171 replies to this topic

[fishinghat]

Juli's method is typical and excellant. If you know what you want to taper onto let me know and I will try to work up something for you.

[fishinghat]

Several of the members posted how their dr cross tapered then so I can research that post the way they did it for your review if I know what you want to change to.

[fishinghat]

"If the cross taper doesn't work, should I immediately stop the Prozac? "

It takes Prozac 4 to 6 weeks to fully kick in. If by that time you see little to no progress than normally the dr would take you off it and immediately switch to a different AD like Zoloft, Lexapro, etc.

"Should I keep trying to taper the Cymbalta by itself and get down to 30 mg or plunge ahead with the Prozac bridge? "

If you feel the symptoms getting better and you think you can handle it, sure drop the Cymbalta some but only a little at a time.

"Should I keep trying to taper the Cymbalta by itself and get down to 30 mg or plunge ahead with the Prozac bridge? How long should I take the Prozac before making a Cymbalta cut? My doctor suggested a week, but I don't know if that's long enough for it to have an effect."

You take it until you reach the 6 month mark (meaning it will not work) or your symptoms get better, in which case you can begin tapering your Cymbalta again.

"I keep wondering if I'm still in benzo withdrawal. I've been off 7 months and my symptoms have lessened but I'm still not ok....not sure how much of that is due to the benzo vs the Cymbalta taper."

Your gaba receptors are still healing but any effects from the Benzo withdrawal should be minor by now. Gaba receptors will mostly heal by the 6 month but there will still be some improvements over the next year and a half. This has been determined by studying patients who have come off benzos and tracking their sensitivity to set backs after stopping the drug. For whatever that is worth. lol
Also realize the Cymbalta withdrawal does not effect the GABA receptors but serotonin and norepinephrine. I wouldn't worry about the benzo withdrawal at this point.

Let me know if you have any questions. I know it is tough to decide what specific direction to go in, especially when a lot of this information applies in general and there are a lot of exceptions especially considering the genetic variability that comes into play.


 

[juli]

Praying for you GardenLady.  I feel for you because I am also one of the unlucky ones that had such a hard time of it.  I know how you are feeling and it can seem hopeless.  Please know that brighter days are ahead.  I promise you that.  I was convinced that I was permanently broken.  You are not broken and will be back to your old self soon.

 

Since you had such a difficult time tapering and reinstating, as did I,  I think the new AD is just what your body needs to heal.

 

It is what the doctors are doing now with patients who can't get through this, so have faith my dear. It's the withdrawl that is making things seem so hopeless.

[fishinghat]

I would wait about 7 to 10 days. Also most people drop by 1% or less when they get to the hard part. A 1 mg drop is too much for you to deal with (that is around 3%).

[fishinghat]

The danger of being on two antidepressants at once is the risk of Serotonin Syndrome. There are two ways the drs handle this. Some drs will phase out one drug (in your case Cymbalta by around 25% a week each week for around 4 or 5 weeks time while going up on the new drug (Prozac) by around 25% of target dose every week. This is a smother process than the second method but carries a greater risk of serotonin syndrome. The second method that drs use is to stop the Cymbalta cold turkey and raise the Prozac by about 25% every week or so, This eliminates the risk of serotonin syndrome but this can also be a very rough rise. For me and most others who have cross-tapered when NOT going through withdrawal this is a fairly smooth process. However for myself and many of the others I have talked to if you are in withdrawal this is a rough ride either way. Juli's process went fairly smooth for het but I would say that is case for about 30% of the people. Now the amount a dr will increase dose or the time period between changes varies from one dr to the next. Some drop by as little as 20% while some drop as much as 1/3. And it may be 7 days between changes in dose or some even take 2 weeks between dose changes. The example I gave is sort of a typical switch over.

[fishinghat]

In my experience on this site I have talked to a great many members who have cross tapered and only remember 2 or maybe 3 that experienced serotonin syndrome. It is a rare event.

