203 replies to this topic

[invalidusername]

Hi Troy,

 

This is a fascinating read and Hat has put some fantastic stuff out there. I would like to weigh in with my own brand of support and experience in these things.

 

You are right insomuch that there is a catch 22 as to when to accept exposure and when not to. But Hat is right. If you are really feeling the pull of anxiety, then it is not the right time. This often happens during withdrawal. Exposures must be faced, but from a position of strength, otherwise you will go into a situation and almost will the negative response which in turn will result in the conditioned response that Hat mentioned. 

 

The bottom line is that you need to believe that what is happening to you is just a symptom, like a sore throat in a cold. When you have a sore throat, you don't panic when you are talking - although you might reduce the conversational time to aid healing, but you KNOW it will pass. It is very difficult with the brain as it tries to reason and understand what is happening. But observing it from outside, you need to understand that the brain is just an organ like anything else and subject to ailments that will also heal in time.

 

I have been there. I couldn't even fill up with gas at one point for fear of queuing. I would time the fuel filling so I would be able to go right in, pay the cashier and walk out. I was not ready, but these were thing I had to do. This is where you start. You start to reason with yourself. What is the worst that can happen? Has anything bad happened before? It's been fine every time. But you need to break that connection. I started to realise that this was just a thought. I would start to tell myself to "bring it on" and "do your worst". 

 

What you resist persists - the opposite is true.

 

It is all about letting go in these situations. It sure isn't easy, but I followed the work of Dr Claire Weeks. Her work, combined with my weekly therapy, got me out of my symptomatic head and back to where I should be. Just let your head shout as loud as it wants. Let it be. You will soon realise that there is nothing to come from it. But you have got to be in a place to start accepting that this is the case. If you attempt this without believing (or knowing) that this is truly the case, it won't work.

 

This is all I would append to what Hat has already very well described. He has always been the scientific part to my more holistic and therapeutic theory. Always a good combo!!

 

Wishing you a good Sunday my friend

 

IUN

[fishinghat]

"There is a study showing alpha2 receptors can have some negative feedback too BTW."

 

Clonidine has specificity towards the presynaptic α2-receptors in the vasomotor center in the brainstem. This binding decreases presynaptic calcium levels, thus inhibiting the release of noradrenaline. The net effect is a decrease in sympathetic tone. Of course if the levels of noradrenaline are reduced then the formation of adrenaline is reduced. 

 

"Which leads to a bit of a delay in the feedback."

 

True but that is under normal conditions. In a chronic adrenergic state feedback has been shown to be the same but because of conditioning the adrenal gland just increases production to accommodate.

 

"Have you got any studies showing how long it takes to stabilise serotonin, and adrenaline?"

 

Studies on the effects of ssri/snri withdrawal on the human body are woefully lacking. There has been some speculation that the ability to compensate for serotonin, adrenaline, norepinephrine, histamine etc imbalance if fairly quick (say a couple months give or take) but the recovery of the synapses and condition responses often take years. While not proven I would tend to agree as what I have seen here is a 2 to 3 year to "fully" recover from a ssri/snri withdrawal with a few taking 3 to 5 years. This would tend to support the theories of recovery. It would also help explain the wild mood swings during recovery as the body continually tries to control the swings in neurotransmitters. Oh course this is further complicated by reoccurring mental or even physical stress. Then there are the effects of diet, exercise, sleep, etc to even further complicate the recoveery.

 

"So SNRIs really fk up the HPA in other words."

Oh so true. Not only are they detrimental to the HPA but they effect and alter the function of receptors which can take years to recover.

[Troypants]

Dropped another 0.6 bisoprolol 4 days ago, also started keto about 4 days ago so hard to tel what is what. Had some in comfortability and heart palps, anxiety yesterday and the day before. Has gotten better today but still not back to where I was.

Getting those nice horrible brain rush sensations like someone's stirring my brain with a spoon, kind of vertigoish. Funny how they say it is cardioselective but it still affects the CNS. Unless its due to something else, but I had a similar experience last drop.

[fishinghat]

Someone told you bisoprolol is cardioselective?  What a joke.

[Troypants]

Checking in

Things are still getting better, I have started a DBT course and am doing emotional regulation at the moment so hopefully I can get something out of it.

Cut the beta blockers down to 300mcg by splitting the 2.5mg pills into 8, will go off them next week. Had some disturbing palpitations last night but overall its been pretty painless, I get about a week of blood pressure dysregulation and it seems to level out after that.

Still on 2.5mg of cymbalta, I want to start reducing again some time this year. I will join a group therapy session, when I get used to being out and about and I am confident my brain is healing and I can handle the drop I will take a bead off every month.

How is everyone?

[Troypants]

Checking in

Things are still getting better, I have started a DBT course and am doing emotional regulation at the moment so hopefully I can get something out of it.

Cut the beta blockers down to 300mcg by splitting the 2.5mg pills into 8, will go off them next week. Had some disturbing palpitations last night but overall its been pretty painless, I get about a week of blood pressure dysregulation and it seems to level out after that.

