17 replies to this topic

[VaguelyFamiliar]

Hi,

 

Newbie here...posting for the first time.  I just completed a pretty short taper 3 weeks ago.  

 

I was placed on Cymbalta 60mg over 7 years ago, after hitting a tipping point in my sanity.  In hindsight, it was the Hindenburg waiting to happen.   The usual recipe...abusive alcoholic parent, married young to a sociopath, traumatic pregnancies, major medical issues (cancer/chemo), spousal infidelity and then hostile divorce.  

 

For the majority of my life, I was somewhat able to manage my anxiety/depression thru diet, exercise, meditation (mostly just being outdoors) and reading every book I could find and then eventually therapy.  If none of that worked...I just faked it.  Apparently, I'm pretty good...because no one was aware I struggled with these demons.  Always the peacekeeper and smiling face....

 

I won't say that I regret taking Cymbalta.  It did help initially with the panic attacks, intense anxiety and suicidal thoughts.  And, I'm grateful that its numbing abilities kept me emotionally level during the most vicious and soul destroying moments of my life.  I wouldn't be here otherwise.  However, I never planned on being on a pharmaceutical at all and especially not for this long.  At this stage, the list of cons are long...the withdrawal has been a nightmare.  I do not plan on reinstating.  I just can't.  

 

So here is what I did.

 

Per my MD, I started my taper the end of February.  This is what was recommended.  I can't say with all certainty that I followed this exactly but it was pretty darn close.  I was written a prescription for 20s, in order to change dosage each day.

 

3 weeks:  (alternate) 60mg/40mg

3 weeks:  (alternate) 40mg/20mg

3 weeks:  (alternate) 20mg every other day

Final weeks: 20mg every other day, then every 2 days then every 3 days.... 

 

I took my last 20mg over 3 weeks ago.  After stopping, I experienced the usual brain zaps, dizziness, nausea, GI upset, headaches the first week.  Now, it is mad itch, foggy brain, emotionally all over the place, anger, and intense bouts of self loathing..those come and go.   It's much worse if I ride my bike or do anything physically intensive on consecutive days.  Is that a release from fat breaking down?  

 

I do have Lorazepam on hand for rescue therapy but after reading on here that it can be addictive...I'm scared to use it.  Even though, I break into quarters and only take .25 when I'm feeling intense anxiety.   I've only taken it 5 times over the course of the taper which only equates to slightly over one full pill.  It does help.  I'm just scared of it now.

 

I've read thru the ebook (which is fantastic) but it's hard to process the technical parts when you're this foggy.  I'm not even sure what I'm asking for now that probably hasn't already been said.    

 

 

 

 

[invalidusername]

Hi VF and welcome to the family!

 

I have already given you your first "like" because that is one of the most down to earth, no b-s, clean and cut introductions I have ever heard during my time here. Your language use and anecdotes were great and I could really see what you have been through. But never dull it down - nothing "usual", you have been through a lot there, and I am glad that you feel that you are at a place to come off the pills.

 

So what has happened is quite straightforward really. As my dear brother, FishingHat (who will be along soon) will say, your Doctor is an idiot! He should never have told you to go that fast, but far more importantly, he should have known Cymbalta has a very short half life and taking a dose every other day is a big no-no.

 

Just to explain that in case you are having a foggy moment. A half life is when the amount of Cym reaches 50% level in your system. Ideally you want to keep this level as flat a curve as possible. Cym hits 50% after 12 hours, then 25% at 24 hours, but then you take your next dose, so the fluctuation during peak time is around 25%. If you wait until 48 hours has passed, the level in your system by the time you take your next dose is around 5%, so that fluctuation almost doubles, PLUS the 5% in your system is akin to having a mini-withdrawal which explains what would have been happening, and for the most part, what is happening now.

 

Essentially, this rollercoaster of levels has not given your brain a consistent lowering to measure by, so it is really confused now, so by going a drop every other day and stopping, your poor brainium has got a lot of work in front of it to work out what the homeostatis should be. A slower and more consistent withdrawal, and your brain would have worked it out along the way. It may be rought for a bit I am sorry to say my dear, but we are here for you and can help you with supplements, support, prayers etc.

 

Finally, your exercise will exacerbate the loss of what is the precursor to adrenaline, called norepinephrine. This is controlled by the Cym, but as I said above, your brain has no idea how much it should be putting in and when, so when you do activity that involves adrenaline, it will be all over the place and yes, cause what you are feeling. It is better to do very little and gentle exercise at these times. If you search the site, you will find this to be the case for so many we have spoken to.