 

1) Normally I would say 25% but in your case I would do 10%. Just an educated guess though.

 

2) I have seen no indication of that in the research or here on this site. I would say that going through 3 ADs is an issue. For example weaning off Cymbalta, cross tapering to Prozac and then if it doesn't help going to a third one, say Lexapro. In a few cases on this site members (including me) have had to go to 2 different ADs and still not had success. When finally on the third one success is obtained but coming of the other ones is very difficult. I was in Cymbalta withdrawal and went to Olanzipine, didn't work, then Prozac, didn't work, off Cymbalta and Olanzipine, (horrible), onto Lexapro at same time, serious side effects, then off Lexapro and onto Zoloft. This all occurred in a 5 month time frame. Although the Zoloft did help it took me and the Zoloft four months to stabilize and recover. Too many changes in quick succession is usually a big issue for recovery.

 

Hang in there Gardenlady, I will be back in the morning. We will work through this with everyone's help.

[juli]

when i was planning my taper I made sure not to go too slow because I did read that being on 2 ADs together for too long can cause the brain to get used to being on both.  so basically it is don't go too fast and don't go too slow.

 

i remember reading that you should be off the Cybalta and on the therapetic dose of the new AD in 4 to 5 weeks.  

[fishinghat]

"i remember reading that you should be off the Cybalta and on the therapetic dose of the new AD in 4 to 5 weeks."

I would say that is about right although some of my drs were not familiar with that. lol

"I did read that being on 2 ADs together for too long can cause the brain to get used to being on both."
I have read research on that as well but I have never read anything on them being harder to come off of.

[fishinghat]

Thank you kindly gardenlady. May God keep and bless you.

Slow but steady wins the race.

[fishinghat]

There are a couple options but the one that seems to be most effective and easy to deal with is ginger products. A lot of pregnant women relie on ginger to help them and it is just as effective for Cymbalta related nausea. Be sure it contains real ginger and not just flavoring. Ginger ale, ginger root, ginger gum, etc.

[fishinghat]

Luckily it is one of the first symptoms to fade away but it still could be quite awhile.

[fishinghat]

I had serious feelings of fear and doom during my Cymbalta withdrawal. I actually slept on a pile of blankets and pillows in my wife's walk-in closet for several months. At night the fear was so bad I often screamed out in desperation. I fought this for nearly 9 months after finishing my Cymbalta. I finally gave up and went on Zoloft.

The Clonidine and hydroxyzine are both for anxiety and will bot help with the depression. It is interesting b8t during my period of doom and fear I had no depression only anxiety. It is amazing how complex and different our brains are.

The only thing I can think if is to stay at your current dosage for a few weeks and see if it gets better. Give your body a chance to recover some.

[juli]

Gardenlady you shouldn't have to deal with this pain an agony for so long.  Ask your doctor to go on another anti-depressant and come off of the Cymbalta.  

[juli]

Don't be afraid to try to go on a new anti-depressant.  You can start it and reduce the Cymbalta when and as slow as you like.  You stabilize and feel good on the prozac and then start to reduce when you feel comfortable.  I hate to think about you in so much pain when this has a very high chance to help.

 

If the Prozac doesn't stabilize you then you could try Zoloft or Lexapro.  

 

You deserve to feel good.

 

Can you talk to your doc about this?

[juli]

I believe when this severe depression lifts and your mood improves you will know it is working. I would try it and see.  Did the doctor give you a start up schedule?

[juli]

By the way, my doctor didn't believe me either.  SHe just gave me this strange look like I was nuts.  Luckily she prescribed the Lexapro and let me manage the taper. 

[juli]

Got it.  I am sure that Fishinghat can help with the schedule but if it were me I would start the new AD as a first step and don't make any reductions until you are feeling yourself again.

 

I really believe that the reductions will be much easier once the new AD has kicked in.

 

Just my very humble opinion.