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Those Dang Capsules! How Do You Open Them?


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#1 MentalHealthGal

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Posted 18 June 2020 - 11:49 AM

In 2011 I was diagnosed with Major Depressive Disorder and Panic Disorder and after a couple of failed medications, I ended up on Cymbalta, 30MG twice per day. One in the morning and one at night pulled me out of my zombie state and over the years, has helped me come out of my shell and face my biggest fears (going to a store alone, ordering in a drive-thru, talking on the phone for work, being yelled at or treated poorly). I am a whole new person at 23 than I was at 14. Now that I'm older, growing, and looking at my life, I know that I need to change my medication to something less severe than Cymbalta. I hope to have a family someday. I hope to lose the weight that Cymbalta made me gain, say goodbye to withdrawals from waiting just an hour too long to take my night dose, and take my life back.

 

Now, I got the go-ahead from my doctor to start tapering. My normal dose was 30mg in the morning and 30mg at night, as 60mg at once was too much when I tried. I noticed my withdrawals feel worse if I miss my night dose vs my morning dose. For the next week, I will be taking 30mg before bed and after a week of doing that, I'll be starting Viibryd, 20mg at night, My fingers and toes are crossed that this SSRI will work for me and help, at least a little, with the emotional side while I deal with the physical side. After that, I'll talk to my doctor again. 

 

 

The big reason for my first post is... how do you open the dumb little capsules?? I tried the other day, just to see, and the capsule just bends but stays together. Any advice?

 

Also, I plan on posting more as time goes on. Today is my 2nd day without the morning dose and I feel decent! Fatigued and a little dizzy and small headache.. but decent. I know it's only the beginning.. but let's do this! 


#2 fishinghat

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Posted 18 June 2020 - 01:46 PM

Hi MHG
 
Most don't seem to have much of an issue opening them but a few have mentioned problems over the years. The two halves of the capsules just snap together and should easily slip apart BUT....
 
I do know one thing several people have tried to freeze them and it just causes the capsules to become brittle and break. When I had a stubborn one I would simply twist it a couple of times and then it would open. These problems may be related to a specific brand, I just don't know. May be someone else has some tips.
 
Just a side note, Viibryd, as you noted is an ssri and as such it helps control serotonin but Cymbalta is an snri so it helps control serotonin and norepinephrine (related to adrenaline). There will obviously be withdrawal like symptoms during the cross over but m ore importantly after the Viibryd does fully kick in you will probably experience some significant anxiety until your body learns how to regulate the norepinephrine again.

#3 MentalHealthGal

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Posted 19 June 2020 - 01:09 PM

Hi MHG
 
Most don't seem to have much of an issue opening them but a few have mentioned problems over the years. The two halves of the capsules just snap together and should easily slip apart BUT....
 
I do know one thing several people have tried to freeze them and it just causes the capsules to become brittle and break. When I had a stubborn one I would simply twist it a couple of times and then it would open. These problems may be related to a specific brand, I just don't know. May be someone else has some tips.
 
Just a side note, Viibryd, as you noted is an ssri and as such it helps control serotonin but Cymbalta is an snri so it helps control serotonin and norepinephrine (related to adrenaline). There will obviously be withdrawal like symptoms during the cross over but m ore importantly after the Viibryd does fully kick in you will probably experience some significant anxiety until your body learns how to regulate the norepinephrine again.

 

Hi fishinghat! Thank you for responding.

 

I definitely expect to deal with some anxiety while my body adjusts, and did a lot of research. I'm moving to an SSRI on purpose. I rarely ever have anything close to panic attacks anymore, and have grown so much over the last 9 years. I'm very lucky and have learned a lot of coping skills and faced a lot of my fears that caused anxiety. Depression is my main concern, as the panic attacks were mainly caused by the results of my depression. Thank you for saying something! I appreciate it.

 

Also, it's so weird that I haven't found anything online about people having trouble with the capsules. I take 30mg duloxetine from a walmart pharmacy. I hope I can figure it out. 


#4 fishinghat

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Posted 19 June 2020 - 02:08 PM

Let us know if you find any easy way so we can pass it on to others in the future.


