Jump to content



Photo

Esroar's Cymbalta Taper


  • Please log in to reply
78 replies to this topic

#61 ESRoar

ESRoar

    Advanced Member

  • Members
  • PipPipPip
  • 42 posts

Posted 22 November 2020 - 10:33 AM

Frog - thank you for telling your story.  It makes me sad how it affects so many people in such a bad way and for years on end!

 

I met with a 4th psychiatrist yesterday to find out what to do with my medications after Monday's episode, since the Dr. I was going to stick with isn't available until 12/15.  It's so frustrating not having any continuity of care.  Anyway, she thinks I need to start tapering the cymbalta.  She thinks I might never feel good being on both the cymbalta and zoloft.  The morning nausea has been pretty unbearable.  I'm so sick, I'm dry heaving.  It's just awful.  I've been trying the ginger root tablets, which I think help.  This morning they seemed to give me heart burn.  So she wants me to drop 2mg of cymbalta this week.  I started that dose this morning - 37mg.  We'll see how it goes.  Hopefully it can't get much worse than how I'm feeling now.  She told me to reach out to her if I have trouble with the cymbalta drop causing anxiety.  She mentioned giving me guanfasine for that.  I've never heard of that before, so I'll have to do some research.

 

She also thinks it's good I stopped the buspar.  She thinks the cymbalta + zoloft + buspar was too much serotonin.


#62 fishinghat

fishinghat

    Site Partners

  • Active Members
  • PipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPip
  • 12,433 posts
  • LocationMissouri

Posted 22 November 2020 - 01:44 PM

Guaifenesin for anxiety? I couldn't find anything on that at all.

#63 ESRoar

ESRoar

    Advanced Member

  • Members
  • PipPipPip
  • 42 posts

Posted 23 November 2020 - 09:33 AM

Guaifenesin for anxiety? I couldn't find anything on that at all.

It's guanfacine.  It looks like it's usually prescribed for ADHD.

 

So I dropped the 2mg yesterday morning and I feel like a truck hit me today.  I'm stuck in bed because I'm so dizzy, nauseous, jittery, tearful.  Just overall feel so sick.  I feel like I forgot to take my cymbalta pill, but I did take it.  I don't know where to go from here.  I can't live like this.  I don't know if I should add 1mg back in.  I'm so desperate to feel better.  Maybe I should just go back on a higher dose of Cymbalta, stop the zoloft, and be done with it.  


#64 fishinghat

fishinghat

    Site Partners

  • Active Members
  • PipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPip
  • 12,433 posts
  • LocationMissouri

Posted 23 November 2020 - 11:27 AM

Ahhh, now I understand. Not a typical drug used for anxiety but it does have anxiety fighting properties.

Side effects of guanfacine are dose-dependent.[12]

Very common (>10% incidence) adverse effects include sleepiness, tiredness, headache, and stomachache.[13]

Common (1-10% incidence) adverse effects include decreased appetite, depressed mood, anxiety, irritability, mood changes, insomnia, nightmares, dizziness, lack of energy, slowed heart beat, low blood pressure, feeling faint when standing quickly, vomiting, nausea, diarrhea, constipation, dry mouth, urinary incontinence, and rashes.[13]

Typical side effects such as fatigue, irritability and stomach upset can take a week or two to subside. Increases in dosage can have the same adjustment period.

 

A 2 mg drop is a big drop. I normally recommend a 0.3% drop or less.  I would return to the previous dose and stabilize which will take 3 to 7 days. Once you are doing better try a much smaller drop. 


#65 ESRoar

ESRoar

    Advanced Member

  • Members
  • PipPipPip
  • 42 posts

Posted 23 November 2020 - 12:41 PM

Thank you, as always for your guidance FH.

 

I put 12 beads in a capsule and took it.  I was hoping I'd be able to drop from 39mg to 37mg with the help of the zoloft on board, but I'm still as sensitive as ever to the cymbalta.  

 

I also ordered enteric-coated capsules from the advice on the other thread.  I'm wondering if they'll help with any of my nausea/diarrhea.  


#66 fishinghat

fishinghat

    Site Partners

  • Active Members
  • PipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPip
  • 12,433 posts
  • LocationMissouri

Posted 23 November 2020 - 01:17 PM

They might help.

 

How long you been on the Zoloft now and at what dose?


#67 ESRoar

ESRoar

    Advanced Member

  • Members
  • PipPipPip
  • 42 posts

Posted 23 November 2020 - 03:49 PM

They might help.

 

How long you been on the Zoloft now and at what dose?

 

I've been on the Zoloft 2 weeks and 2 days.  50mg.  That's the dose I was on for ~12 years prior to going on Cymbalta.  It doesn't feel like it's doing anything except maybe helping me to fall asleep at night and contributing to my nausea.


