38 replies to this topic

[JaiVon]

Hi there.  I started to post yesterday but didn't want to be a baby about it.  Today, I'm barely hanging on.  Those of you (and her) going through this are likely suffering way more than I am, it just feels like I'm losing my wife and I'm scared to death.  I don't even know what to ask for other than a miracle.  I'm absolutely lost.  I am so sorry for all of you struggling to come off of this drug...

[fishinghat]

You have not lost your wife. She is just in for a long battle. Remember it is not her it is the withdrawal speaking. She will probably have periods and anger and may say things she doesn't mean. It is just the Cymbalta. Try and do everything you can to minimize her stress. Take as much work load off her shoulders as possible, let her vent emotion, make sure she can get much rest and reassurance. When the time has passed she will return to you and with great appreciation and respect. Time and patience.

[Raven72]

Like FH said, you have not lost your wife.  She is just struggling like the rest of us. But we are glad you are both here because we can offer you the support you need.  She may seem like she is gone, but the wife you know and love is still there. And that is the key, LOVE and patience.  My husband is the reason I am here.  He has been my rock and it's been and still is a rough ride but we make it from day to day. You are never judged here no matter how you feel.  This drug hurts everyone, especially the ones that try to help us when we won't listen. We are here for you.

[Raven72]

If you like music then go to We Believe and you will see you are not alone.

[JaiVon]

I really appreciate the both of you; I think the hardest part has been the abrupt change in how we relate.  We used to text nearly all day about this or that, sharing sweet pet names as always then boom... the bottom drops out. 

She tells me to just relax but the way she's acting, it's as if there's another guy in the picture.  I can't talk to her about how scared I am because she just shuts down.  I don't accuse her, I just ask one or two questions with not much assurance.  She's constantly on her phone but again, rarely messages me anymore. 

 

Does this all sound familiar?  This just isn't like her at all.

[FiveNotions]

Welcome to the forum, JaiVon, I'm so glad you found us !!  

 

It will help us help your wife (and you) if you'd share a bit more information about her specifics ... what dose she was / is on, for how long, for what reason (fibro, depression, etc) ... also, what other meds is she taking and for what conditions (drug interactions can factor in to cymbalta withdrawal) ...

 

also, is she off the stuff cold turkey now, or using some other dosing down approach? (Bead-counting, I hope ... it's the best method ... I quit cold turkey, and that's the ride from hell    )

 

Hang in there, have hope, she / you can do this ! 

[FiveNotions]

JaiVon, are you saying that she's still on the stuff ... and that her behavior on the drug is what's wrong, or that she's actually trying to get off of it, and is having withdrawal symptoms?

[Raven72]

Yes, I agree with FN - Please let us know if she is acting this way while still on it or if she is going through withdrawals.  Cold turkey is how I did it and is not always the best choice but for me it was the only way I had any chance of saving my family. Please enlighten a little more if you can.

[JaiVon]

Thank you FN, she's been on 60 mgs for ±2 yrs now and has been trying for the past 4-6 months to come off.  The point at which I described the abrupt behavioral change was when she went from 30 to 20.  From 60 to 30 wasn't fun for anyone either, but for whatever the reason, when that 30 to 20 mg change happened, it was as if someone had swapped bodies with her.  She's not the same person.  She tells me she doesn't feel like she's handling it all that poorly but there's no communicated care for my feelings whatsoever so I've back way off to try and give her space.  It's been a month now.

Depression was the initial reasoning.  She's been on a number of different versions over the past 15 yrs and also takes Adderall for ADHD.   If I failed to answer all the questions I apologize for the oversight. 

[FiveNotions]

Behavior changes while on Cymbalta are common ... and they can be extreme / bizarre ... for example, I went from being sober for 20 years to drinking like a fish ... 1-2 bottles of wine a night, or 1/2 bottle of vodka ... plus, I did some major very bizarre online shopping ... also, lost all emotions ... never laughed, never cried ... just flat ...

 

And, most bizarre ... I thought I was just fine ... 

[FiveNotions]

JaiVon, I've got to sign off for a few hours (work duty calls) ... I'm leaving you in the competent hands of Raven and the others who'll check in shortly ...

 

My main suggestion is to get her into bead counting to dose down ... first, get her stabilized ... which might mean going up a bit in her dose ... then, once stable, start dosing down again, but by removing beads ..

