11 replies to this topic

[msmalcolm]

I have been on Cymbalta, Wellbutrin and klonopin for 21 years for pain. I have been trying to come off of them. I’d get to a low dose and something would fall apart with anxiety, heart palpitations, irritability and insomnia and I’d have to go back up. Now I think it was the Cymbalta. In August 2021, I was down to 1mg klonopin, 25mg Wellbutrin and 7 beads of Cymbalta (100 beads in 20mg capsule). Two weeks after I got the recommended shot, the world fell apart. My heart started pounding at night and I thought I was having a heart attack. I went to ER and my heart is fine. Multiple specialists and psychiatrists later, my endocrinologist said this is Cymbalta withdrawal. I had gone back up to 10 beads of Cymbalta so I’m on 2mg.  My doc said I could stop the Wellbutrin in August since that made me anxious and he upped my klonopin in August and November.  

My symptoms are anxiety, increased heart rate, insomnia with waking heart rate around 100, brain fog, nervousness, inability to handle stress and crying a lot. I’m a 51 year old mess. I’m not working or cooking or doing much of anything. My psychiatrist didn’t catch what was going on but decided to start me on Zoloft which I’m reading can counter the withdrawal side effects. I’m only on 37.5mg of Zoloft as I’m sensitive to medicine and I had an increase in anxiety when I started Zoloft. I have been on it for 9 days and my heart rate has come down and I’m sleeping better at night. I still have a lot of anxiety and I’m scared that I have to manage my medicine cause my doctor doesn’t know how to. All the other psychiatrists I have called aren’t seeing new patients.

Anyway, how much Zoloft can or should I take with 2mg Cymbalta? When do I stop the Cymbalta? And I’m not putting the beads in a capsule, just taking them plain. Is this wrong too? I don’t know how I got to this point, but I feel like I’m in a hole I can’t get out of. Once I deal with this, I still have the klonopin. No one ever told me these things were hard to stop. I never even took opiates for the pain cause I didn’t want to get addicted, so ironic.

 

[fishinghat]

Welcome msmalcolm

 

Well that was not to bad a response by the drs overall.

 

Those last 2 ng are usually horrific and in some cases can take a long time to come off of. Updosing back to 10 beads was a good effort but our experiences here is that updosing is a hit and miss effort. It may work well for some people and not for others. 

 

Did you stop the Wellbutrin like the one dr suggested? My thought is to leave that dose alone until things settle down. Stopping it now would just complicate the issue.

 

Zoloft is often good for helping with Cymbalta withdrawal but considering it also has a withdrawal (not as bad though don't take anymore than necessary to deal with the situation. If you have gotten significant improvement on 37.5 mg in just 9 days that is a very good sign. It takes Zoloft around 6 to 8 weeks to fully kick in so for right now just hang in there and re-evaluate your situation at that time. Don't feel bad that the drs don't seem to understand the issue. They are not required to be trained on withdrawal scenarios. 

 

2 mg of Cymbalta are a minimal dose and should present no issue with 37.5 mg of Zoloft. Many use up to 100 mg when on a low dose of Cymbalta but at this point I am optimistic that the 37.5 mg Zoloft may be enough. 

 

Taking the beads in a capsule is the best way. The individual beads are enteric coated but the capsule provides some additional protection to make sure the Cymbalta enters the small intestines before being released. If the Cymbalta is released into the stomach the acid in the stomach will convert much of the Cymbalta to Naphthol which is very hard on the stomach. 

 

I would strongly suggest that you do not change the doses on any of your meds until the Zoloft fully kicks in and you get much more stable. This is a slow process but everyone here will help in anyway we can. You can do this but you will have to be patient.

 

There are some tricks to coming off the klonopin when the time comes so hang in there and we will help you along the way.

[invalidusername]

Hi Malcolm and welcome...

 

If I am reading this right - you were being advised to taper ALL THREE of these meds at once?! Bloody hell - no wonder you are feeling that bad. Tapering a drug should be done one at a time unless there is a good reason to remove all. 

 

For one reason, you would get a load of withdrawal all at once, and secondly, you cannot attribute withdrawal symptoms to any one of the drugs, which is the difficultly you are having now. These symptoms you are having could be put down to all three of your tapers, but less likely to be the Wellbutrin.

 

I am very sorry to hear you are going through this and I hope that you can stabalise. I went through something similar years ago before I became educated. I was on Citalopram for years and the doctor told me to stop after a 2 week taper. I went the same you have. The problem is that a lot of the medical community are not correctly warned of these issues, which is why we have our little corner of the internet to help people like yourself.

 

Ideally you would have stopped one at a time as I said, but that has been and done so we must deal with the present. So allow me to address your questions.

 

You can take the maximum dose of Zoloft with 2mg Cymbalta, but I would not advise this as you will end up with another withdrawal. It sounds like it has worked somewhat. You should only take sufficient to level you out. It can take up to 8 weeks to fully kick in, so don't let the doctors tell you to up the dose prematurely. Wait until you are stable before going any further with ANY of the tapers - not only the Cymbalta.

 

And yes, you should be putting the beads in capsules otherwise they will not be doing their job as efficiently as they should be.

 

EDIT - just noticed that Hat posted at the exact same time as me!! Has often happened - but we usually agree on these things, and reading we have pretty much said the same thing - so obviously I agree with everything said.

