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#1 Ctrahan626

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Posted 27 April 2020 - 11:35 AM

Going to try to keep it short. my girlfriend was taking duloxetine 60mg and 4mg clonzepam a day for about a year straight. She started to lower the amount of clonzepam about 6 months ago and got down to 1.5mg and she decided she wanted off duloxetine as well. She went from 60mg to 30mg in about a week and then down by 5mg each week until she was off. she got off lexapro same way few years ago and thought she would be ok. the first week off she was having anxiety but it was manageable and then the second week she couldn't stop crying and shaking. that was when we found this site and got scared and decided for her to start the 30 mg duloxetine again and get a psych dr to help her get off. he lowered her duloxetine to 20mg and put her on 20mg fluoxetine and  .1mg clonidine 3 times a day. as directed after a week she stopped taking duloxetine. she was fine for about two weeks felt completely normal and fine. then the third week she felt how she did when she stopped duloxetine the first time. so after a week she called her dr. he upped the fluoxetine to 40mg. last week she felt exactly the same way crying uncontrollably all day till about 7 or 8pm. just got off the phone with the Dr and he said basically well i don't know call me back in a week.

 

what can she do to get relief. i don't know what to do for her anymore we are getting desperate. some other daily stuff she has been taking multivitamin, vit b complex, vit c, vit d, 12.5 mg synthroid (hypothyroid).  she has been trying cbd and ashwangndha. she has been taking dramamine for stomach aches she gets from panicking. she has to take benadryl to sleep at night. it seems like a lot and it might be but like i said we are getting desperate.  

 

could this still be duloxetine withdrawal symptoms? the Dr made it seem like because of the Fluoxetine she shouldn't be feeling anything from the duloxetine.

 

her last does of duloxetine20mg was 32 days ago she has been taking Fluoxetine for 39 days (14 of those days at 40mg)


#2 fishinghat

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Posted 27 April 2020 - 12:49 PM

Welcome Ctrahan
 
Unluckily this is all to common a story. His basic approach was sound but let me make a few observations. Fluoxetine is a good med for cross over to get off the Cymbalta.   BUT the Fluoxetine takes 6 to 8 weeks to kick in. The relief you have seen is from the clonidine which was a good move as it is non-addictive and has no withdrawal. She is probably right now just starting to getting any benefit from the Fluoxetine 20 mg and will be another 6 to 8 weeks to stabilize. During that time she will be suffering a lot but it will fade.

The next observation is that Fluoxetine controls serotonin while Cymbalta controls both serotonin and norepinephrine (that is related to adrenaline). So she is still going to have some issues with anxiety but the good news is that is what the clonidine is for as it should help control the anxiety.

Next, the multivitamins are a mixed bag. Toxic reactions to multivitamins are the number one toxic condition seen in the ER. (other than street drugs). They have landed many members in the hospital over the years. B vitamins are the primary source of those toxic events especially Vitamin b6. If you wish to provide me a list of those items and their ingredients I would be more than happy to review them. Vitamin C is used in the production of adrenaline so it should be used in very low doses if at all during withdrawal. Vitamin D also has its own issues but that is dose dependent. It has been the experience of our members that those who have hypo or hyperthyroidism usually have a worse withdrawal.

CBD can be a good choice but that is really not my area of expertise. IUN will be along later and address that.

Ashwangndha can help take the edge off but your body builds up tolerance to it so many take it for a week and then off it for a week, Dramamine is OK if the right active ingredient. Dramamine has six different versions, some help and some make it worse so again I would need to know the active ingredient.

Benadryl also has several different products. The one you want has an active ingredient of diphenhydramine. It is like Ashwangndha in the sense your body gets conditioned to it. Usually 7 days on and 7 days off.

There are a lot of other things to try and also to avoid but I think this will get us off to a good start. I would also recommend our ebook which is a summary of member experiences, medical journal articles and other research. It will answer a lot of questions. Tell her to be patient and we will walk her through this. She can beat this. Feel free to update, ask questions or just come here and complain. We understand, we have been through the same thing.