#68 fishinghat

fishinghat

    Site Partners

  • Active Members
  • PipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPip
  • 12,433 posts
  • LocationMissouri

Posted 23 November 2020 - 06:01 PM

Zoloft has a very long half life and normally takes 6 to 8 weeks to kick in. It is way too early to see any effects.


#69 ESRoar

ESRoar

    Advanced Member

  • Members
  • PipPipPip
  • 42 posts

Posted 24 November 2020 - 10:45 AM

I'm really struggling.  Bedridden.  Extremely nauseous.  It's hard to eat and drink.  Dizzy, tremors, sweating.  I don't think the cymbalta and zoloft together are agreeing with me.  I'm so physically sick that I don't even notice my mental health.  I think I need to stop the Zoloft, but I'm not sure how to do that.  I reached out to the dr. through the patient portal.  At this point, I almost wish I could be hospitalized.  I cannot function.


#70 fishinghat

fishinghat

    Site Partners

  • Active Members
  • PipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPip
  • 12,433 posts
  • LocationMissouri

Posted 24 November 2020 - 11:02 AM

Definitely dr time. You have been on the Zoloft over 2 weeks so it is possible that stopping it may cause some additional withdrawal symptoms. Just my opinion but I would say that dropping the dose to 25 mg to see if it improves would be a good next step but I would strongly suggest you talk to your dr first to see what they think. 


#71 ESRoar

ESRoar

    Advanced Member

  • Members
  • PipPipPip
  • 42 posts

Posted 29 November 2020 - 08:36 PM

I ended up back in the ER on the 24th.  I met with a young, angry psychiatrist who suggested that I had serotonin toxicity and that I should stop all meds for 3 days.  I told him I couldn't do that because of the withdrawals.  He actually threw his arms up and told me he didn't know how to help me.  The nurse practitioner overseeing my care at the ER recommended I dial back the Zoloft to 25mg.  I did that for Tuesday night.  Then Wednesday, again soooo sick.  Extreme nausea, dry heaving, internal tremors.  I met with the new psychiatrist and she agreed that I keep getting worse and said that while I may not have full blown serotonin syndrome (no fever), I was experiencing too much serotonin.  She told me to stop the zoloft and zofran and then try taking 20mg of Cymbalta in the AM and 20mg in the PM.  She wanted me to try splitting the dose to see if that helped with the side effects.  Friday morning I started the 20mg BID of the cymbalta.  To make this even more interesting, the brand is changed because the old brand is no longer manufacturing cymbalta.  Saturday and today have been terrible.  Severe nausea to the point that I can barely eat or drink until dinnertime.  I've tried using Emetrol and Dramamine, but they haven't seemed to help much.  I also have the terrible internal tremors that make me want to jump out of my skin.  I feel so irritated by everything and sounds.  I again reached out to the psych dr. through the patient portal and asked if there's anything I can do.  She recommended I take 40mg cymbalta tonight and go back to taking it once per day at night, which is what I've done for years.  

 

Is it possible to have withdrawals from me splitting the dose into 2?  Dr. doesn't think I'm having zoloft withdrawals since I was only on it for 2.5 weeks.  I'm not sure if I should take 20mg or 40mg tonight.  I'm upset that I ever went to these drs and got all of these meds prescribed.  I should've just stayed on the 39mg of cymbalta and dealt with the side effects.  

 

Is there anything I can do or take to help the internal tremors and irritability I'm feeling?  I tried taking Propanolol 10mg earlier and I think it helped a little, but I still couldn't get up and be productive.


#72 fishinghat

fishinghat

    Site Partners

  • Active Members
  • PipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPip
  • 12,433 posts
  • LocationMissouri

Posted 30 November 2020 - 08:16 AM

This is a complicated situation. This is part of the dilemma of adding other serotonin related drugs during withdrawal. 

 

First of all, 2.5 weeks of Zoloft is enough to generate some withdrawal when stopping it. Other than that I pretty much agree with the drs approach but....

 

unluckily it will be a difficult rebound. My experience on being on this site for years tells me it normally takes 3 to 7 days to settle down when going back to a higher dose of Cymbalta. Given the mess these drugs have made and the sensitivity of your nervous system then it may take longer. Even when you start to stabilize you will still be very uncomfortable for quite awhile.

 

Secondly, I really don't understand why they didn't put you on either clonidine and/or hydroxyzine to help the symptoms. They wouldn't cure you but they would typically help a bunch. They do not effect serotonin but do relive the effects of increased adrenaline and histamine AND do not have a withdrawal. 

 

Thirdly, there are some supplements that may help your situation but I hate to recommend anything given the mess your neurotransmitters are in. What if you had a reaction to one or it caused bad side effects? You have enough problems as it is. The supplements may help you but their effect would be limited. What ever you decide we will be here to support you and if you decided to try some supplements just let me know and I will recommend some that other members have used with some success.


#73 ESRoar

ESRoar

    Advanced Member

  • Members
  • PipPipPip
  • 42 posts

Posted 30 November 2020 - 09:25 AM

fishinghat, thank you for weighing in.  I know that it's a complex situation because there have been so many factors changing.  