Still on 2.5mg of cymbalta, I want to start reducing again some time this year. I will join a group therapy session, when I get used to being out and about and I am confident my brain is healing and I can handle the drop I will take a bead off every month.

How is everyone?

[Troypants]

I have not been seeing replies... Sorry about the double post and not getting back to you sooner

[fishinghat]

High TP

 

It sounds like you are proceeding well. That plan seems like a good one. Keep us updated please.

[Troypants]

How hard do you guys reckon it will be to come off the last 2.5mg if I drop 1 bead every 2weeks to a month? That will take me 8-16months

I looked at the pharmacokinetics curve and it looks like I've already done the hardest part dropping from 20ish to 2.5mg by 1mg per month, but its hard to tell.

Have you any insight?

[invalidusername]

Hi Troy,

 

These things are very much subjective. I cannot lie to you. Some find that the "easier" part is dropping down to the last 5 or 10mg, whilst others find the battle starting when you reach those 5 or 10mg. There is no way of knowing until you get there. 

 

The best thing you can do is listen to your body so that you balance your withdrawal out so that you don't get too many symptoms along the way. If you have been steadily going through it and had very little (or tolerable) symptoms to this point, then the chances are that you will enjoy the same as you go forward. Just make sure you continue listening to your body If it feels as though you should go slower, then do it. 

 

I have been coming off valium for months now. It took me about a year to get from 10mg to 2,5mg. I have been stuck on 2.5mg for about 10 months now. No because I cannot do it, but because I know that my circumstances will not will not tolerate it. I am listening to my body and my self-control. My wife's mental health is very bad, I have work issues... it is not the time to drop this last 2,5mg. 

 

I could... just get rid of it, but I would guarantee you that I would need to reinstate. But in doing doing so, people usually reinstate back to a dose larger than where they came from. So I would much rather stick at 2.5mg than chance a drop to nothing and then having to reinstate 5mg as I would have a longer journey to get back. 

 

This is EXACTLY what we mean by listening to your body. Don't give in to the need to get it out of your system. It will get there there quickest when you are most aware of your circumstances. There is no guilt to be felt, no shame... if you have to stay at a stale dose for a few more weeks, a few more months, then do it. You will thank yourself afterwards...

 

IUN

[Troypants]

Thanks IUN, I am still coming off the bisoprolol now, ive got 100mcg to go, should take me about a week. I decided to use a liquid suspension to do the last bit.

I think I will wait a week or 2 after that and see how I go dropping a bead. I have some circumstances coming up within the year and I may not have the freedom to break the caps down and do my own doses so I'm taking steps to see if I can handle it, if I can't right now then I can't.

Sorry to hear about your work and wife, hope things turn around for you soon and give you some clear time to do what you need to do

[Troypants]

And yeah hat I found this study,

https://pubmed.ncbi....h.gov/28930747/

I thought I felt the anxiousness and vibration every time I dropped. Apparently I was right, bisoprolol indeed does have an effect on the CNS.

[fishinghat]

Excellent advice IUN. Totally agree.

 

Thanks for the article TP. An example of better living through chemistry. NOT!!

[invalidusername]

Thanks IUN, I am still coming off the bisoprolol now, ive got 100mcg to go, should take me about a week. I decided to use a liquid suspension to do the last bit.

I think I will wait a week or 2 after that and see how I go dropping a bead. I have some circumstances coming up within the year and I may not have the freedom to break the caps down and do my own doses so I'm taking steps to see if I can handle it, if I can't right now then I can't.

Sorry to hear about your work and wife, hope things turn around for you soon and give you some clear time to do what you need to do

 

Thank you Troy. I very much doubt there are many people in the world today who don't have issues of some flavour. The whole covid thing has been a test on us all. Preying on the weak, testing the strong. It should never have happened. Something that will go down in the history books for sure. 

 

Just don't look back, don't look forward. Take each day as it comes otherwise you will worry. All you can change is what is happening now. That is why you cannot plan too far ahead with a withdrawal or taper. Sure - have a plan, but a plan is just that.. " a proposal". Proposal need other variable in place in order to succeed. Withdrawal plans almost ALWAYS change as they go which is why I tell people not to get too regimented with this plan. 

 

It sounds like you have a good idea of what I am saying. It is stuff like this that doctors and health professionals do not tell you. They don't take the time (not that they have the time always) to go through what we do here. In an ideal world, all doctors who require people to come off Cymbalta would say... "Go to this Cymbalta withdrawal forum - they will be able to fill you in on a lot more detail and help you through"!!. But protocol, pride, red tape... will always get in the way.

 

You have made the best step by getting here with us. It is the best place you can be.

 

IUN

[Troypants]

@hat - haha yeah I am coming to the realisation that the only meds worth anything are those that you take for a short period of time. Everything else just takes you out of homeostasis, and forces your body to adapt abnormally, causing more issues.

