289 replies to this topic

[juli]

I was just thinking to myself that I am just now starting to feel pretty normal.  It's the kind of thing where I was consistently feeling better but not back to my pre-cold turkey self.

 

I can even have a cup of coffee in the morning without regretting it all day

 

I look back on the past year and just can't believe that a little pill could put me through all that misery.

 

I am still on my Lexapro and am not even thinking about touching it.  Just want to feel good and normal for a while.

[EBB]

THanks FH and Juli.  Hmm.  Lexapro seemed to give her some improvement up to 5mg.  She is taking a total of 200mg of Hydroxyzine over a 24 hr period.  She had taken clonidine before but it was better without it.  Maybe we should try it again.  We have some leftovers somewhere...  As for Xanax, her prescriber is reluctant to give her more benzos as she is already taking 2.5mg per day of Ativan.  But I want it to be Friday NOW so we can see if the neurofeedback will help her.  Thanks for the advice, as always.  You all are the best!

[fishinghat]

Take her bp a couple of times and lket me know what she is running for bp. Do NOT try any of the items below before we see what her bp is.

Maximum dose on the hydroxyzine is 400 mg per day but 200 is a standard dose. IF you want to find out if an increased dose will help try 100 mg the next time it is due.  and see if that brings improvement. Do not exceed 200 mg in a day though or you will run out of tablets.
 
If you try the Clonidine then try 0.1 mg twice a day.
 
Please only try one of these at a time so we can see how they work and by all means keep me posted.
 
I will watch for the bp info.

[fishinghat]

Juli, that is great. Are you planning on weaning of the Lexapro at some time?

[juli]

yes i will at some point in time but not sure when that will be.

[EBB]

Hey this is Chris.  It's been a while since we posted, sorry for the silence.  We're stuck.  EBB has made slow progress up until a couple weeks ago.  She tested positive for a parasite (cryptosporidium parvum) and was advised to take Alinea for it.  After the first course (3 days) she was feeling pretty horrible, but she was encouraged to take another course because it doesn't always completely get rid of it.  She finished the second course 6 days ago and is still feeling totally miserable.  We saw her DO and she suggested we try the 5HTP again.  Didn't help.  She tried more hydroxyzine a while back, and that had no effect at all.  She's been reluctant to increase the Lexapro and is at 7.5mg.  Every time she goes up, she feels bad, and seems to get more pronounced the higher she's gone.  She is really at her wit's end, and we need to do something that will help her quickly.  The thing we haven't tried is Seroquel, which has been mentioned quite a bit in this thread.  I think Juli said it helped immediately but didn't last.  Any thoughts on this?

[fishinghat]

Sorry to hear of the issues she is having.

I did find this.

"7.1 Highly Protein Bound Drugs with Narrow Therapeutic Indices
Tizoxanide (the active metabolite of nitazoxanide) is highly bound to plasma protein (>99.9%). Therefore, monitor for adverse reactions when administering nitazoxanide concurrently with other highly plasma protein-bound drugs with narrow therapeutic indices, as competition for binding sites may occur (e.g., warfarin)."

"Distribution
In plasma, more than 99% of tizoxanide is bound to proteins."
https://dailymed.nlm...54-00144ff88e88

"Duloxetine is highly bound (>90%) to proteins in human plasma, binding primarily to albumin and α1-acid glycoprotein."
https://www.accessda...s011s013lbl.pdf

Cymbalta is a drug that is highly bonded to proteins and therefore would compete with the Aliniea for binding with proteins in the blood. This would reduce the amount of available Cymbalta in the blood and cause an increase in withdrawal symptoms.

I don't know if this helps any but might explain why she fells worse.

Seroquel, clonidine and of course benzos which have their own issues. I can't really think of anything else. Oh, how about L-theanine? Have you tried that?

[gail]

Hi Chris,

So sorry for Ebb. This has been going on for quite a while.

Seroquel, that was me that mentioned it.

Story: I stopped Cymbalta then waited seven months. Then I went on Seroquel 150 xr taken before bed. I was sleepy when I woke up but felt completely normal. That lasted for one month, one month of feeling so normal. Then, it pooped, it stopped working. Then it was trial and error for many years.

Worth a try, doesn't mean it does that to everyone. Best of luck!