 

Last night I took the 40mg Cymbalta.  I slept good, despite a lot of sweating.  I woke up and feel like I did weeks ago when I was taking the 39mg of Cymbalta at night.  I feel very anxious in the morning, nausea, but I've been able to eat toast.  This is the same feeling that made me seek out a psychiatrist a few weeks ago.  And here I am feeling grateful that I'm back at this point.  

 

Are clonidine and hydroxyzine different than Propanolol?  

 

I tried taking L-theanine this morning for the first time.  I haven't noticed much effect.  


#74 ESRoar

ESRoar

    Advanced Member

  • Members
  • PipPipPip
  • 42 posts

Posted 30 November 2020 - 11:57 AM

Regarding the cymbalta brand change, I went from Prasco to Breckenridge.

 

This morning my husband opened up the Breckenridge capsules to see what we're dealing with.  The beads appear to be the same at the Prasco beads; however, there was a difference in bead counts.  He counted out 3 of the Breckenridge capsules.  They varied:  113, 115, and 117 beads.  So an average of 115 beads.

 

I was on 39mg of Prasco brand and 40mg of Breckenridge is an average of 8 beads less.  In recent months, I have only been able to handle drops of 4 beads at a time.  So here I was thinking that I had increased Cymbalta dosage by 1mg and it appears that I've actually gone through a drop of twice what I can normally tolerate.  This would explain how terrible I've felt.

 

The Dr. recommended I try taking 5mg of cymbalta to see if that helps my symptoms, so I just did that.  


#75 fishinghat

fishinghat

    Site Partners

  • Active Members
  • PipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPip
  • 12,433 posts
  • LocationMissouri

Posted 01 December 2020 - 08:52 AM

"Are clonidine and hydroxyzine different than Propanolol?"
 
Yes, propranolol blocks the action of adrenaline on beta adrenergic receptors in the nervous system thereby reducing the effects of adrenaline in key systems. Clonidine effects the center that controls adrenaline production in the brain and thus reduces the production of adrenaline and reliever anxiety system in all the adrenaline receptors. Hydroxyzine reduces the effects of histamine on the histamine H1 receptors. Histamine is also involved with anxiety. By blocking these receptors it has a calming effect. 
 

"I tried taking L-theanine this morning for the first time.  I haven't noticed much effect." 

​What dose are you taking and how frequently?

 

 

"Regarding the cymbalta brand change, I went from Prasco to Breckenridge."

Oh yea, that could make a big difference.

 

 

"The Dr. recommended I try taking 5mg of cymbalta to see if that helps my symptoms, so I just did that. "

This was a good idea by your dr.


#76 ESRoar

ESRoar

    Advanced Member

  • Members
  • PipPipPip
  • 42 posts

Posted 02 December 2020 - 11:10 AM

I took L-theanine 200mg.  I only tried it 1 day so far.

 

I am hanging in there.  I'm pretty much back to my baseline of the past year:  wake up with lots of jitters, nausea, diarrhea and then these symptoms dissipate throughout the day.  I feel my best at nighttime.  Then I go to bed and the cycle starts all over again.  I never had any of these issues when I was taking 90mg of Cymbalta for years.  Something has changed in my body since I had my daughter.  

 

I asked the psychiatrist about clonidine or propanolol, but she didn't think it would help the withdrawal symptoms I was having.  She said the clonidine would put me to sleep.  


#77 fishinghat

fishinghat

    Site Partners

  • Active Members
  • PipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPip
  • 12,433 posts
  • LocationMissouri

Posted 02 December 2020 - 11:23 AM

Clonidine put you to sleep? Well if the dose is real high it might. Most drs start at a low dose and work up anyway. The drowsiness would only last a couple days but that is her call. Did you ask about the hydroxyzine?

 

With the L-theanine is usually started at around 100 mg a day and then raised by 100 mg every 2 or three days until relief is obtained. So in other words 100 mg every day for 2 or 3 days, then 100 mg twice a day for 2 or three days, etc up to a max dose of 400 mg/day.


#78 frog

frog

    Like a Family Member

  • Active Members
  • PipPipPipPipPipPipPip
  • 520 posts

Posted 03 December 2020 - 05:31 PM

FH

I'm also planning on trying L-theanine again. I was taking it over the summer and then stopped when I ran out because I wasn't sure if it was helping, but I think I felt better when I was taking it than I do now so wanted to experiment and see if that was true. 

 

Is it ok to take 200mg at once or better to take 100 in am and 100pm? 


#79 fishinghat

fishinghat

    Site Partners

  • Active Members
  • PipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPipPip
  • 12,433 posts
  • LocationMissouri

Posted Yesterday, 12:17 PM

It is better to take separate 100 mg doses as it tends to provide a more stable serum level and less of a rollercoaster.





0 user(s) are reading this topic

0 members, 0 guests, 0 anonymous users