@iun - yeah I completely agree about the covid stuff going down in the history books, an example of how corrupt the establishment has become. It's been hard on everyone in ways we dont even realise yet. And yeah, take each day as it comes, its something we say in Narcotics Anonymous, one day at a time. Which has been useful in the recovery from cymbalta too. Doctors can ever only know so much about each topic, and the new stuff they learn comes mostly from the drug companies who only share them positively biased information which leads to more addicts dependent on medications.

[Troypants]

You guys are doing a great job here

[invalidusername]

...the new stuff they learn comes mostly from the drug companies who only share them positively biased information which leads to more addicts dependent on medications.

 

You got it there. Its been the story for too many years now. 

 

Have a read;

 

https://qz.com/11621...use-depression/

[Troypants]

Yep, its not just depression, many diseases have their symptoms treated without curing the cause. Its a sick way to practice medicine, I hope I can help change the way we treat disease in the future and concentrate on the cause rather than the symptoms.

Depression and anxiety really can't be treated using drugs I believe, it just causes dependency. We need to treat the faulty thinking which is painful and takes time but it really is the only way for long term change. Maybe in the future we can create drugs which can return the body to homeostasis quicker rather than mask symptoms by bringing it out of homeostasis, that would be nice.

[Troypants]

I hate the way this recovery goes, good for a while, like a week, then slowly the brain starts to get that rushing sensation again, hypersensitivity, affecting breathing, anxiety will probably follow. Its not as bad as it was but jeez its shit.

It seems like about, a week on, a week off at the moment, which is heaps better than all the time feeling shit.

I'm just trying to ignore it and go on about my life.

How's everyone going?

[fishinghat]

Hang in there, it will slowly get better. You are doing great.

[Troypants]

Thanks hat, its veryyyyy slow

[Troypants]

I'm still on 16 beads, but last week I'm trying to drop to 15..

I thought I'd ask you guys if you think its a good idea, I'm not 100% yet but its been a year since my last drop. Considering I still have waves, do you think its a good idea to drop? Is a year long enough.

I don't feel too bad ATM but I just want to be cautious and do this right so I don't stuff it up and make things worse

[fishinghat]

I would think a year is definitely enough. I would do a 1 bead only drop and see how it goes. This stuff is so nasty at the end of the wean.

[Troypants]

Is it possible its so nasty because it becomes more tilted to norepinephrine releasing compared to serotonin as the dose lowers?

[Troypants]

And is it normal to have shitty obsessive thinking that won't shutup

[fishinghat]

I would say yes to both questions.

 

Obsessive thinking is one of the most disturbing parts of this withdrawal. 

 

There is no parasympathetic feedback in the adrenal gland so getting your body to adapt to changes in norepinephrine and adrenaline levels takes considerable time.

[invalidusername]

Hey Troy,

 

I am eagerly awaiting to hear how this next drop goes for you. And exactly as Hat said, there is no neural feedback, so your brain producing what it will in terms of norepinephrine is something that has to be dealt with. The brain will always have moments of trial and error to get the production right for your system and it can really be a long process. I wasn't even on the Cym for 10 weeks, but it took a good three months for my own adrenal system to sort itself out. It almost became unbelievable that it could do such a thing. I was still having issues walking up and down the flight of stairs to my apartment weeks after my final dose. 

 

Please keep in touch and let us know how you are doing.

 

I made a foolish mistake in dropping too early with my Valium a couple of weeks ago and have really been paying for it since. Silly thing was that it didn't hit until after the first week - whereas usually, a benzo withdrawal is going to hit its worst between 3-5 days. I thought I was in the clear. But longer half life and having built up a tolerance, it can easily change. I even know this!! Feel like such a fool. I can give the best advice I can out all day long, but when it comes to my own withdrawal I think I am bloody Superman!!

 

IUN

[Troypants]

The drop's going OK so far (2 weeks in) and I haven't exactly gone easy on the stress, had a fair bit of obsessive thoughts and a bit of anxiety. First couple of days brought the ear ringing back bad, but its hard to tell if its due to the drop or just time for another wave. I usually get tinnitus on and off but it was pretty bad.

@hat the obsessive thinking paired with intrusive thoughts is the worst

I had some work the last couple of days, and although I cut some convos short and had some anxiety, I went to work and got through the day so that's got something to say.

I feel like the speech centres in the brain are affected too because if I'm feeling nervous I cant think of the right words to say.

Benzo withdrawal has some real similarity with SNRI withdrawal doesn't it, same anxiety shit, how you feeling now, IUN?


Can't wait till I'm off everything

[fishinghat]

Hang in there Troy. Time and patience.

[Troypants]

Had a pretty good day today but I stuffed up this morning, I normally take the cymbalta at 8am, but I got up for work at 6am and just popped it in my mouth without thinking, then spat the water up so I could take it at the right time. But I couldn't find the capsule so either I ate it or didn't but I don't know.

Been having funny little feelings all day though so I'm not sure, maybe just a bad day or maybe I missed the dose. I'll make sure I don't do that again tomorrow!