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Compounding Or Weighing


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#1 Dakini

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Posted 11 September 2020 - 11:07 AM

Hi-  I'm new here.   Below is my history with this drug.  

 

2012-2014 - Cymbalta/Duloxetine 60mg

2015- Duloxetine compounding pharmacy taper from 60mg at 5mg per month, ~10 months.

January to June 2016 – I was off Duloxetine.  (I'm researching the precise dates)

June 2016- Tried many different drugs to treat sever anxiety: Paxil, Prozac, Latuda. 
July 2016- Reinstated Duloxetine 60mg.  Perhaps I was experiencing protracted withdrawal symptoms because the compounding taper wasn’t slow enough. 
8/24/20- Reduced from 60mg to 30mg of Duloxetine.  (I thought I could do this due to my whole food plants only diet and vigorous exercise routine, :wacko:
 huge mistake!)

9/6/20 – Reinstated 60mg due to unbearable withdrawal symptoms: non-specific anxiety, anger, agitation, sore eyes, weight loss, headache, trouble staying asleep, and dizziness. 

9/11/20 – I’m feeling much better after reinstating 60mg, but still a little anxious, jittery, shakey, and nervous.

 

I want to do a 10% monthly taper from the last dosage once I stabilize on my initial dose of 60mg.  I will round up the taper attached. 

 

The doctor recommended Escitalopram 5 Mg to deal with withdrawal symptoms.  I do not want to add another medication as this will make it impossible to tease out withdrawal symptoms from side effects of a bridge drug.  Joseph Glenmullen states that “severe withdrawal symptoms are an important signal to slow the taper down in order to ease the stress. I prefer to slow the taper rather than mask the stress with other drugs.”

 

I’ve been talking to a compound pharmacist.  He said that he couldn’t guarantee the precision of the dose, but he also said that the small scales weren’t not that accurate, so I’m not sure what method to do.  Of note, he doesn’t recall compounding this drug.  I did order a scale to see if weighing is feasible.  

 

Does anyone have any advice on experienced compounding pharmacists for Duloxetine?  Should I just do this myself given that neither method is 100% accurate and I could more easily reinstate the last dose if I’m having withdrawal symptoms?

 

 

Thanks for your support. 


#2 fishinghat

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Posted 11 September 2020 - 12:48 PM

Welcome Dakini

 

You have a good understanding of your situation and the challenges ahead. We have an ebook of all the things members have tried and what worked and what didn't as well as a lot of other related subjects.  One of those subjects is a comparison of weighting versus bead counting. Several members have tested different ideas. I think you would find the conversations very interesting. The ebook can be found at...

 

https://www.cymbalta...tion-the-ebook/

 

Look thos over and feel free to ask questions, make comments or address any other issues you have. There is also a lot of info in there on supplements, other meds, etc. that have been tried.


#3 invalidusername

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Posted 12 September 2020 - 04:51 PM

Dakini,

 

My apologies - I somehow missed this yesterday.

 

This issue when it comes down to the wire about bead counting is that the beads themselves are made of two parts; the medicine and the coating. There is no way of knowing how much of each there are on each bead, so nothing can be guaranteed. We once had one guy who couldn't even get passed the last bead as he was too sensitive to that amount of change. The more beads, the less the variance. With me so far?! :)

 

As Hat says, it sounds like you know what you are doing. I would opt for a decent set of scales and do the weighing yourself. A compound pharma isn't going to be that much more accurate with a beaded med. Something else like Lexapro is different as you cannot get lower than 10mg, so that requires more precision. 

 

I also agree with you that you should not throw something else into the mix, unless you are cross-tapering. Escitalopram (Lexapro) can have a withdrawal even at 5mg. It is a potent little bastard. 

 

The eBook has got a lot about weighing, scales and so forth, so I suggest you download and have a look. But please let us know if and when we can help.

 

Welcome to the forum

 

IUN





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