#3 frog

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Posted 27 April 2020 - 01:34 PM

Hi Ctrahan, 

Hat has you off to a great start. He's been through this and has also been on this forum for many years and has helped many people along the way (including myself! I'm so grateful to have found him and IUN here when I was where your girlfriend is now)

 

I just wanted to say that I feel for your girlfriend (and for you! I'm sure it's extremely stressful watching your loved one go through this). I also want to reassure you that this 100% sounds like cymbalta withdrawal. I was also on 60mg of Cymbalta and tapered down to about 18mg, and then jumped off completely. Big mistake! And it caught up with me 3 weeks later. Same exact thing as your girlfriend, I went through weeks of shaking and crying and sudden panic attacks which I had never had before, and overall feeling like my brain was completely broken. A week into the withdrawal I even had to start a brand new job! It was absolute agony. It's a little over 6 months now and I would say I'm 85% of the way back to myself. I haven't had a panic attack in at least a month now.

 

CBD did jack squat for me, I did see some benefit from the Ash but as Hat said, it takes the edge off. It won't put things right completely. I never tried clonidine, but my psychiatrist gave me beta blockers which I was taking twice a day every day for the last 4 months and they were a godsend for the panic attacks that I started having during withdrawal. I tapered off them recently because I haven't had a sudden out of nowhere panic attack in at least a month. 

 

All this to say, it will get better! I know it's hard to believe when you're going through the worst of it, but we are all here to prove that it does get better. Just remember that no matter what any doctor says you are not crazy, the withdrawal is real and it can take a while before things return to normal. My psychiatrist told me I'm the worst case of Cymbalta withdrawal he's ever seen, but here I am!

 

And remember to be kind to yourselves. With the current state of things due to the virus stress and anxiety are already high. 


#4 invalidusername

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Posted 27 April 2020 - 03:48 PM

Hi Ctrahan and welcome...

 

I am the IUN referred to by my friends above... and yes, Hat has got you covered for this first installment. As he says, your girlfriend has jumped classes of anti depressant from an SNRI to SSRI, and it is not comfortable to do so in such a short period of time. The taper she did would only really have been necessary under emergency situations. Ideally she would have cross-tapered over the course of a good 2 months so the Fluox/Prozac had time to work in the system. 

 

She is now in a place where she has cym withdrawal AND Fluox start-up symptoms. You need to reassure her that this is all med-based, she has done nothing wrong - the doctors have. I do not care for these numbnuts who just throw pills at a problem to cure another. 

 

She is better off now waiting for the Fluox to kick in before coming off this as she has been on them for 5 weeks. There is also a chance that they will not help, but regardless of whether or not they help, they will cause issues if she were to try coming off these now whilst her system is getting rid of the Cym. It would be too much.

 

Regarding the ashwangndha, what brand and dose was it? Ideally you want KSM-66 as it is standardised - try the best to know whether it is going to work for you or not. Don't mess around with cheaper stuff that could have any unknown levels of withanolides. Again with the CBD - there are far too many people out there selling olive oil in a bottle - you need to make sure that the seller has got an up-to-date (within the last 12 months) certificate from a 3rd party who has tested the product - and not some dodgy lab in the middle of Mexico. There are more bad CBD products out there than good. So you need to watch what you buy.

 

You have a lot of info here to wade through, so will let you absorb and come back to us in your own time where we will be able to guide further...

 

All the best.

 

IUN


#5 Ctrahan626

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Posted 27 April 2020 - 03:52 PM

Thank both of you so much for the quick and helpful responses. This morning when she got off the phone with her Dr. I think we were both very scared because he made it seem like everything should be fine and what she was going through was something else wrong. He seemed very uninterested and really brushed her off which was upsetting.

 

The multivitamin she is taking is the Garden of Life women's multi which is all from whole food blends.

 

The Vitamin B she takes is Terry Naturally Bioactive Vitamin B which is vitamin b already in methylated form. The active ingredient listed are

Vitamin B6 (as pyridoxal-5-phosphate)       25mg       1,250%

Folate (as (6S)-5-Methylfolate)                    800mcg    200%

Vitamin B12 (as methylcobalamin)           1,000mcg   16,667%

Calcium (from methylcoalamin and dicalcium phosphate)   36mg        4%

 

The Vitamin C has been a recent thing she started taking at the start of the Covid-19 pandemic but she might be doing away with that for now if there is a possibility of that messing with her.

 

The vitamin D she takes is a D3 2,000 IU chewable which is also a whole food blend but her Multi also has 1,000 IU. she has been taking both because she was very deficient on a blood test about 6 months ago but has since leveled out and her most recent test about a month ago came back in range.

