26 replies to this topic

[whosthat]

I was on for about 9 months. Quit cold Turkey for 1.5 months. At which point I started having what I consider to be panic attacks in conjunction with or perhaps because of my inability to breathe. It's not exactly like I couldn't breathe, but that my breathing was somehow inhibited.. This I think led to panic and anxiety which made the breathing problems worse. Tightness in chest, upper back, fatigued when walking up the stairs, increased general heart rate.

 

For brevity's sake my history then is... 9 months on, 1.5 months off, 1.5 months on, 1.5 months off, 3 days on, now i've skipped my last dose and am on day 2 of being off after have only used 3 days in the last 1.5 months.

 

 

The breathing issues after having been off this last time were immediately remedied after only using for 3 days again.

 

I went to the doctor and he said he did not think I was in danger, but that having suddenly stopped the drug could be responsible. He actually recommended I go back on it. I find the medical community painfully ignorant about this drug. After having got off the first time I actually went to the ER because I thought I was having a heart attack and they ended up giving me a shot of Benadryl and marking my reason for visit "stuffy nose."

During this visit one of the nurses actually commented "You shouldn't have any withdrawal symptoms from Duloxetine."

 

 

I guess my question is this, and maybe this forum isn't the appropriate place, but my general doctor doesn't think there are generally side effects to this medicine, a psychiatrist told me I could quit cold turkey with no issues, my current psychiatrist doesn't seem too "impressed" by cymbalta withdrawal, and ER nurses have told me there are no withdrawal symptoms, so I don't know who to ask.

 

 

Is it simply a matter of waiting it out for the drug to completely leave my system before my breathing returns to normal? Is there something else I should do? It's causing me panic attacks which I'm taking Klonopin for.. doesn't help much. Or is this something that has damaged me in a way which will require my continuation of this drug? The breathing issues absolutely and without doubt completely subsided after having been back on the drug for 3 days. And now I've missed a dose and been 36 or 48 hours without and they are back. 

 

Such a nasty drug.. thanks for any advice

[fishinghat]

Welcome Whosthat
 
Actually breathing problems have occurred with many of our members during withdrawal.
 
Also, Benadryl is a standard treatment for many withdrawals and OTC Benadryl has been used successfully by many of our members. It contains diphenhydramine which is anxiolytic.

"During this visit one of the nurses actually commented "You shouldn't have any withdrawal symptoms from Duloxetine."
 
You are right, drs can be idiots. There are a number of FDA warnings about Cymbalta withdrawal. By the way the FDA has a black box warning about cold turkey withdrawal as it can cause seizures, suicidal thoughts, and many other serious complications. The FDA recommends bead counting to withdraw from Cymbalta.

"I guess my question is this, and maybe this forum isn't the appropriate place, but my general doctor doesn't think there are generally side effects to this medicine, a psychiatrist told me I could quit cold turkey with no issues, my current psychiatrist doesn't seem too "impressed" by cymbalta withdrawal, and ER nurses have told me there are no withdrawal symptoms, so I don't know who to ask."

This is definitely the right place to ask. I literally have a library of information on Cymbalta withdrawal research, manufacturer's statements, court cases, and medical research. It is a well known condition but since the FDA has issued its statements on the severity of Cymbalta withdrawal there has been no requirement to retrain drs. So the drs are operating in the dark.

The breathing problems typically subsided after 2 on 3 months for most members. It is a shame you went back up all the way to your full dose. Most of our members do bead counting. You open a capsule and count the beads inside(usually around 300). And then remove 1% of the beads a day until down to zero. This provides a slower smother withdrawal and not as severe symptoms as cold turkey. Considering you have been off for 1.5 months and only back on for 3 days I would consider counting your beads and taking say 10 mg a day. If that is not enough for relief you can always go up to 15 mg and so on until you find what minimum level brings relief. Then when stable bead count from there.

I am sure you are going to have question s so don't hesitate to ask or just come back and complain. We will look forward to your updates.

[Raven72]

Welcome whosthat,

You have come to the right place for help. This is a horrible drug and the medical community can be extremely naive about its side effects.

While being on it has it's own set of aide effects, it is the withdrawal from it that had the worst side effects.

As for the not being able to breath, this one is new for me. My guess would be that brain zaps are involved. You said that your inability to breath triggered your panic and anxiety attacks. This may sound off but I think that the panic and anxiety caused the not being able to breath. I know it sounds odd but the common brain zaps can make you think one thing when it is actually the opposite.

We offer advice here and it is up to you to accept it. I suggest looking for a new therapist and primary care giver. I had to do this because my primary only wanted to raise my dose and not wean me off of it.

