12 replies to this topic

[popprincess]

Hi everyone,

 

Thank you for all of the information you have provided on this site. At the moment I'm finding it overwhelming to comb through, so I'm wondering if someone can give me some advice for my specific problem. I am in a very bad place.

 

Currently I am on 13mg of Cymbalta (and 200mg of Wellbutrin). After taking Cymbalta 60mg / Wellbutrin 200mg for two years (before that, I had been on some combination of SSRIs and Wellbutrin for the previous 15 years), I began to taper off the Cymbalta for the past year as follows:

 

Sept-Nov 2017: From 60mg to 0mg. This was WAY too fast; shortly after I got to 0 my withdrawal symptoms became very severe and I went back to 40mg.

 

Nov 2017-Jan 2018: Stayed on 40mg.

 

Jan-May 2018: Slowly tapered from 40mg to 20mg, stopping at a dosage whenever I felt symptoms until they stabilized.

 

May-early August 2018: Same as above from 20mg to 12.5mg.

 

Last three weeks: Stayed on about 13mg.

 

I had been managing the very slow taper well from 40mg to 13mg. But for these last three weeks on 13mg, my symptoms have been very, very bad. My anxiety is absolutely crippling, especially in the mornings. Because of this, two weeks ago I started to take 7.5mg in the morning and 7.5 in the evening to try and extend the Cymbalta's half life, but it doesn't seem to have helped. These last couple of days, my anxiety has extended throughout the day. I also have diarrhea and stomach aches every morning.

 

I am not being monitored by a doctor. I recently lost my insurance and, anyway, the psychiatrist I was seeing had told me to take Cymbalta every other day to wean off it, which was obviously a disaster.

 

I'm determined to come off this drug but terrified that I won't be able to. I'm at the point where I'm considering packing up my life and moving home (my home is in a different country so it would not be a small deal) until these symptoms subside because I'm unable to function on my own.

 

Here are my questions. Please let me know if you have any advice that you think could help ease this pain.

 

1. Should I keep toughing it out through withdrawal at this dose or should I increase my dosage? I am very reluctant to increase but also pretty desperate--if so, what is the best way to increase with fast results without having to go up too much?

 

2. How long will this withdrawal last? I know no one knows, but... what is a reasonable amount of time to give myself to adjust to a dose before giving up and increasing?

 

3. How long does it take for the symptoms to "catch up" with the dose? Meaning--am I reacting right now to the drop from 40 to 20mg? Or from 20 to 13?

 

4. What if my brain just doesn't work anymore? I've been on SSRIs or SNRIs my entire adult life. Is this my brain just not knowing how to function on its own? Is there any hope for me to be off these things or am I stuck?

 

I am so, so scared and feel so alone. 

 

 

 

 

 

 

[gail]

Hello PPrincess,

Welcome to the forum. The first thing we !earn when we come here, is Slow and Patience. There is no fast way to do it unless looking for trouble.

Now, 3 weeks at 13 of so mgs. Probably too fast. The last mgs are the toughest. I would reinstate to 20mg, when stabalized, the proper maner is to bead count. Exemple, remove 3 beads the first day than 6 on the other then 9 and so on. So yes, reinstate for question #1.

Reinstating at 20mg will procure fast enough relief. If you were feeling ok at 20, you are reacting to the last decrease. If you were not feeling your oats at 20, reinstating at 30 would be better. I will leave the rest to Fishinghat, pretty tired at the moment. Don't hesitate to ask questions, our leader has lots of knowledge! You'll be ok Princess.

[popprincess]

Hi Gail, thank you so much for replying and your kind words.

 

I have been doing the bead removal method--it actually took me 12 weeks to go down from 20mg to 13mg, sometimes removing just one bead a week, and now I've been on 13mg for three weeks. So I am frustrated at the thought of having to undo that painstaking work by going back up to 20 or even higher. I'm wondering if it may be enough just to go up by a couple of milligrams.

 

How long do you think I should wait for the new dose to kick in before deciding whether or not to increase even more? (Fishinghat, please feel free to answer this one on Gail's behalf if you can!)

[fishinghat]

Hi popprincess

First of all if you have been doing the bead counting and are down to 13 mg I wouldn't go all the way up to 20. I would increase by 1 or 2 beads over your current dosage. It will normally take 12 to 48 hours to feel any improvement.

How long will it last? Well I would say 6 to 8 months is average after your last dose. I have seen as little as 3 weeks nd as long as 2 years.

"what is a reasonable amount of time to give myself to adjust to a dose before giving up and increasing?"

I guess that just depends on how bad the symptoms are. It is not unusual for it to take 3 to 6 weeks to stabilize even after a 1 bead drop at your current dosage.