 

Glad you found the eBook a good read, and please feel free to ask questions along your journey. Again, we are here for you.

 

Others will be along no doubt to talk, but for now, I hope this has you started.

 

Take care.

 

IUN

[fishinghat]

Welcome VF

 

It looks like IUN has got you off to a good start. I really can't add much to that except you are right about the lorazepam. Very addictive and considered the second hardest benzo to come off of. It can take time for all of this to subside so try to hang in there. As you probably read in the ebook there are a lot of supplements that can possibly help so if things get too bad let us know and we can try to work with you on the issues you are having.

[VaguelyFamiliar]

Thanks Invalidusername.  I really appreciate your kind words and response!

 

"Finally, your exercise will exacerbate the loss of what is the precursor to adrenaline, called norepinephrine. This is controlled by the Cym, but as I said above, your brain has no idea how much it should be putting in and when, so when you do activity that involves adrenaline, it will be all over the place and yes, cause what you are feeling. It is better to do very little and gentle exercise at these times. If you search the site, you will find this to be the case for so many we have spoken to."

 

 

 

Ahhhh...that explains things well.   And, to think I haven't been doing myself a favor by trying to sweat it out!  It's such a double edged sword.  The only thing that has briefly helped with the sudden bouts of rage/anger/anxiety are hopping on my bike and going for it.   Now you've got me thinking, the intense emotions could have been triggered by the high temps and desperate peddling from the previous ride.    

 

I suppose I can't outrun the chicken... much less the egg.

[VaguelyFamiliar]

Welcome VF

 

It looks like IUN has got you off to a good start. I really can't add much to that except you are right about the lorazepam. Very addictive and considered the second hardest benzo to come off of. It can take time for all of this to subside so try to hang in there. As you probably read in the ebook there are a lot of supplements that can possibly help so if things get too bad let us know and we can try to work with you on the issues you are having.

Thanks FH,

 

I've been trying to sort thru posts that are similar in nature to mine. I did see where Lorazepam has been a challenge for you to get off of.   As if Cymbalta wasn't enough??   Prozac was mentioned as a bridge by my Dr but I didn't want to go that route.  Is there something similar to a benzo but not addictive that can help with extreme bouts of anxiety/panic?     Also, I'm now having major issues with itching allover and pins/needles feeling.   I've tried Benadryl, dry brushing, lotion, baths...it peaks at bedtime (of course) so I can't sleep.   Please tell me this one goes away soon.

[VaguelyFamiliar]

Hi VF and welcome to the family!

 

I have already given you your first "like" because that is one of the most down to earth, no b-s, clean and cut introductions I have ever heard during my time here. Your language use and anecdotes were great and I could really see what you have been through. But never dull it down - nothing "usual", you have been through a lot there, and I am glad that you feel that you are at a place to come off the pills.

 

So what has happened is quite straightforward really. As my dear brother, FishingHat (who will be along soon) will say, your Doctor is an idiot! He should never have told you to go that fast, but far more importantly, he should have known Cymbalta has a very short half life and taking a dose every other day is a big no-no.

 

Just to explain that in case you are having a foggy moment. A half life is when the amount of Cym reaches 50% level in your system. Ideally you want to keep this level as flat a curve as possible. Cym hits 50% after 12 hours, then 25% at 24 hours, but then you take your next dose, so the fluctuation during peak time is around 25%. If you wait until 48 hours has passed, the level in your system by the time you take your next dose is around 5%, so that fluctuation almost doubles, PLUS the 5% in your system is akin to having a mini-withdrawal which explains what would have been happening, and for the most part, what is happening now.

 

Essentially, this rollercoaster of levels has not given your brain a consistent lowering to measure by, so it is really confused now, so by going a drop every other day and stopping, your poor brainium has got a lot of work in front of it to work out what the homeostatis should be. A slower and more consistent withdrawal, and your brain would have worked it out along the way. It may be rought for a bit I am sorry to say my dear, but we are here for you and can help you with supplements, support, prayers etc.

 

Finally, your exercise will exacerbate the loss of what is the precursor to adrenaline, called norepinephrine. This is controlled by the Cym, but as I said above, your brain has no idea how much it should be putting in and when, so when you do activity that involves adrenaline, it will be all over the place and yes, cause what you are feeling. It is better to do very little and gentle exercise at these times. If you search the site, you will find this to be the case for so many we have spoken to.

 

Glad you found the eBook a good read, and please feel free to ask questions along your journey. Again, we are here for you.

