19 replies to this topic

[Bat]

Hi

It has been around 17 weeks without cymbalta till now. Still i get some anxiety so the doctor prescriped buspar 15 mg for 4 days then 15x2 per day.
Yesterday was my first dose at night, after around 45 minutes I've started getting very strong brain zaps (stronger than when i stopped cymbalta) and very loud tinnitus (buzzing). I stopped cymbalta in 15 days and the brain zaps waren't as strong.
The brain zaps went in an hour and the tinnitus is still there after 13 hours.
I don't feel good like when i was starting Lexapro long ago. My stomach doesn't feel good and leads to a feeling that i'm short in breath especially when i move or tightness in the chest i can't describe.
I've just took Librax to help calm me down as the doctor prescrped it as needed.

Did i took a large dose or what happened means i shouldn't take this medicine?
I don't think i can take it again

Thanks in advance!

[fishinghat]

My understanding on buspar is a slow increase in dose. Most of what I have seen is 5 mg for a week and then 10 mg thereafter. It does concern me that it may not set well with you due to the occurance of shortness of breath and stomach issues which is unusual. My suggestion is to wait until 48 hours after your last dose and try just one 5 mg dose. You might also consider calling your dr and see what he thinks.

[Bat]

Thank you so much. I sent him and waiting his reply.

[Bat]

I'll suggest that too when he replies

[invalidusername]

Just done a bit of homework on this and it appears that with some other users who have gone to Buspar following SSRI treatment (or SNRI) have found a return (and intensification) of some symptoms INCLUDING ZAPS. So you are absolutely not an isolated case;

 

"Also it should be considered whether the brain zaps occured before the initiation of treatment (perhaps as a result of SSRI discontinuation as in my case) and the buspirone just intensified them (very, very strongly in my case) or made them come back after they'd already disappeared. A tentative hypothesis could be a further drop in serotonin levels in synapses with presynaptic 1A receptors in the first stage of treatment. If this is valid, the zaps should disappear over time."

 

source: https://en.wikipedia...ne#"Brain_zaps"

 

Looks like quite a plausible phenomenon. So from that perspective, I can imagine that the zaps will cure over time.

 

Regarding the issue breathing, this is not such a good one. As Hat says, I wouldn't ignore this. I would immediately bring this up with your Doc and if it doesn't improve, then these are NOT for you and cause further issues judging by the way in which this is documented in other cases.

[Bat]

Thank you so much for your reply.

Most probably it is the case as i still have rare brain zaps from leaving cymbalta. May be starting buspar at 15 mg was too much.

I'm really afraid to start buspar again. My doctor has just replied told me to start slow at 5 mg like fishinghat said.

The shortness in breath wasn't so severe, I think is related more to my anxiety.

Strangely, the doctor doesn't want to start me on cymbalta again and wants me to start buspar.

I get periods of depersonalization or derealization or a strange feeling being uncomfortable and not normal. I can't explain the feeling.

[Bat]

Does starting at 5 mg instead of 15 mg make a difference in the severity of the brain zaps?

[fishinghat]

Buspar will have a greater effect on reducing brain zaps the greater the concentration (usually).

 

The depersonalization/derealization is common when starting any new antidepressant. It should fade within 3 or 4 weeks. Just keep an eye on it. You have a good dr. He knows that it should not be necessary to go back to Cymbalta to handle the withdrawal. He also knows that going on another addictive drug like benzos is usually not necessary. There are other meds like the buspar that can be used first and may be sufficient to handle the withdrawal symptoms.

[invalidusername]

Does starting at 5 mg instead of 15 mg make a difference in the severity of the brain zaps?

 

 

This has always opened up a debate in my head as an SSRI or SNRI acts on serotonin by preventing the re-uptake of that which is usually flushed out of our system, thereby increasing it. Buspar is an antagonist which stimulates the nerves endings at the receptors to produce more serotonin. Many have been put on both usually the SSRI first, and then the antagonist such as Buspar to increase the serotonin when sufficient isn't being produced. 

 

However, there is no means of measuring the amount of serotonin being produced in the brain and thus if an SSRI has been tried at the highest dose, an antagonist cannot be trusted for concerns of serotonin syndrome, so wherever the antagonist has been tried in the failing of the SSRI, there seems little point in continuing with the both.

 

Bit off topic, but just some musings.

 

The way in which Buspar releases more serotonin is not the same as Cymbalta and whilst one working in conjunction with the other is plausible in theory, the brain is a subjective organ and we have no way of knowing how one person will take to each treatment. 

 

The hypothesis of the zaps in my mind requires you first to understand how the SSRI works.... you have a presynaptic receptor which shoots out serotonin across the synapse cleft which is then taken up by the postsynaptic receptor. When the postsynaptic receptor has done its bit, the presynaptic receptor hoovers up the serotonin which is left. The SSRI stops this from happening, which means there is more serotonin available for the postsynaptic receptor to process. An antagonist on the other hand acts like a cattle-prod to the presynaptic receptor (!)... in that it stimulates it to produce more serotonin, which the postsynaptic receptor makes use of.

 

So... with this in mind. The Buspar is attempting to get the presynaptic receptor to generate more, but due to the sudden withdrawal of the SSRI, the reuptake (the hoovering up) has gone into overdrive as the brain doesn't know what to do with the serotonin. Thus, this leads to more being removed in the early stages, hence the return of the zaps.

 

In due course, the brain will realise that it isn't supposed to reuptake (hoover) quite as much serotonin as it is trying to do, and will level out. So yes, more Buspar would resolve this, but once your system gets itself back together, it may end up being too much. But no-one can know this until the chemicals have settled, which is why one should not trust a doctor who just throws massive amounts of an antagonist at these problems.