Our resident medically knowledge Fishinghat will chime in shortly. Please feel free to private message me if you have questions you wish not to be aired publicly. If I do not know the answer then I will find it.

Blessed Be,
Raven

[Raven72]

Well....woukd you look at that. He was posting when I was.

[whosthat]

Welcome Whosthat
 
Actually breathing problems have occurred with many of our members during withdrawal.
 
Also, Benadryl is a standard treatment for many withdrawals and OTC Benadryl has been used successfully by many of our members. It contains diphenhydramine which is anxiolytic.

"During this visit one of the nurses actually commented "You shouldn't have any withdrawal symptoms from Duloxetine."
 
You are right, drs can be idiots. There are a number of FDA warnings about Cymbalta withdrawal. By the way the FDA has a black box warning about cold turkey withdrawal as it can cause seizures, suicidal thoughts, and many other serious complications. The FDA recommends bead counting to withdraw from Cymbalta.

"I guess my question is this, and maybe this forum isn't the appropriate place, but my general doctor doesn't think there are generally side effects to this medicine, a psychiatrist told me I could quit cold turkey with no issues, my current psychiatrist doesn't seem too "impressed" by cymbalta withdrawal, and ER nurses have told me there are no withdrawal symptoms, so I don't know who to ask."

This is definitely the right place to ask. I literally have a library of information on Cymbalta withdrawal research, manufacturer's statements, court cases, and medical research. It is a well known condition but since the FDA has issued its statements on the severity of Cymbalta withdrawal there has been no requirement to retrain drs. So the drs are operating in the dark.

The breathing problems typically subsided after 2 on 3 months for most members. It is a shame you went back up all the way to your full dose. Most of our members do bead counting. You open a capsule and count the beads inside(usually around 300). And then remove 1% of the beads a day until down to zero. This provides a slower smother withdrawal and not as severe symptoms as cold turkey. Considering you have been off for 1.5 months and only back on for 3 days I would consider counting your beads and taking say 10 mg a day. If that is not enough for relief you can always go up to 15 mg and so on until you find what minimum level brings relief. Then when stable bead count from there.

I am sure you are going to have question s so don't hesitate to ask or just come back and complain. We will look forward to your updates.

 

Well I did not exactly go back to my dose. The 9 month period was 60mgs and the subsequent period was 30mgs, with this last 3 day period being 20mgs. The thing surprising to me is that it seems only after having been off the drug for 6 weeks or so do the breathing problems come... I would think after 6 weeks it would be mostly out of my system. So perhaps it has some anxiolytic properties to me which are then removed at the 6 weekish marker and my anxiety returns?

I have do also have fibromyalgia, anxiety, depression and borderline personality disorder and have been suggested to have derealization/depersonalization and schizotypal disorders from other psychologists. Those are probably interfering in some way.

 

I do recall prior to having ever used duloxetine that I was having some panic and anxiety issues.. so I'm wondering if maybe my natural state is one in which I may suffer anxiety or panic attacks, resulting in the breathing difficulties.. So maybe it is actually helping with those, and only having gone off for an extended period of time causes them to return? That might explain the 6 weeks of normal breathing? But then I've read other people have had these issues.. So I'm not sure if it is the withdrawal or if it is my anxious self bereft of the aid in at least this one sense duloxetine was providing.

 

I feel so terrible all the time with my mental health and fibromyalgia issues and I've been through cymbalta withdrawal so much now that I'd rather not take it again. I am just very much wondering now if it isn't the case that it may have actually been helping with the panic, and not causing it via withdrawal. Any thoughts?

Welcome whosthat,

You have come to the right place for help. This is a horrible drug and the medical community can be extremely naive about its side effects.

While being on it has it's own set of aide effects, it is the withdrawal from it that had the worst side effects.

As for the not being able to breath, this one is new for me. My guess would be that brain zaps are involved. You said that your inability to breath triggered your panic and anxiety attacks. This may sound off but I think that the panic and anxiety caused the not being able to breath. I know it sounds odd but the common brain zaps can make you think one thing when it is actually the opposite.

We offer advice here and it is up to you to accept it. I suggest looking for a new therapist and primary care giver. I had to do this because my primary only wanted to raise my dose and not wean me off of it.

Our resident medically knowledge Fishinghat will chime in shortly. Please feel free to private message me if you have questions you wish not to be aired publicly. If I do not know the answer then I will find it.

Blessed Be,
Raven

Oddly enough the first time I got off (60mgs, 9 months) I had brain zaps for some time, but after having used 30mgs for 6 weeks I had no brain zaps.