At your current level it usually takes 12 to 36 hours to see the effect from a drop in dose.

" Is this my brain just not knowing how to function on its own? Is there any hope for me to be off these things or am I stuck?"

Antidepressants, benzos and psychotics actually effect the protein transporters for neurotransmitters or the synapses they bind to. Once the AD is removed from your system it takes your brain and nervous system to fully return to normal (according to research). This is one reason this is such a slow process. But the good news is that function of the brain does return to normal or near normal levels in nearly all cases.

By the way, have you considered hydroxyzine and/or clonidine for the withdrawal. They don't work for everyone but for some (including me) they are a big help. Neither drug has withdrawal or are addictive.

Where I live generic clonidine is a $4 prescription so not to expensive.

"I'm wondering if it may be enough just to go up by a couple of milligrams."
You shouldn't need to go up a couple milligrams just 1 or 2 beads. How many beads in your capsules?

 

Obviously this are typical values and people do vary a lot.

 

Last but not least. You are NOT alone anymore when dealing with this. We are here for you if you have questions, want to vent or just talk.

 

Hang in there. Slow and patient.

[popprincess]

Dear Fishinghat,

 

Thank you so much for your reply. 

 

My 20mg capsules have 100 beads, so I am currently taking 65 beads (split into two doses morning and evening). I will try adding a couple and going from there--12 to 48 hours is not too long for me to be able to wait and see if the dosage increase helps.

 

And thank you for the info about 3 to 6 weeks! I hadn't realized it would take longer to stabilize at the lower dosage, so now it feels less scary that my withdrawal symptoms have been going for so long. 

 

I will look into clonidine or hydroxizine--I'm seeing a new primary care doctor on Wednesday, so maybe she will be able to help with that.

 

One question: do you think it's wise to be taking the Cymbalta in two doses? I always took it only in the morning, but for the last three weeks my anxiety has been severe each morning, so I switched to taking it morning and evening hoping that the evening dose would "cover" the morning better. But it doesn't seem to be helping much.

 

Thanks!

[fishinghat]

Yes, dropping below the 5 mg level is particularly tough. One ahs to be extremely patient.

 

The two dose idea is excellent. It provides for a more stable blood level of Cymbalta and should help some.

 

Hang in there.

[gail]

Hello Princess,

I'm sorry as I hadn't realized that you had bead count to 13 mg. I just thought that you had made a sudden drop. Mes excuses!

So on this Fishinghat has given you geat advice, even though I would have suggested going back to 15mg. One thing for sure, don't go down before you have stabalized for a while.

We're here for you Princess even though point of views may vary(in milligrams), lol!

[popprincess]

No worries, Gail! I figured you had just misread my first post. 

 

How long after stabilizing on the slightly higher dose do you guys think is ok to start tapering again?

[gail]

Hi PPrincess,

I would wait about a week or so. Update us as you go on, please! Thank you.

[popprincess]

Hi Gail and FishingHat,

 

So after bumping up to 14mg for almost a week I've been on 15mg for the last 48 hours. But my anxiety has not improved at all--in fact, the last couple of days seem even worse.

 

I'm so desperate now that I'm thinking of going all the way back up to 20mg and hoping it does the trick. I'm under a lot of stress because I need to move in the next couple of weeks and still don't have a place to go, and I am basically not functional and struggling to get anything done.

 

Do you think I should go up to 20 or keep going up slowly? I hate throwing away 4 months of work getting down to this level, but... I am feeling really hopeless.

 

Also, the symptoms are much worse in the mornings--do you know why this might be? I tried splitting the doses into morning and evening but it doesn't seem to be helping.

 

Thank you in advance.

[fishinghat]

Going back to 20 may be a good idea. These bouts of stress during withdrawal can really set you back. By going to 20 you may get some relief, handle your move, etc, and then go back to weaning. It will also give your body a chance to recover some.

The only thing I can think about with the morning withdrawal is that is when your body is lowest in serotonin. As the sun sets your body begins to convert it's serotonin to melatonin so sleep an be induced. During the night the serotonin levels continue to drop reaching their lowest right after sunrise. As the sun comes up your serotonin will continue to rise until around 10 or 11 AM when it approaches its peak. Just a thought.

[popprincess]

Thank you so much, FishingHat. I've decided to start 20mg to give myself a break. I'll let you know how it goes.

 

Hmm, the weird thing is that the withdrawal anxiety has been ok in the early morning and then at its worst from 10am-1pm. So that doesn't really make sense with your theory. It's a mystery, I guess!

[gail]

Wise decision Princess,
We'll see you back when the timing is right for you!