 

Others will be along no doubt to talk, but for now, I hope this has you started.

 

Take care.

 

IUN

Hi IUN,

 

I replied to your post above but didn't realize I could reply this way without having to copy and paste quotes!  I'm learning.

[fishinghat]

VF

 

There are a couple prescription items that can help most people. Neither have a withdrawal or addictive.

 

First is clonidine, usually prescribed at 0.1 mg up to 3 times a day. The other is hydroxyzine which is usually started at 25 mg 2 or 3 times per day and 50 mg at bedtime. :Like all anxiety meds they can lower bp and/or cause sleepiness. Most drs recommend starting with a small dose just at bedtime to see how much sleepiness it will cause. Doses can be adjusted as needed from there.

 

There are also supplements that can help but the two mentioned above are usually more effective.

[frog]

Hi VF! Welcome to the forum!

I was also on 60mg for about 5-6 years. I was prescribed it for chronic nerve pain and similar to you it gave me my life back, so I don't regret it. But the coming off of it part has been another story. I do wish I had done that differently but whatever, hindsight is 20/20 isn't it? 

 

I can definitely say from personal experience that intense exercise makes things worse while you're in this sensitized state. Like IUN said, if you're really pushing your body you it reacts by increasing adrenaline production, but since Cymbalta is no longer controlling your norepinephrine levels, your brain is relearning how to do the job and it's going to take a while for it to get better at it again. Anecdotally, when I was tapering, I ended up jumping off cold turkey from like 18mg and I was pretty fine for the first 3 weeks, same stuff as you: brain zaps, headaches, high irritability. But I think my life was pretty balanced with regard to stress and my brain was able to keep a lid on things. Then one day I decided to do a high intensity spin class, and my theory is that this spiked my adrenaline and caused a cascade of stress side effects and sent my poor brain into a tailspin. Just a theory but the timing fits...

 

It's funny but when I was deep in withdrawal I could barely take a hot shower (nevermind a hot bath... which used to be my favorite thing) without feeling intense anxiety/stress effects afterward. I think something about the rise in body temperature made my body go into fight or flight mode. Nowadays showers aren't a problem. Baths are still a littttttle bit iffy, but if I feel like I'm overheating I just drink some cold water and it brings everything back down to normal.

 

Physical activity is still a really great way to work off some excess anxious energy imo. You should just see where your limits are. Maybe you can go for a long walk with no problem, or do some strengthening exercises instead of cardio. 

 

FH has already given you some options on a couple meds. I want to also throw propranolol in the ring. It's a beta blocker that people often take to deal with performance anxiety, so it works perfectly well if you take it as needed. You do not need to take it daily to get the benefits. It helped me TREMENDOUSLY because I was having terrible frequent panic attacks during the first 5 months of my withdrawal (I had never had a panic attack before in my life except once when I got off Effexor years ago). Beta blockers block the physical effects of adrenaline: the heart pounding, shaking, rising body temperature, all that stuff. If I was starting to feel panicky and adrenaline'd up I would desperately wait until 8pm when it was time to take the prop and within 15mins everything would calm back down (I took mine on a schedule because I was struggling daily at the time). When I got to 5 months off Cym the panic attacks just kind of tapered off and went away and I tapered off the propranolol and no longer take it. I did have increased anxiety while I was coming off it but it wasn't that severe. 

 

Hang in there! Everything you've said sounds like Cymbalta withdrawal so eventually it will pass

[fishinghat]

"It's funny but when I was deep in withdrawal I could barely take a hot shower (nevermind a hot bath... which used to be my favorite thing) without feeling intense anxiety/stress effects afterward. I think something about the rise in body temperature made my body go into fight or flight mode."

You are exactly right Frog. Research has shown that as the temperatures exceeds 30C (86F) the body becomes increasingly stressed and does indeed stimulate the fight or flight response.

[invalidusername]

 I suppose I can't outrun the chicken... much less the egg.

 

You really do share my sense of humour!! LMAO!!

 

Just finished work and glad to see my chums have offered their wonderful support. You have some lovely experience stuff from our Frog here. Whereas Hat and myself don the proverbial white coats, Frog is there with explaining her myriad of experiences. She has a wonderful way of putting things across. Truly a lovely team here. 

 

Keep in touch and we'll see you clear tulip. Just go easy with the bike for a while! 

[VaguelyFamiliar]

VF

 

There are a couple prescription items that can help most people. Neither have a withdrawal or addictive.

