256 replies to this topic

[thismoment]

AM

I don't take any meds either, but I do take the supplements omega 3 and vitamin D.

The strongest GERD symptom would appear if I should eat just a bit too much-- and it's difficult to tell where that limit is-- therefore its best to err on the light side; I stop eating when I still fell hungry.

If I were to eat even a small meal and then lie down, I would be in great GI discomfort. Therefore, I need to go food-free for about 4 hours before going to bed.

Is this a normal phase of life that has arisen due to regular cause-and-effect, or is this discontinuation from antidepressants that may yet fade away? The question is moot and probably irrelevant. We keep going.

The Dude abides.

[TryinginFL]

Interesting about the small meals...

 

Since being off the poison drug, I can only eat a small amount at a time.  I have the equivalent of a small meal once a day and at other times a small snack - every 3-4 hours.  I don't eat within 4 hours of going to bed, either!

 

This was never my eating pattern before, but I find myself in pain and feeling "stuffed" if I eat even close to what I used to.

 

It took a while for me to adapt to this schedule, but since it has become habit I have not only lost weight but feel comfortable!

[DoneWithCrap]

Good morning

Funny you should mention similar eating habits. I too, become over stuffed on a typical portioned meal and the reflux lasts the rest of the day. A couple times we went out to eat and I over indulged only to toss it up in the parking lot
I can't sleep lying down anymore. I sleep on my couch with a wedge pillow propping my upper half at a 45 degree slope.

[TryinginFL]

Wow!

 

I can't help but think this, too, is related to that crap...

 

Strange that we all have noticed such a change in the amount of food we are able to consume - thankfully, it's much less!  A blessing in disguise!

[thismoment]

Before I learned to adapt to the symptoms, I would go to bed following an evening meal or snack and within an hour I'd be up-- sitting up straight or at least 45 degrees-- until 3 or 4 in the morning before being able to lay down again.

Once I figured it out-- eat very small meals and no eating 4 hours before bed-- it became tolerable. I felt better and I got more and deeper sleep. While this may be discontinuation, it's not a difficult change-- and its not a bad lifestyle when all things are considered.

Perhaps I'm making lemonade from the basket of discontinuation lemons I've received. I don't know.

[thismoment]

And speaking of Gastrointestinal Distress, have a look at this:

 

http://stuartshipko.com/research.html

[AnotherMind]

My new gp adamant that I should return to a very low dose of Cymbalta to treat this intolerable gut pain. How ironic. This is the third time he's tried to convince me. Confused.

[thismoment]

Hi AM

My GI issues appeared somewhere after 6 months off Cymbalta. I tolerated it for a long time, but at about a year and-a-half off I couldn't bear it and went to the doc (one of my many symptom-induced visits). He prescribed pantoprazole (brand name Protonix), and that made it tolerable. I took that for about 6 months around the same time I had to swallow some dye and get rolled around on the machine. Esophageal inflammation.

At nearly 31 months off I still have to watch what I eat, and how much; sometimes it feels like the meal could suddenly go either way-- up or down!

What kind of plan did your GP propose-- a month or two to test, then withdraw? Doctors treat symptoms with drugs-- that's their career . . . well sometimes it seems that way.

Take care.

[AnotherMind]

That's very interesting TM - My Gi probs emerged the day I started withdrawing from Cymbalta and havent gone away. My gp was suggesting we need to break the pain cycle, hence the Cymbalta return. Like you I feel like food wants to go either way - I feel like I have a nail in my sternum all the time and nausea and pain when I eat. There doesnt seem to be a plan - just lots of dismisal and blundering in the dark. If its neuropathic - what can be done?

 

Fed up and scared. Pain so intense Im almost tempted to go back to the SSRI/SNRI devil.

 

Just looked up Protonix - Im on a PPI now, low dose - not helping.

[thismoment]

AM

Most serotonin is produced in the gut. Serotonin and GI problems go hand-in-hand.

http://www.nature.co.../ctg20128a.html

If it is serotonin-related, surely there are other treatments other than another SS/SNRI.