[msmalcolm]

I appreciate the replies more than you know. I did stop the Wellbutrin in August because "it was such a small amount it couldn't have been doing anything". I haven't changed anything since and I'm not going to until I feel sane again. My doc wants me up to 50mg Zoloft but with the anxiety, I'll hold here. It's good to know other people have made it out of something like this cause there's a large chunk of my day I don't feel like I'll get there. 

[fishinghat]

Oh Yea. The stopping Wellbutrin at 25 mg explains a lot. The "it is so low it isn't doing anything" is a wrong approach. Those 25 mg were reacting with your brain synapses. It may not have been enough to help your symptoms but those nerves are used to seeing this low dose each day. Once removed the nerve endings no longer are exposed to the drug and can cause a severe withdrawal. The good news it will recover. This can be illustrated by dropping the last 2 mg on Cymbalta. While a very low dose with little benefit it ca cause a tremendous withdrawal once discontinued. Nearly all of our members experience this when they get to a very low dose and try to stop. The good news it will recover.

[msmalcolm]

Yesterday, I took my 2mg cymbalta and put it in a capsule. Yesterday afternoon my heartrate went up a lot and again last night I was waking up every 2 hours. Today my heartrate and anxiety are up. I didn't use the capsule today but took the beads with food as usual. Did I mess up and get too much cymbalta yesterday? My doctor wants me up to 50mg of Zoloft because of my depression symptoms. I know it's only been 12 days at 37.5 but I felt better a couple days ago. Should I go up on Zoloft? Thanks so much.

[fishinghat]

After your recent changes in meds I would recommend just staying on your current doses until you stabilize. During that time your anxiety, pulse blood pressure will make routine swings as your body fights to get control. I would hate to see you use any more meds than you have too as that just makes withdrawal later that much harder but having said that, 50 mg will not hurt you any but it would mean further to wean down later. Just remember, I am not a doctor and my experience is based on years and years on this forum as well as my formal education. Unluckily there are no clearcut answers. 

 

Ultimately this is your decision. I can assure you that no matter what route you chose there are always potential complications (side effects, withdrawals, interaction with other meds, vitamins and supplements, etc.) 

 

Whatever route you chose we will be here to help in any way we can. 

[msmalcolm]

Thank you, expecting swings helps. I am dealing with chronic back pain and don't anticipate being able to drop the Zoloft until I lose that symptom. I just desperately want off the cymbalta. This process has consumed too much of my life. 

[invalidusername]

Hi Malcolm.

 

As usual, Hat has got this covered well. I agree completely. In my opinion, it would be using drugs to cover the effect of drugs. Out of the pan and into the fire. Best thing you can do is let your brain recover so you know what it REALLY needs. 

 

We see this a lot where people are given one drug to cover up the effect of another drug, only to give its own issues. It then becomes a self-fulfilling loop. One problem replaced with another. 

 

Just imagine you have had a bad day and then you come home and four people are all talking to you at the same time, asking you questions, asking you to do things... What would you do?! You would just want to silence everything to have some peace so you could deal with the bad day you have already had, right?

 

Multiply that by 10... you are in your brain.

[msmalcolm]

So I had been referred to a neuropsychiatrist to make sure nothing was being missed. He did computer testing and I'm testing like I have ADHD because I'm so anxious, but I don't care about that really. I've been on cymbalta and wellbutrin and klonopin for 20 years. He said that 20 years ago they didn't know about these drugs and their addiction problem. But that my brain has basically built itself around cymbalta and I'll never get off these drugs due to the length of time I've been on them. He said he would go back on cymbalta and stop the suffering or maybe the zoloft can handle the withdrawal symptoms. So basically, he was saying to just accept that I will be on these meds for the rest of my life and move on. And he said it's not just cymbalta, that the brain gets wired to depend on any of the antidepressants after such a long time. 

 

Has anyone ever been successful quitting after 20 years? I'm miserable. Is it pointless suffering? 

[fishinghat]

Yes they have but it is not easy.  I firmly believe the key is to wean very very slow. I had a nervous breakdown in 2000. At that time I went on a benzo, clonidine, an antidepressant and a beta blocker and several supplements. I was on all of that for 7 years with only minor changes before my symptoms started to improve. In 2013 I started weaning off Cymbalta first and now am only on a low dose clonidine and Zoloft. The Cymbalta wean was terrible, as you have figured out. After that I weaned off the rest at a very very slow pace. Slow enough that I had little to no withdrawal. I have also noticed that those who take 2 to 3 years total to wean off Cymbalta have an easier time and are more successful. I know many on Benzobuddies as well as this site who have been very successful in weaning of benzos over a 2 or 3 year time period with little to no symptoms. I have weaned off benzos twice that way with no withdrawal. It takes a lot of patience but can be done. Several on here have done it after being on meds for a long time.

[invalidusername]

Yes, Hat is proof more than most that it can be done. I am in a similar situation to you Malcolm as I have been on Citalopram for coming up to 15 years. I no longer suffer depression or anxiety - no more than what is considered "normal", but every time I drop I crash and I cannot stand it, but these drops are 5mg at a time as the NHS will not provide me with liquid to drop less. But I need to do something. I worry for the long term effects.

 

Regarding this doc you saw - what he is saying is simply not true. If you have a look at the medical advances in brain plasticity, you will soon find out that the brain will cope with any changes over a period of time. No-one is permanently addicted to any drug or substance. It sounds to me like this doc was told what he said to you by a pharma rep as this was what my doc said to me... if I was diabetic I would take insulin for the rest of my life and because I am "prone" to mental health, I need to take an antidepressant for the rest of my life. Rubbish. The two are totally different and you CAN get off these drugs - it is just a question of time.