 

First is clonidine, usually prescribed at 0.1 mg up to 3 times a day. The other is hydroxyzine which is usually started at 25 mg 2 or 3 times per day and 50 mg at bedtime. :Like all anxiety meds they can lower bp and/or cause sleepiness. Most drs recommend starting with a small dose just at bedtime to see how much sleepiness it will cause. Doses can be adjusted as needed from there.

 

There are also supplements that can help but the two mentioned above are usually more effective.

 

Thank you FH!   Frankly, I could use the sleepiness.  After many years of no sleep, I would welcome with open arms.  

[VaguelyFamiliar]

You really do share my sense of humour!! LMAO!!

 

Just finished work and glad to see my chums have offered their wonderful support. You have some lovely experience stuff from our Frog here. Whereas Hat and myself don the proverbial white coats, Frog is there with explaining her myriad of experiences. She has a wonderful way of putting things across. Truly a lovely team here. 

 

Keep in touch and we'll see you clear tulip. Just go easy with the bike for a while! 

It's nice to know I'm in good company.   As for the sense of humor ...mine has come back with a vengeance.   I've had a flat few years.  Now, either I'm laughing, crying...or want to poke somebody's eye out.  Thanks Big C!  So many gifts.

[VaguelyFamiliar]

"It's funny but when I was deep in withdrawal I could barely take a hot shower (nevermind a hot bath... which used to be my favorite thing) without feeling intense anxiety/stress effects afterward. I think something about the rise in body temperature made my body go into fight or flight mode."

You are exactly right Frog. Research has shown that as the temperatures exceeds 30C (86F) the body becomes increasingly stressed and does indeed stimulate the fight or flight response.

Thx Fishinghat. I would have never made that connection.  I had just started getting into a routine of sauna/steam room sessions at my gym before all the business closures from COVID.   It's good that hasn't been an option. I would have wrongly assumed it would be beneficial to detox while tapering.  It's such a hard thing understand.  

[VaguelyFamiliar]

Hi VF! Welcome to the forum!

I was also on 60mg for about 5-6 years. I was prescribed it for chronic nerve pain and similar to you it gave me my life back, so I don't regret it. But the coming off of it part has been another story. I do wish I had done that differently but whatever, hindsight is 20/20 isn't it? 

 

I can definitely say from personal experience that intense exercise makes things worse while you're in this sensitized state. Like IUN said, if you're really pushing your body you it reacts by increasing adrenaline production, but since Cymbalta is no longer controlling your norepinephrine levels, your brain is relearning how to do the job and it's going to take a while for it to get better at it again. Anecdotally, when I was tapering, I ended up jumping off cold turkey from like 18mg and I was pretty fine for the first 3 weeks, same stuff as you: brain zaps, headaches, high irritability. But I think my life was pretty balanced with regard to stress and my brain was able to keep a lid on things. Then one day I decided to do a high intensity spin class, and my theory is that this spiked my adrenaline and caused a cascade of stress side effects and sent my poor brain into a tailspin. Just a theory but the timing fits...

 

It's funny but when I was deep in withdrawal I could barely take a hot shower (nevermind a hot bath... which used to be my favorite thing) without feeling intense anxiety/stress effects afterward. I think something about the rise in body temperature made my body go into fight or flight mode. Nowadays showers aren't a problem. Baths are still a littttttle bit iffy, but if I feel like I'm overheating I just drink some cold water and it brings everything back down to normal.

 

Physical activity is still a really great way to work off some excess anxious energy imo. You should just see where your limits are. Maybe you can go for a long walk with no problem, or do some strengthening exercises instead of cardio. 

 

FH has already given you some options on a couple meds. I want to also throw propranolol in the ring. It's a beta blocker that people often take to deal with performance anxiety, so it works perfectly well if you take it as needed. You do not need to take it daily to get the benefits. It helped me TREMENDOUSLY because I was having terrible frequent panic attacks during the first 5 months of my withdrawal (I had never had a panic attack before in my life except once when I got off Effexor years ago). Beta blockers block the physical effects of adrenaline: the heart pounding, shaking, rising body temperature, all that stuff. If I was starting to feel panicky and adrenaline'd up I would desperately wait until 8pm when it was time to take the prop and within 15mins everything would calm back down (I took mine on a schedule because I was struggling daily at the time). When I got to 5 months off Cym the panic attacks just kind of tapered off and went away and I tapered off the propranolol and no longer take it. I did have increased anxiety while I was coming off it but it wasn't that severe. 

 

Hang in there! Everything you've said sounds like Cymbalta withdrawal so eventually it will pass

 

 

Thank you Frog!  