 

 

It's such a tough spot because with the fibromyalgia I have all sorts of odd bodily perceptions, from muscle twitching to random tingling and numbness on any part of my body, to general fatigue...Which I find the duloxetine does actually help with. But then it causes my sleep to be completely erratic. Sort of paradoxical in that when I take duloxetine I am a bit less fatigued but I feel like I always need to sleep, and when I'm not on it I feel intense fatigue but not necessarily like I need to sleep.

 

Really unsure what to do. I have been to so many doctors and psychiatrists and they just don't seem to help me. I tell them absolutely antipsychotics DO NOT AGREE with me and they push them on me. I have psychological evaluations indicating borderline personality disorder as well as the agreement of multiple psychologists that I have it, yet my current psychiatrist says no, I don't (his citing that people with the disorder experience dissociation from reality--- of which I have also been "diagnosed" and have expressed to this very doctor multiple times!!!! I am so disappointed with how hard it is to find help for my issues.

Anyway that wasn't strictly relevant just venting I suppose...

 

I thank you both for your kind words and input

[fishinghat]

"... I would think after 6 weeks it would be mostly out of my system."

It is nearly all out of your system after 4 days. This is not a side effect but the symptoms are from withdrawing the drug. When on the drug the Cymbalta controlled the use of both serotonin and norepinephrine. During this period the synapses change shapes a little bit to better fit the drug. Once the drug is removed the body is confused. It has forgotten how to control these two neurotransmitters AND the synapses are the wrong shape to properly interact. It has been shown that for most anxiety drugs and ADs it takes 2 years for these synapses to return to normal. The symptoms from this lack of control are numerous and usually severe. If you look at Wikipedia at he body's uses for serotonin and norepinephrine you will see they are involved in nearly all of the body's organs and functions. Until these nerves heal properly and the body learns to gain control again it is a battle.
The symptoms for withdrawal goes through stages. First is usually some digestive issues and some flu-like symptoms, then the breathing, itching, brain zaps, and other electrical impulse issues. Finally the deep anxiety, fear and panic. Now I must mention that everyone is different. Not everyone gets all symptoms but this is the gereral pattern.

"I do recall prior to having ever used duloxetine that I was having some panic and anxiety issues.. so I'm wondering if maybe my natural state is one in which I may suffer anxiety or panic attacks, resulting in the breathing difficulties"

 

I have to agree with Raven on this. Panic attacks and anxiety are part of what is called a Chronic Adrenergic State, or if you will a state of chronic adrenaline production. The extra adrenaline in your system stimulates all the adrenaline synapses and causes elevated blood pressure, nervousness, restlessness, tightness in muscles, especially in chest muscles. This is often compared to having a big rubber band around your chest. It causes the heart to race and pound as well. This tightness in the chest can be severe and cause the difficulty in breathing.

 

All this will fade. You may want to stay at the 30 until stable and then bead count or as I originally suggested try going to say 10 mg a day and see if that is enough. You can always up the dose if needed.

[whosthat]

"... I would think after 6 weeks it would be mostly out of my system."

It is nearly all out of your system after 4 days. This is not a side effect but the symptoms are from withdrawing the drug. When on the drug the Cymbalta controlled the use of both serotonin and norepinephrine. During this period the synapses change shapes a little bit to better fit the drug. Once the drug is removed the body is confused. It has forgotten how to control these two neurotransmitters AND the synapses are the wrong shape to properly interact. It has been shown that for most anxiety drugs and ADs it takes 2 years for these synapses to return to normal. The symptoms from this lack of control are numerous and usually severe. If you look at Wikipedia at he body's uses for serotonin and norepinephrine you will see they are involved in nearly all of the body's organs and functions. Until these nerves heal properly and the body learns to gain control again it is a battle.
The symptoms for withdrawal goes through stages. First is usually some digestive issues and some flu-like symptoms, then the breathing, itching, brain zaps, and other electrical impulse issues. Finally the deep anxiety, fear and panic. Now I must mention that everyone is different. Not everyone gets all symptoms but this is the gereral pattern.

"I do recall prior to having ever used duloxetine that I was having some panic and anxiety issues.. so I'm wondering if maybe my natural state is one in which I may suffer anxiety or panic attacks, resulting in the breathing difficulties"

 

I have to agree with Raven on this. Panic attacks and anxiety are part of what is called a Chronic Adrenergic State, or if you will a state of chronic adrenaline production. The extra adrenaline in your system stimulates all the adrenaline synapses and causes elevated blood pressure, nervousness, restlessness, tightness in muscles, especially in chest muscles. This is often compared to having a big rubber band around your chest. It causes the heart to race and pound as well. This tightness in the chest can be severe and cause the difficulty in breathing.