[AnotherMind]

Is that why GI problems arise as a discontinuation symptom - a drop in seratonin? and does that imply that the bodies own self-regulatory capacity is inhibited after prolonged SNRI use or that an immune response has been activated?   - is that response reversable or are we are doomed to need our seratonin levels pharmacutically augmented once this problem evolves?

Sorry struggling to get my head around the article.

[thismoment]

AM

 

Excellent questions! I wonder what your GP might say.

 

Of course it takes time for our bodies to adapt to life without the drug, and I guess that's what dependency and withdrawal are all about. Withdrawal is another word for physically adapting to the new drug-less physical reality. 

 

There are other ways to augment serotonin other than RTIs, and hopefully your medial people will have something to say; I'd really like to hear what they say. So many folks have reported that their doc simply said, "This isn't withdrawal because that only last a few weeks at most."

 

5-HTP may be used to enhance serotonin levels, but it skips a chemical step and needs to be used with caution; it's better to start with the precursor tryptophan-- available on Rx. This is just off the top of my head-- look into it carefully.

 

It's never wrong to start with the pharmacist. 

[AnotherMind]

Thanks TM - I will look into Tryptophan.

 

My Gp's have said pretty much the same and still dont really believe that I went thru all this turmoil with Cymbalta, nor that these remnants seem connected. Oh well.

We do what we can. Even with a belly ache.

[thismoment]

AM

It's always interesting to hear physicians and Phd therapists chanting the mantras of undergraduate pharmaceutical sales reps. It's amazing how schmoozing advertising hype morphs into terse medical aphorisms. With regard to withdrawal, often the very label on the package contradicts the advice given by the physician.

Regarding the serotonin/gastrointestinal issues and the serotonin RTIs-- the little that is known seems to encounter a closed door at the doctor's office. Remember, fluoxetine (Prozac) the first SSRI was marketed just 26 years ago, and since then there has been a flood of these drugs entering the market-- billions and billions of dollars in profits. Therefore, you and I are among the first waves of that long-term drug history that begs to be studied.

It would be wonderful if a regimen of tryptophan could cure the GI issues that have emerged from the use of antidepressants-- maybe it can. I fear the problem-- perhaps the damage-- is broader and won't be solved by simply elevating the level of a single neurotransmitter. But I don't know.

My post-SS/SNRI GI condition is manageable. Most symptoms that emerged as I started to withdraw from Cymbalta/duloxetine some 2 years and 7 months ago have vanished-- even the ones that I thought were killing me! Yet there are a few withdrawal artifacts that still persist, but they are forgotten most days.

Conditions have continued to slowly and steadily improve out here on that thinning razor-edge of long-term withdrawal. My level of function is acceptable-- even good.

I am satisfied with where I landed, and now it's up to me to tidy up the place and get on with other things.

[fishinghat]

I have used dicyclomine since 97 for my digestive issues (Irritable Bowel) with good success. It is an anti-cholinergic.

[thismoment]

Thanks FH, I'll check it out.

[AnotherMind]

Have people tried glutamine? I was reading that it is used to heal guts post surgery.

 

TM - so true we are the first wave of long term users of this stuff - dubious honour of being pioneers/guinea pigs. And yes, sometimes the advice on the label does contradict that of the physician. It's a strange position to be in as patient - you can research and bring your findings to the GP only to be met with derision or dismissal, which leaves you doubting your own capacity for understanding your subjective experience, or capacity to aquire knowledge. I have felt very powerless at times through the Cymbalta experience. My pysch was adamant that Duloxetine did not cause visual hallucinations - but I did some research on reported side effects and there it was - 1 in 1000 - but recorded all the same. I feel vindicated in some small way. I was plagued by hallucinations on the stuff, now Ive stopped taking it - it's stopped happening.

 

we land in post-drug territory - reorienting is incremental and hard. Im really glad to hear you say your satisfied with where you've landed TM. Heartening.