 

Is she on the brand (better for bead counting cuz way more beads), or the generic?

 

Also, do you have children at home? (This is important to consider in context of the entire situation / approach to reducing)

 

And, is your wife open to, able to, post here and participate herself?

[JaiVon]

Thank you FN, she's on the generic and yes, we have kids ranging from 7-13 in the home. 

I'm not sure I want to ask her to post at this point.  I'm afraid it will be perceived as me pressuring her from something she's doing 'wrong'.  Again at this point, she feels like she's doing very well. 

[Raven72]

JaiVon,

 

It breaks my heart to see you struggling the way you are.  I can related to what she's going through as far as thinking she is doing fine.  The whole time I was on what I call Sinbalta I felt like I was not the problem. Never felt I was doing anything wrong.  Things ranging from biting my husband's head off and pushing him and pushing just to see how angry I could make him to not even really caring hardly what happened.  I put our family in financial stress to the point that it almost cost me my family.  My husband was already stressed with the job he had at the time and he was trying his best to handle that and me at the same time.  I just didn't make it easy for him at all.

 

We would love to talk to her and help her but if you are worried she will go further away then I wouldn't press the issue at this time. I was on the generic like her and I think that is why it was best for me to go cold turkey, but I am not suggesting she do that.  I would read up on bead counting throughout the forum and try to help her that way.

 

Please let us know if we can do anything else to help.

[fishinghat]

These are common occurences with Cymbalta withdrawal. Like FN said, get her on bead counting. If I understand correctly she is on 20 mg right now. If so open one of the capsules and count the tiny beads inside (usually 200 or more depending on brand). The normal procedure is to remove 2 or 3 beads each day until weaned off. In your wife's case she is deep in withdrawal. She will need to at the 20 mg until stable. The problem is that might take 2 or three months. Yea, months. The drug from hell. A dr recently wrote a journal article about success he had with a patient using small extra doses to break up the withdrawal. When ever it got to bad he would have the patient take a stronger tablet ONE TIME ONLY to give the patient a break n the withdrawal. That is too much od an up and down for me but I would suggest that she take a few beads (about 10% out of one of the 20 mg capsules and place them in an empty capsule. Take that extra 10% beads with her normal 20 mg tablet ONE TIME ONLY. This would be about 22 mg total and should ease things. If that doesn't work good enough try going up 15%. When the withdrawal gets real bad again do the same thing. Eventually she won't need the 'kicker' and will stabilize. When she feels comfortable she can start bead counting. Most of us got out extra empty capsule from our local pharmacy. Most have them but if not they can tell you where to get them.

 

I know this is a lot to take in so don't be afraid to ask questions. We will all do our best to help her out. She will come out of this OK.

[JaiVon]

Thank you Raven, you're describing a very similar situation to ours, wow.  And to you as well fishinghat; I will ask her if she'll consider the bead counting as well as your other information.  You wouldn't happen to have a link to that article would you?

[fishinghat]

http://neuro.psychia...opsych.12110265

Long-term duloxetine withdrawal syndrome and management in a depressed patient.
I will try to post this article. It has an interesting approach to handling Cymbalta withdrawal.

LETTERS
Long-Term Duloxetine
Withdrawal Syndrome and Management in a Depressed Patient

To the Editor: Serotonin and norepinephrine reuptake inhibitors (SNRIs),
such as venlafaxine,1 have been reported to be associated with withdrawal
syndromes. However, duloxetine related withdrawal syndrome is infrequently
mentioned. We want to report on a depressed patient who experienced a long-term duloxetine withdrawal syndrome and relief after gradual tapering procedures.

Case Report
“Miss B” was a depressed patient (depressed mood, anhedonia, anergia, binge eating, and suicide ideation) with partial remission of symptoms under duloxetine treatment (60 mg/day) for 1 year. However, she disliked the side effects of duloxetine (dizziness and
sedation). Therefore, duloxetine was abruptly switched to bupropion 150 mg/day. She started to feel more energy, but with intermittent severe nausea, unexplained fear, and di zziness after quitting duloxetine for 1 day. She still had withdrawal symptoms once-to-twice every week in the following 6 months after the switch. She took duloxetine 30 mg
only while feeling withdrawal discomfort in the next 3 months, and then took 15 mg (discarding half the dose of the 30-mg capsule) in the same way for the last month. She took 10 months to recover from longterm and intermittent duloxetine withdrawal syndrome. No residual withdrawal syndrome was noted since that time.