#5 frog

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Posted 22 June 2020 - 02:30 PM

Hi not sure if you've figured out how to open them but they can be a little tricky for sure. I generally had success with pinching the middle of the bottom half and at the same time twisting or pinching the top half off. Unfortunately it does often mangle the capsule so hopefully you weren't planning on reusing


#6 MentalHealthGal

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Posted 08 July 2020 - 12:17 PM

Hi frog! So, I eventually got one open but it was so hard and the beads went freaking EVERYWHERE. It was awful. Because I handled going from two 30mg a day (one in the morning and one at night) to only one a day (still taking at night), my doctor told me to go ahead and start 20mg a day and after a few days just go to every other day until I feel okay to stop completely. I'm praying for more good results so I don't have to open the darn things. Viibryd has been my mood saving grace. 


#7 fishinghat

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Posted 08 July 2020 - 02:06 PM

Oh MHG, don't gp to every other day. Bad idea. Cymbalta has a half life of 12 hours so by the time 48 hours is up your system is almost free of Cymbalta. Then you take another xapsule and boost your system's Cymbalta levels way back up again. This causes you to repeat the same withdrawal over and over, making things much worse.

 

In Joseph Glenmullen's book, 'The Antidepressant Solution' (devoted to withdrawal), he states the situation very clearly, on p.97:

"Q. Can antidepressants be taken every other day as part of tapering off them?

A. None of the short acting antidepressants should be taken every other day as a method of tapering them. Because of their short half-lives, the every other day schedule can result in roller coaster levels of the drugs and roller coaster levels of withdrawal symptoms."
 


#8 MentalHealthGal

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Posted 14 July 2020 - 12:15 PM

Oh MHG, don't gp to every other day. Bad idea. Cymbalta has a half life of 12 hours so by the time 48 hours is up your system is almost free of Cymbalta. Then you take another xapsule and boost your system's Cymbalta levels way back up again. This causes you to repeat the same withdrawal over and over, making things much worse.

 

In Joseph Glenmullen's book, 'The Antidepressant Solution' (devoted to withdrawal), he states the situation very clearly, on p.97:

"Q. Can antidepressants be taken every other day as part of tapering off them?

A. None of the short acting antidepressants should be taken every other day as a method of tapering them. Because of their short half-lives, the every other day schedule can result in roller coaster levels of the drugs and roller coaster levels of withdrawal symptoms." 

 

Thank you for the input! I remembered seeing that but was too shy to say something to my psychiatrist when he mentioned doing that for a few days until I'm ready to just stop entirely. I decided to try it just so I can tell him I can, and I'm honestly doing okay. I don't know if I'm just lucky, or if it's the calm before the storm... but I feel okay. Last thursday night I took the 20mg for the first time. Next day I felt pretty much the same as always except more vivid dreams (one of my biggest withdrawal symptoms). Friday night I didn't take one, and I slept a lot on Saturday. I was dizzy, getting some brain zaps and was barely able to focus on ANYTHING for very long. I was very foggy but overall not as bad as I expected. That night I took one again, the 20mg, and Sunday I felt fine except a little foggy still. Sunday night I didn't take one, and on Monday, I honestly barely felt anything all day besides being a little moody in the evening (normal, as my low dose of my new med Viibryd probably needs to be boosted to balance things out in the mood department). I am debating on stopping Cymbalta this weekend or sooner since it's better and better each time I skip a day. I am prepared for the worst but hoping for the best. 


#9 fishinghat

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Posted 14 July 2020 - 01:08 PM

We have only had one member that had success with the every other day routine. Maybe it will work for you. Plus you have the added advantage of the Viibryd. Hang in there and keep us posted. 


#10 MentalHealthGal

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Posted 14 July 2020 - 04:13 PM

We have only had one member that had success with the every other day routine. Maybe it will work for you. Plus you have the added advantage of the Viibryd. Hang in there and keep us posted. 

 

Thank you FH. I may not be med-free for a while, or ever, but going to just an SSRI only is my goal for now. Fingers crossed and I will keep notes and keep posting here! :) Thank you for all the comments and kindness.





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