 

All this will fade. You may want to stay at the 30 until stable and then bead count or as I originally suggested try going to say 10 mg a day and see if that is enough. You can always up the dose if needed.

 

Yes, that is it exactly. But it sounds like you're saying this may be part of panic/anxiety issues I have. Are you saying having those in conjunction with withdrawal may be exacerbating the issues and that in time I will feel better? Basically that I may have some mild panic/anxiety disorder which is aggravated by withdrawal? I have not actually had the muscle tightening or "rubber-band" feeling prior to duloxetine, so perhaps that is it.

Thanks so much

[Raven72]

Anytime 🙂 We are always here for you. I certainly was not trying tell you what to do, just offering suggestions.

[Raven72]

The anxiety and panic attacks are different for each individual. However, in answer to your question, yes. They are enhanced withdrawal symptoms. How long it takes you to feel better depends on how quickly your body has a tendency to heal both externally and internally.

I have been free from the MONSTER for 1 years exactly today. I still have minor setbacks along with the occasional anxiety spell, but no panic attacks in over a year. It gets better with time and we are here to help you with it.

[whosthat]

 "You may want to stay at the 30 until stable and then bead count or as I originally suggested try going to say 10 mg a day and see if that is enough. You can always up the dose if needed."

 

 

I was on 30 for 1.5 months and then off for 1.5 months and then on 20mg for 3 days and now off for 2 days. After being basically off for 6 weeks you think it still best to start taking it again?

[whosthat]

The anxiety and panic attacks are different for each individual. However, in answer to your question, yes. They are enhanced withdrawal symptoms. How long it takes you to feel better depends on how quickly your body has a tendency to heal both externally and internally.

I have been free from the MONSTER for 1 years exactly today. I still have minor setbacks along with the occasional anxiety spell, but no panic attacks in over a year. It gets better with time and we are here to help you with it.

 

My issue now is that I really need some form of help through medication, but I'm scared to try anything else because of side effects. I've been on some things for a single dose and had such a horrible high and dissociation from reality I never took them again. But things like duloxetine are more nefarious- at least in my case- where by the time many months had passed and i started noticing side effects I was already dependent on  the medicine. Will have to ask my doctor about a mild anti-depressant I guess

[fishinghat]

"Basically that I may have some mild panic/anxiety disorder which is aggravated by withdrawal?"

Raven got it right with "yes"

Your suggestion about a mild antidepressant is worth considering. Normally Zoloft, Prozac and Lexapro are considered the easiest to deal with. Just a suggestion. You might also talk to the dr about hydroxyzine and or clonidine which are not addictive and have no withdrawal.

[Raven72]

There are mild antidepressants out there to help. I would not suggest Paxil from personal experience. It did bad things to me and made my recovery much worse.

I would like to correct my statement of sobriety from Sinbalta. Yesterday was 2 years sober from this horrible drug. It can be done with hard work and support.

[Cjmansf]

I have had breathing issues during use and now in withdrawal. Just as you described. Out of breath going up stairs and such. Early on after stopping I had a tight chest nearly 24/7. Discomfort that radiated through to my shoulder blades. I still get this at 8 wks off from time to time. The breathing thing seems to finally be letting up here and there.

[fishinghat]

You might try some lemon balm tea. It has a weak beta-blocker in it which may give you some relief.

[Raven72]

How are we feeling today?

[TryinginFL]

https://www.facebook...1478980/?type=3

[TryinginFL]

thanks for asking, Raven - how about you?

 

I had a long message typed here and it went POOF as so many do - makes me so angry!

 

Perhaps I can do better later - bear in mind that video I just posted - Many thanks to the poison drug for one of its many gifts

[Raven72]

I seem to be doing alright. I had to take a long nap today. For some reason I was worn out after only being up a few hours.

[TryinginFL]

Raven,that fatigue seems to come and go....I still have days where I could sleep at any hour..

[Raven72]

I know, I guess I thought after 2 years it would have tempered off some. I can't sleep at night because my husband works nights. I don't get in the bed until after 1am.

[gail]

 "You may want to stay at the 30 until stable and then bead count or as I originally suggested try going to say 10 mg a day and see if that is enough. You can always up the dose if needed."
 
 
I was on 30 for 1.5 months and then off for 1.5 months and then on 20mg for 3 days and now off for 2 days. After being basically off for 6 weeks you think it still best to start taking it again?