Discussion
Venlafaxine has a higher selectivity of serotonin receptor (30-fold versus norepinephrine) than duloxetine (10-fold).2 Perahia et al. reported that discontinuation-emergent adverse effects of duloxetine happened in around 44.3% of patients, versus 22.9% in a placebo group. They found that duloxetine withdrawal syndrome included dizziness, nausea,
headache, paresthesia, vomiting, irritability, and nightmares,3 which were similar to the symptoms of this patient. Duloxetine withdrawal syndrome is similar to that seen in
discontinuation of SNRIs and serotoninergic-related antidepressants. 3 A 10-fold selectivity for serotonin receptor of duloxetine might explain duloxetine withdrawal syndrome
in this patient and why it is not so frequent as with venlafaxine, which has 30-fold higher affinity.2 In a current literature search, duloxetine withdrawal syndrome is just mentioned in a few reports.3,4 Besides, a relatively longer half-life of duloxetine (12 hours)5 than the short half-life (5 hours) of venlafaxine,6 and possible genotype polymorphism of Asian people,6 might explain why the long-term and intermittent duloxetine withdrawal syndrome happened in this patient. A gradual tapering-down of duloxetine dose (not an abrupt switch) or occasional re-use of duloxetine while withdrawing might be helpful for this kind of long-term duloxetine withdrawal syndrome.

Yi-Cheng Hou, MSc
Chien-Han Lai, M.D.
Department of Nutrition,
Taipei Tzu Chi Hospital,
Buddhist Tzu Chi Medical
Foundation, New Taipei City,
Taiwan, ROC
Corresponding author:
Chien-Han Lai, M.D.
Department of Psychiatry,
Cheng Hsin General Hospital,
Taipei City, Taiwan, ROC
e-mail: stephenlai99@gmail.com

References
1. Agelink MW, Zitzelsberger A, Klieser E:
Withdrawal syndrome after discontinuation
of venlafaxine. Am J Psychiatry 1997;
154:1473–1474
2. Montgomery SA: Tolerability of serotonin
norepinephrine reuptake inhibitor
antidepressants. CNS Spectr 2008; 13
(Suppl 11):27–33
3. Perahia DG, Kajdasz DK, Desaiah D, et al:
Symptoms following abrupt discontinuation
of duloxetine treatment in patients
with major depressive disorder. J Affect
Disord 2005; 89:207–212
4. Abdy NA, Gerhart K: Duloxetine
withdrawal syndrome in a newborn. Clin
Pediatr (Phila) 2012; 52:976–977
5. Carter NJ, McCormack PL: Duloxetine:
a review of its use in the treatment of
generalized anxiety disorder. CNS Drugs
2009; 23:523–541
6. Baboolal NS: Venlafaxine withdrawal
syndrome: report of seven cases in Trinidad.
J Clin Psychopharmacol 2004; 24:229–231
E4 http://neuro.psychiatryonline.orgJNeuropsychiatry Clin Neurosci 26:1, Winter 2014
 

[JaiVon]

Beautiful, thank you!

[Raven72]

Good luck JaiVon and we are here if you need us. Even we are all still struggling.

[JaiVon]

Guys, I'm losing her...  Today I went up front at church for prayer and the elder praying for us mentioned the struggle with the medications.  A couple of people flipped out and texted her mom, dad and sister saying how inappropriate my actions were.  I didn't know what else to do and I didn't go down from to trash my wife!  This is so out of control.  She said she knew I would go down front and that she had hoped I would, but what have I done?!!!  I can't take this anymore guys

[fishinghat]

Praying to God is never ever inappropriate. His love and ability to help this situation is far more than any of them. I would think it was inappropriate if you didn.t do that. The elder should not have mentioned the medical situation to the congregation. He should have respected your situation. If you had wanted the whole church to know you could have told them yourself. Actually, as a Christian I respect your action. You did that out of love and concern for your wife. It sounds like your wife took it well. This isn't the dark ages anymore. Psychiatric issues are much better understood and anyone who still thinks it is socially taboo is ignorant and is spreading the lack of understanding to others. When I had my nervous breakdown I never hesitated to tell my friends, church members, family, etc. If they truly cared about me they would understand and support me. If not...oh well, that is sad. You both have done NOTHING wrong and deserve no judgement but only support. There are 31 million people in the USA on anti-depressants. About 1 in 12. This situation you are in is common and will increase in frequency. The bible says to judge not less you be judged. They should have realized that was not their job to judge.

