8 replies to this topic

[Nortonj]

I've been on Cymbalta more years than I can remember (60 mg).  I never wanted to get off since I could feel the effects by mid-afternoon if I didn't take the pill that morning.

 

There is no arrhythmia according to the heart monitor, but I show a Low QTc, leaky valve and abnormal electronics. I am a 61 year old female.  All stress tests passed.

 

The next day I took half a capsule, Thursday maybe a 10th of a capsule, Friday night (last night) 2-3 teeny ones and woke up this morning feeling like a truck ran me over and I can't raise my head from the dizziness.  So I took probably 1/8th of a capsule this morning hoping I could level out.

 

My next EKG is scheduled for Wednesday.  His hope was the Cymbalta would be out of my system by then, so we could see if that had any effect.

 

However, I cannot withstand the withdrawals.  What would you do?

 

1. Ease back on the Cymbalta with a 30mg dose (half my normal dose) and tell the doctor it's going to take longer to get off as we hoped. (this is what I think I will do)

2. Self medicate with hubby's reserve of Prozac to balance the seritonin?

3. Suffer these side effects until the EKG is performed, then revisit the correct antidepressant?

 

I suspect the cardiologist is not aware of these withdrawal symptoms, although he says he's experienced people having heart issues in connection with Cymbalta.

 

Any personal experiences facing issues such as this?

 

 

 

[TryinginFL]

Welcome Nortonj!

 

Sadly, you have put yourself into complete cold turkey withdrawal - This poison drug has only a half life of 12 hrs!

 

Did your cardiologist suggest that you do this??  I sure hope not, as this is definitely NOT the way to go.  I went off 60mg cold turkey a little over 3 yrs ago and did not find this wonderful place until it was too late.  I went through one year of hell - you don't want to do this!  It appears that one's age also has something to do with how difficult this can be (and I am older than you!)

 

I strongly suggest that you go back on 30mg and see if you can stabilize - many folks have dropped from 60 to 30 w/o too much trouble.  If you are still in severe withdrawal, then go back to 60.  I seem to think that you have done some reading here on bead counting as this is the way to go.  You are in control and can keep yourself comfortable. 

 

Regardless of what that cardiologist said (most of the drs. are asshats regarding this subject) cold turkey can result in seizures and worse - you might like to print some of the posts here to show him/her.

 

We can help you w/bead counting which is safe.  Regardless of what the Dr. says, this cannot be a race!  We are all different and maybe you will be one of the lucky ones who doesn't experience horrible effects, but try the 30mg drop to see.

 

We are always here for you!!  Others will hop on shortly

 

Liz

[gail]

Hello Norton,

Liz is right, get back on 30mg. As she says, many do great from 60 to 30.

Your number 1 solution is right. Almost instant relief.

Fishinghat will drop in later, and for sure the same advice will be given to you.

[fishinghat]

I do agree with Liz. As long as you can stay stable at 30 mg stay there until you feel strong again and then bead count. For bead counting you open a capsule and count the little beads inside. Remove about 1% a day to wean. ABYTIME you feel bad stop at your current dose until stable again and then continue weaning. Some people take 2 or 3 months and others as long as 1 to 2 years with the average being around 6 to 8 months.

 

By the way the manufacturer and the FDA both warn against rapid cessation. It can cause not only severe withdrawal but also seizures, suicidal thought and even suicide. If you dr recommended this he is an idiot.

 

Do not underestimate this withdrawal. Time and patience and you will defeat it. I am sure you will have a lot of questions along the way so please feel free to come back anytime if nothing else just to complain. We are here for you.

[Nortonj]

30MG is working fine so far.  Next EKG tomorrow.

[fishinghat]

Sounds like if the EKG is OK then maybe you can begin weaning.

[gail]

Fishinghat, you got any research related to heart condition and Cymbalta?
I don't remember hearing of this. Have you? Thanks!

[fishinghat]

Oh Yea Gail. This drug is an snri which means it regulates norepinephrine a precursor to the formation of epinephrine (adrenaline). Anything that effects these two will have a significant effect on the heart. A small sampling of what is in me "library"  is....
 
https://www.ncbi.nlm...pubmed/27130441
Differential inhibition of cardiac and neuronal Na(+) channels by the selective serotonin-norepinephrine reuptake inhibitors duloxetine and venlafaxine.

https://www.ncbi.nlm...pubmed/23666493
"Whereas inhibitory effects of duloxetine seem negligible under therapeutically relevant concentrations, hERG block should be considered in cases of duloxetine overdose and when administering duloxetine to patients susceptible to drug-induced QT prolongation."

https://www.ncbi.nlm...pubmed/23422380
"In conclusion, in healthy adults exposed to DLX (Cymbalta) or ESC, no clinically significant effects on HRV (heart rate variability) were observed."

https://www.ncbi.nlm...pubmed/22163139
Abstract
Takotsubo cardiomyopathy is characterized by transient multisegmental left ventricular dysfunction, dynamic electrocardiographic changes that mimic acute myocardial infarction, and the absence of obstructive coronary disease. Takotsubo cardiomyopathy has been solidly associated with antecedent emotional and physical stressors that trigger catecholamine surges, which lead to coronary vasospasm or direct myocardial injury. Some medications can also cause catecholamine surges, although this phenomenon is not as well described. Duloxetine is a combined serotonin and norepinephrine reuptake inhibitor (SNRI). The basic goal of SNRIs is to increase catecholamine levels in neuronal tissue. However, the increased catecholamine levels may also affect the cardiovascular system.Herein, we report the case of a 59-year-old woman whose takotsubo cardiomyopathy was temporally associated with the titration of duloxetine. The duloxetine therapy was subsequently discontinued, and the patient's left ventricular function recovered completely 1 month after the index event. The purpose of this report is to alert clinicians to a possible association between SNRI medications and takotsubo cardiomyopathy.

https://www.ncbi.nlm...pubmed/18728105
Duloxetine-associated tachycardia
"Clinicians should be aware of the possibility of clinically significant tachycardia in patients receiving duloxetine, even in low doses."

https://www.ncbi.nlm...pubmed/18445706
Heart failure worsening and exacerbation after venlafaxine and duloxetine therapy.
"Use of drugs that increase serum norepinephrine levels, such as the SNRIs, may be potentially deleterious in individuals with unstable or advanced HF. These medications should be avoided or used with caution and monitored regularly in this patient population."

https://dailymed.nlm...f2-c185fbad64ba
"Cardiac Disorders — Frequent: palpitations; Infrequent: myocardial infarction and tachycardia. "
Post Marketing reports - supraventricular arrhythmia,

[gail]

Thanks Fisherman, a lot to read, maybe not today though.