 

The Dramamin she has been taking the past couple days is a Walgreens knock off called Wal-Dram and the active ingredient is Dimenhydrinate 50mg. She only takes it as needed right now. She has been getting a pain in her stomach recently that acts up when her anxiety does.

 

The Benadryl's active ingredient is Diphenhydramine HCI 25mg. 

 

She's calmed down since this morning and she's reading the ebook now. Thank you for taking the time to respond and help out because I have been so lost and confused and we are trying to figure this out and haven't had much help until we found this site. She is very appreciative and grateful as well. 


#6 Ctrahan626

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Posted 27 April 2020 - 04:22 PM

Hi IUN thank you for responding. 

 

The ashwagandha she has been taking is Now brand 400 mg which is not ksm-66 but she does have some from Garden of Life that is that she is going to try again. She said when she took the Garden of life brand before it made her feel a little jittery but that was before withdrawals.

 

The cbd is from cured nutrition full spectrum hemp oil which is third party tested and certified. She takes it kind of as needed or when she remembers. 

 

Thank you all again. What yall are doing for people on here is amazing.


#7 fishinghat

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Posted 27 April 2020 - 04:36 PM

There are 8 different versions of Garden of Life women's multi. If you could give me a product code I can investigate further.

The Vitamin B she takes is Terry Naturally Bioactive Vitamin B which is vitamin b already in methylated form. The active ingredient listed are
Vitamin B6 (as pyridoxal-5-phosphate) 25mg 1,250%
Folate (as (6S)-5-Methylfolate) 800mcg 200%
Vitamin B12 (as methylcobalamin) 1,000mcg 16,667%
Calcium (from methylcoalamin and dicalcium phosphate) 36mg 4%

WOW! This product is horribly high especially for B6.
My wife has had numerous back/neck spinal surgeries and this resulted in neuropathy. Multiple cat scans, nerve conduction tests etc and everything was good. The drs said it was what it was and get use to it. I spent a month in the medical journals looking for any source of peripheral neuropathy that the drs and I had not considered. I came across references to the Vitamin 6 toxicity and how common it was. After my wife had her surgeries they recommended Stress Tabs. The RDA for B6 is 1.5 mg/d for women over 50 and her stress tabs were 5 mg/d! Her serum Vitamin B6 was determined to be almost 200 times normal values. She stopped taking the Stress Tabs and with a half-life of 15 to 24 days it took her 6 months to get back in normal range and 9 months to be symptom free. She no longer suffers from peripheral neuropathy.

The vitamin B12 is rediculous as well . High levels of vitamin b12 supplements. especially if taken with vitamin C, can cause significant anxiety.
I would do away with the vitamin C as well. If she is interested in an antioxidant for covid-19 she would be better off with Astaxanthin 6 to 12 mg/day. It is a good antioxidant as well as having antiviral properties. Vitamin C does not have antiviral properties.
That is not a bad dose for the Vitamin D. I would leave it as is.
The Dimenhydrinate is good for sleep but is incompatible with hydroxyzine and Benydryl (diphenhydramine). These are significant drug interactions. She could alternate 1 week on diphenhydramine (50 mg total) and then one week on Dimenhydrinate. That way you don't build up tolerance to them.


#8 Ctrahan626

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Posted 27 April 2020 - 06:07 PM

The Multivitamin she takes is the Garden of Life, mykind organics, women's multi, whole food multivitamin. Couldn't find a product code but found a link to what she takes.

https://www.vitamins...tablets/gu-1194

 

During her first attempt to get off we went to a health food/ vitamin shop where she was recommended the Vitamin B complex, magnesium spray and some sort of trauma drops. She has stopped taking the spray and drops but she kept the Vit B. I never realized how much it actually was and I always thought since is water soluble  her body wouldn't store it but i'm now reading an article on how extremely high doses can lead to side effects. I will talk to her about that.

 

Even the Multi says 

Vitamin B6         13mg      650%

Vitamin B12       30mcg    500%

 

which would be 1,900% B6 daily value and 17,167% B12 daily value which seems absurd. 

 

I'm going to talk to her about the alternating weeks as well.

 

thank you again.


#9 fishinghat

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Posted 28 April 2020 - 08:19 AM

Actually that Garden of Life multi isn't too bad except for Vitamins B6 and 12 and the selenium. Selenium is a metal that many people are very sensitive to and I would rather see it about 1/2 that dose but the B vitamins are the real issue.

 

Hang n there and keep us posted.





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