 

From the bottom of my heart. Good for you. You trusted God and asked for help from Him. He will judge the rest, you did what you needed to do. Good Job!!!

[JaiVon]

Unfortunately, I didn't explain it well to you... she did NOT take it well because she too thought mentioning the medication was inappropriate.  Yes, I did trust what I thought was His leading but apparently I made an enormous mistake.  Now she and her family are furious with me.  I can't win.

[fishinghat]

Sorry, but I still feel you did the right thing. You should never have to hide from the truth.

[FiveNotions]

JaiVon, listen to FH's words of wisdom here ... you did nothing inappropriate ... and you must continue to pray ... and we are praying with you, and for both your wife and you ... 

 

Your wife has to fight this battle herself, you can't take it all on yourself ... I can tell you are a man who is a doer ... who's trained to get into the battle, take the challenge, and fix things ... if one thing doesn't seem to work, to try something else, until the problem is resolved ...

 

yet in this situation, what's needed is to step-back ... keep praying, and just step back a bit ... 

 

I can understand both how your wife feels and how you feel now that I'm 2 1/2 years off the poison ... I know I felt deep, searing, shame while going through cymbalta withdrawal ... I didn't want anyone to know ... only my dear friends here on the forum, and just one trusted and beloved friend ... he stuck with me through the whole year ... and I lashed out at him horribly in my worst moments (and there were so many of those moments) ... 

 

Do either of you have any additional support, from a therapist, counselor, or a pastor? 

[JaiVon]

At this point we don't have much additional support.  There's a mutual friend who's very good at keeping us both guided at times but I think you're right; I have to do what is most frightening for me, and that's to let her make whatever decision she makes.  Thank you for your prayers; I don't see any other way for this to work.

 

I love you guys.

[FiveNotions]

JaiVon, it would be ideal if you could get your wife to sign on here and read ... post ... that way we could help her directly ... that would allow you to step back and off the proverbial "firing line"  

[Raven72]

Oh, JaiVon I am so sorry to hear that she took it the way she did. Listen to the others, you did absolutely nothing wrong in turning to God. It is was the Elder's mistake to mention it to the congregation w/o asking you first. I pray that God leads your wife to a better understanding that you are only trying to help her.

[JaiVon]

Hi everyone.  This weekend has been a huge eye-opener for me; I own much more of this situation than does the medication. 

 

My wife and I talked yesterday and I shared with her, through the many conversations I've had with others in trying to gain perspective, I see where most of this lies - me.  The story is long so I won't go into all of it here, but suffice it to say, if she'll give me a little time to allow this new perspective to take hold in our home, the majority of our problem will vanish.  When I spoke the words in church, "Jesus, if You are willing, this will be healed", little did I know I was the one who needed to heal.  To heal from a past which was programed into me as a kid and let go of all the things I thought were important, because they just aren't important.  That's what a lot (if not most) of this has been about. 

 

In an effort to continue to NOT try and control this, I would ask everyone who's willing to stand in the gap for us, to simply continue the words with me:  "Jesus, if You are willing, we will be healed."  

[fishinghat]

Talking is the core of a relationship. I am so so glad you guys talked. If there is anything we can do to help let us know.

 

God bless.

[Carleeta]

The best thing you and your wife can share is honesty and to try and see each others point of view from each others shoes.  It isn't easy, I grant you this.  I see you are very religious and this is truly a wonderful things.  What is best is to please watch the move "War Room"  it is a very powerful movie, and I believe both of you will truly see each other in this movie (not that you and she are having the same issues). I would suggest this movie to everyone I see and meet.  They actually find something in this movie they can relate to and take it from there.  It's truly a powerful movie and it's a religious move (no religion specified in the movie).  From the bottom of my heart I do believe this movie will help you understand and see what the other person is going through and what you can do to help things.....Please Jaivon, consider watching it........

[FiveNotions]

Just saw a preview for this movie (it came with a DVD about the making of the KJ Bible) ... put it on my list to order ... just the preview had me in tears (of course, almost everything has me in tears now that I've got my emotions back again