time and whether they disappeared - either physical or emotional?

 

Did you feel you were at a place before you came off the Cymbalta where you were happy to do so, eg, no depression, no anxiety, limited stress (or pain if that is what you were taking it for)?

[hatecymbalta1]

Hi godlike

I did a fast taper in may-July and 3 months later my withdrawal symptoms showed up. I was in shock to say the least and I had so many symptoms and have a job I was desperate so I waited about 3 more weeks and couldn’t tolerate the symptoms so I reinstated 10mg. Before I came off cymbalta yes i was in a great place and was definitely ready to come off. I’ve attempted to ome off before but had difficulty due to the generic brand and listening to my doctor.

So long story short I only reinstated because my symptoms showed up 3 mo the after I stopped the last pill.

Today I feel okay and have managed to pack a bag and get on a bus to visit my sister. I hope it continues to get better. I don’t know if I should increase the med or just wait and stabilize. Then try again with the powder in about 6-12 months unless my symptoms get worse. Today is okay though finally. What are your thoughts.

[fishinghat]

Definitely wait until you stabilize. One day at a time.