 

So many great points.

 

I think your theory is spot on. The summer heat is amping up here and finding a cooler time to do anything makes it a challenge.  My 3 week mark, plus the heat and consecutive days of intense cycling were no doubt a bad mix.  In the past, it always helped my mental and physical state...so I wrongly assumed this time, more would be better.  It just seems counterintuitive in a way (or at least in my head) but there is no question I'm paying for it!!  

 

Your explanation about the adrenaline release during a sensitized phase makes complete sense.  I guess I'll have to drag my lazy dog an extra block or two ...whether either of us like it or not.

 

I'm going to call my MD tomorrow about switching to a beta blocker and/or one of the drugs FH mentioned.   That was a great tip!  

 

Thanks for taking the time to respond.  All very helpful info.  

[invalidusername]

You sound in high spirits and that is a good thing VF. Know that it is the pill that is causing all the drama. You are doing exceptionally well for where your doctor has put you. But if you do hit a wall at any point during any day, then don't feel you can't come here and vent. We all need to. I have been in recovery now for nearly 9 months but I still have moments when I need to reach out to my family here. 

 

However, I wanted to share a fantastic video with you. I know you will appreciate the humour - it has me in stitches every time I watch it, and you reminded me of this guy. Andy Bailey... he went through Pregabalin (Lyrica to you guys) withdrawal, the same as me - a lot of similar symptoms to Cymbalta. I watched this video soooo many times in my darker places and it pulled me through. 

 

Sit back and enjoy!! Small warning there are a few NSFW words used - but done so in jest!

 

[VaguelyFamiliar]

You sound in high spirits and that is a good thing VF. Know that it is the pill that is causing all the drama. You are doing exceptionally well for where your doctor has put you. But if you do hit a wall at any point during any day, then don't feel you can't come here and vent. We all need to. I have been in recovery now for nearly 9 months but I still have moments when I need to reach out to my family here. 

 

However, I wanted to share a fantastic video with you. I know you will appreciate the humour - it has me in stitches every time I watch it, and you reminded me of this guy. Andy Bailey... he went through Pregabalin (Lyrica to you guys) withdrawal, the same as me - a lot of similar symptoms to Cymbalta. I watched this video soooo many times in my darker places and it pulled me through. 

 

Sit back and enjoy!! Small warning there are a few NSFW words used - but done so in jest!

 

Love this guy. That was fantastic!  Next best thing to Ricky Gervais in Afterlife...which is my favorite Netflix series.  This will be on my list of favorites to watch when I'm down.   Thanks so much.  

[invalidusername]

My pleasure... I love this guy. He has developed MS now, poor bloke, but he is doing so well with it all and continues to entertain his many followers.

[frog]

VF I saw you had commented on someone else's post a few weeks ago about Propranolol for the intense anxiety. 

Wanted to share my experience on that with you in case you're still wondering: 

 

I was put on it in December to deal with the intense and frequent panic attacks I was experiencing. It was prescribed "as needed" but I literally needed it all day every day so I took it in the morning and in the evening, 20mg each I think. It worked quick, like within 30 mins it would calm things down. If you're having problems with panic attacks, I think the propranolol is a good bet. It doesn't take away the mental/emotional chaos so you might still feel all over the place, but it targets the physical effects: heart pounding, chest tightness, shakes. I know for me it was a cascading effect too, as soon as the panic attack would start, I would get scared of the panic attack, which of course made it more intense and worse. So having the beta blocker to dampen the effects, prevented me from totally losing it. It was truly a lifeline during those days. After about 5 months, the really bad panic attacks just kind of... stopped and one day just never came back. Once I felt sure they were over for good I tapered off the propranol. I probably should have waited because I was still so sensitive that even at the small dose I was on, it definitely whacked my emotional state out with each drop, but I got there eventually. 

 

One thing to be mindful of with propranolol, and your mileage may vary, but it does lower your heart rate (by design). As a result I would get very dizzy frequently. Especially if I was doing anything even remotely active because my heart would be trying to go faster to help reoxygenate my body, but the propranolol wouldn't let it, causing lightheadedness. I'm pretty positive it was the propranolol because I rarely feel that weak and lightheaded anymore. 

 

I still deal with some panic response now somewhat regularly: shortness of breath, heart pounding, chest tightness. I think it's all still part of the process of my body readjusting to controlling the levers on its own. I'm about 9-10 months off now and I think this will hopefully still get better. I probably could continue with the propranolol to address these, but I hate taking medication and avoid it as much as I can.