 

Biology lesson over

[Bat]

Thank you for taking the time to explain this.

You mean that by adding too much serotonin (the high buspar dose) and the overdrive of the hoovering from the withdrawal..there was too much hoovering that caused much more zaps.
Adding buspar slowly might help in this as less serotonin means less hoovering up. Right?

Sorry i don't know much about biology.

The problem is that i took the buspar dose after around 17 weeks from the last dose of cymbalta (i stopped cymbalta in 2 weeks), so i thought my brain should be better by that time

[Bat]

Buspar will have a greater effect on reducing brain zaps the greater the concentration (usually).
 
The depersonalization/derealization is common when starting any new antidepressant. It should fade within 3 or 4 weeks. Just keep an eye on it. You have a good dr. He knows that it should not be necessary to go back to Cymbalta to handle the withdrawal. He also knows that going on another addictive drug like benzos is usually not necessary. There are other meds like the buspar that can be used first and may be sufficient to handle the withdrawal symptoms.

Unfortunately the episodes of depersonalization or not feeling normal has increased after 15 or 16 weeks from the last dose of cymbalta. That's why my doctor prescriped buspar as he said most of this is because of my anxiety. I asked to return to cymbalta as i was more stable. But, he told me buspar is safer that can be stopped anytime with lower side effects.

Will buspar help till the overdrive in the hoovering up like what IUN said and my brain in general is better after cymbalta or it will mess my brain up more?

[invalidusername]

Hi Bat,

 

Unfortunately the rate at which the brain heals and restores the default working rate of each synapse in the brain is different from person to person. As both Hat and myself have read, it can take up to two years, and this is seemingly irrespective of how long one has been on such a drug. Once the change is made (usually around 3-4 weeks), it isn't a case of it being a similar timescale to reverse that change. You can't unscramble an egg. Neurological connections are re-grown.

 

Your brain will be hoovering up at a specific rate at the moment, but how that rate will be affected by stimulating more serotonin is anyone's guess. But it is likely that more serotonin produced by the Buspar would not get completely hoovered up and thus your serotonin level will increase. Whilst this is still an unknown, it is logical to assume that the amount that can be "hoovered" is finite. 

 

But as I say, your brain is still in a point of flux so changes will still be occurring if you put more buspar in your system. However, one cannot wait a potential 2 years for the brain to settle if there are problems. Such a subjective issue.

 

I will be interested to read Hat's response on this one. He often has other theories and experiences which can make my hypotheses a bit clearer. I am a PhD researcher not an MD - if that wasn't already obvious!! I'm interested more in what we don't know rather than what we do....

[Bat]

You and Hat are very supportive. Thanks so much.

I've been on SSRI/SNRI for around 17 years. I'm now 35 so around half my life.
I think this is the longest period (18 weeks) with no drugs. What is frustrating is that I don't know what's wrong exactly. Do i have lower serotonin after 4 or 5 months from leaving cymbalta? My mind tells me if it is the case this should be worse in the beginning of the withdrawal period.
The depersonalization or not feeling myself became like a cycle. I become better for a couple of days then for no apparent reason i became worse.
The most frustrating part is that i don't know if this will stop oneday without a helping drug.

[Bat]

I don't want to call it depersonalization as i don t know what exactly the word entails.
This surely happened twice when i woke up i felt like what am I doing and how can i see and walk. I knew the answer but a strong feeling was there.
However what i get nowadays frequently is that i feel a bit dizzy, uncomfortable a bit and something prevents me from being happy. I can go out with my kids and play during this but the feelings are there. I can get slight nausea for a couple of minutes now and then A day after for no apparent reason i feel myself a bit again and a feeling that i could be happy.
It's like one or two days i forget the feeling of being happy and then a day i feel that i could be happy.
During these days i don't get hungry like when i'm starting lexapro. Does that mean new serotonin is being produced? I didn't have this when left cymbalta except after 2 months. I remember taking remeron for 2 days when this happened (not feeling hungry much but it was much better back then) and i started eating for a month or 2. I'm thinking of taking remeron for 2 or 3 days to feel better a month or two haha

Most probably i'll try starting buspar very slowly like what Hat said and see if it will get better.

[fishinghat]

I fully agree with IUN's comments. 

 

Both IUN and I have read a lot of research papers on thd actions of ssri/snri but we can tell you one thing...Don't feel bad the researchers have a lot of theories but they don't know exactly what is going on during withdrawal OR treatment. Add in the various effects of diet, probiotics and dozens and dozens of genetic mutations it will be almost impossible to tell.

[Bat]

Thanks a lot IUN and Hat. I'll give buspar a try and see what happens. I think the more i'm without using ssri/ssni the better.

[fishinghat]

If the buspar does not work or is not effective enough let us know. There is other, non-addictive no-withdrawal meds that can be tried.

[Bat]

If the buspar does not work or is not effective enough let us know. There is other, non-addictive no-withdrawal meds that can be tried.

Sorry i didn't see your reply before returning to cymbalta. Unfortunately 1 pill 5 mg and the second day i went to hell mentally and part physically.
If possible tell me the other meds to suggest the next time i stop.

[fishinghat]

There are three I would consider;

 

Clonidine - Reduces the production in adrenaline. FDA approved for PTSD and more. Commonly used to treat anxiety.

 

Hydroxyzine - An antihistamine. It fights both anxiety and insomnia.

 

Propanolol - Reduces the effects of adrenaline and is calming.

 

None of these have a withdrawal. All three are by prescription only.

[Bat]

Thank you so much