[EBB]

Thanks Gail and FH.  The competing Alinea makes sense to me.  She had an improved day yesterday and I'm hopeful it is the Alinea getting out of her system.  She was also low on zinc so she took a very small amount from a cold-eeze lozenge (so she doesn't get a copper dump) and that might have contributed to the improvement too.  Fingers crossed.  Gail, the Seroquel must have been very frustrating getting your hopes up and then suddenly not working!  We'll keep Seroquel in our back pocket.

[gail]

Hi Chris, hope Ebb is getting better as the alinea gets out of her system.

Oh yes Chris, after 30 days of well being, it was a huge disappointment. So huge.

[EBB]

Hey it's Chris.  One thing that we're wondering about is Lamictal.  I know there are a lot of false positive diagnoses of bipolar with Cymbalta withdrawal, but some of the description of Bipolar II seems to resonate for her.  Lamictal is indicated as a strong choice for it, and her genetic tests show that there are no contraindications for her.  There are scary side effects for a very small percentage of people.  I see in the summary some stuff about withdrawal when coming off of it too fast.  Just wondering if you've come across anyone who has had a good or bad experience with it in alleviating withdrawal symptoms.  She has COMT gene variant, and you mentioned Lamictal has been used for helping this.  What do you think?  Is it worth trying?

[fishinghat]

A lot of people had good experiences in using it to handle Cymbalta withdrawal. There was a couple of comments about excessive habits while on both together. Spending lots of money and/or drinking lots of alcohol. The degree of withdrawal varies a lot. Some say a few weeks and no issues and others say as bad as Cymbalta. Don't you just love prescription meds?

[EBB]

Thanks FH and GL.  I would definitely rather not add more meds with their butterfly effect of more issues.  We are waiting to see how she does before we jump into this stuff.  It's been pretty rough for her, and we just need the next step in our plan should we need it.

[EBB]

Hey people.  Chris (husband) here.  So EBB is definitely better, but still not stable.  She had a really bad day yesterday, but better today.  She is trying Lamictal and seems to tolerate it well.  We've been on lookout for rash, but nothing so far.  Other new elements she's trying are Gabapentin and Progesterone.  Couple of questions:

1. Should she move her 10 beads of Cymbalta to night time?  She seems to feel yucky in the morning and by evening it seems to be better.  The suspicion is the 10 beads of Cymbalta is making her feel bad.  Wondering if it makes sense to try taking it at night so that she's unconscious for the majority of the cymbalta's effects.

2. Is it time to drop a bead?  I know she hasn't COMPLETELY stabilized yet.  But I think the Cymbalta contributes to her lack of stability, especially given that there is a predictable pattern of her feeling better at the 12 hour mark from taking the Cymbalta.  She's taking 8.5mg Lexapro, so I'm thinking she could have less issues with the wean.

 

What are your thoughts?

[juli]

Have you thought about increasing the lexapro a bit so that it provides more stability?

[fishinghat]

"Wondering if it makes sense to try taking it at night so that she's unconscious for the majority of the cymbalta's effects."

Possible but she won't sleep as well if she is 'uncomfortable'.

'...especially given that there is a predictable pattern of her feeling better at the 12 hour mark from taking the Cymbalta.'

If you have that type of cycle you can usually level it off by taking 5 beads in the morning and 5 in the evening.

As far as when to drop a bead well I would suggest she just listen to her body. She should know when she feels strong enough to drop. Any doubts, don't drop.

The increase in Lexapro is an option as well. Is she looking to come off all antidepressants or just Cymbalta?

[EBB]

Thanks Juli and FH.  I think she is less concerned about being on the Lexapro right now, so going up on that is an option too.  I'd like her to be at 10mg just so it's a single pill instead of cutting pills and getting liquid for the difference.

 

As for taking 5 beads at night and 5 beads in the morning, wouldn't that make her feel yucky around the clock?  I'm also wary of messing up her sleep by doing the Cymbalta at night.  She does get up several times in the night, and if she is anxious then, she might have trouble going back to sleep.

 

Thanks again for the advice. You people rock.

[invalidusername]

"As for taking 5 beads at night and 5 beads in the morning"

 

This will balance out the blood levels as Cymbalta has a short half life. A lot of people do this, and it should, in theory, aid the anxiety. 

 

If there has been issues taking it too close to sleeping, then of course I would advise against it.