Just saw your post Whosthat, my opinion here is to reinstate to 30 mg, stabalize, then bead count. I would not change for another antidepressant for the moment. What do you think Whosthat?

[whosthat]

How are we feeling today?

 

 i dont' know. it's hard to say if it is my mental illnesses making me feel horrible, the fibromyalgia, the withdrawal. life is so hard. i'm trying to work now after not having a job for 3 years. 27 years old. live with my mom. between the pain, depression, intense anger due to personality issues, life is really hard. i seem to be allergic or sensitive to every medication i take. i can't even take benadryl without horrible stomach upset and unpleasant feelings. klonopin helps but only to the extent it essentially shuts my brain off.

i've been in and out of psychiatrists and psychologists since i was probably 11. somehow i don't think i'll get better.  nearly quit my job today. i felt like a heroin addict because i was so stressed out i just took a klonpin out smashed it and drank it down then took a deep breath. like an addict getting their fix. not that i abuse them. i probably don't generally even use the 2mg i'm allotted per day.

 

for some dumb reason i wanted to see if alcohol would help me sleep (literally took precisely 1 ounce of vodka) and no luck. feel horrible actually. first drink in probably 2-3 years. won't be doing that again.

i met a girl who seems pretty cool. but in my situation it's hard to connect with anyone. almost seems unfair to try to "lure" someone into my world of pain and suffering. and the scars all over my body from cutting don't ever get easier to explain, especially as they've accumulated over the years. don't really have anyone to talk to in real life. my psychologist actually asked me if i was in pain and i looked at him like he was an alien and told him i have fibromyalgia (he knew this). he presses.. but are you in pain now?

man.. i'm in pain every day of my life. and even in cases where the pain is only slightly present, it's replaced by a crippling fatigue. i have so much fatigue my forearm muscles are suffering to write a few paragraphs. this says nothing of the psychological pain from intense isolation, hopelessness, dread, etc. like someone took a damp blanket and threw it on top of my brain. just burdened by this sort of haze of uncertainty, regret, misery, etc. it's like an umbrella is attached to my head but i keep running around trying to feel the sun. it cant happen. alone in a world full of people. or a room. perhaps even laughing with someone but feeling absolutely nothing inside. i remember with nostalgia and wanting my younger years

 

anyway hope everyone is well.

Just saw your post Whosthat, my opinion here is to reinstate to 30 mg, stabalize, then bead count. I would not change for another antidepressant for the moment. What do you think Whosthat?

i can't do it anymore. i don't want to take it. i am already taking more klonopin than i'd like simply so i can attempt to hold a job. i don't know why i feel so hopeless today. i am reminded of that line from the lord of the rings lately.. i feel worn thin.. like butter scraped over too much bread. i think the scariest part is not when life is difficult and you are fighting to survive, but when life is difficult and you're too tired to fight. that's what gets me

[gail]

Hello Whosthat,

I get it. I just wish that I could take all your pain away. Life hurts!

Your writing is so intelligible, the way you describe your pain, we can almost feel an touch it. So sorry for what you are going through.

Don't lose hope, one day, the sun will shine on you. As it did for me after more than 10 years of internal misery, I began to see the light. Took a long time but it did. I still feel misery but it doesn't last more than four or five days.

Anytime you wish Whosthat, we are always here for you, good or bad. You are not alone!

[fishinghat]

Tough story but not unusual for this site. Have you ever tried hydroxyzine? It is pretty good for anxiety and helps with sleep. You might talk to your dr about it. It also helped me with the Cymbalta withdrawal. Not addictive, no withdrawal either. Just a thought.

Have you looked into Bragg's apple Cider vinegar for the fibro? It actually has helped some here but can be hard on the stomach. If you are interested let me know and I will post some information on it.

I feel like Gail, I just wish I could take your pain and suffering away somehow. Please hang in there and keep us posted.

[TryinginFL]

Good morning, whosthat

 

I, like Gail, can almost feel your pain and what you are going through.  It is similar to how things were for me when I lost my daughter almost 9 yrs ago - she was only 43 and I thought I would fall apart.

 

This is when I was given this evil drug - Dr. said it would help as I could not stop crying.  Yeah, right - it helped that problem but I was not myself while on it.  Drank like a fish, did all sorts of things that I would not do without it.

 

You have my prayers and hope for things to improve soon.  Please be good to yourself.  I find it hard to believe that you are working.  I know that I could not. I also have fibro that was diagnosed about 25 yrs ago and it continues to become more painful as the years go by. 

 

Please keep us updated - yes, someone is always here for you.

 

Liz

[whosthat]

thank you for the kind words, everyone. will look into your suggestions, fishing