222 replies to this topic

[fishinghat]

All of my documents are in the thread "Summary of Cymbalta Withdrawal" in the Medical Support section. There is an index at the beginning of that thread but you may have to do a search to find what you are looking at.

 

I tried your link and it said I didn't have an account so I wasn't able to open it.

 

This site has a "library function" but I have not been able to figure out how to use it.  lol

[invalidusername]

Ah - need to do a bit more searching around then. See if we can work out how to use the library!

 

Really not so good this evening, so might be another veggie pie and crash with a book for now.

[invalidusername]

Guys.... I am REALLY suffering today. Woke up feeling suicidal, and cannot shake it since. 5 hours now...

 

Yesterday I was going downhill as it has been a month without anything stable. I thought that after I went to 20mg Citalopram that I would be on the increase, but I am still the same... or much worse today.

 

I can feel when the depression is related to the withdrawal as it feels like a veil and I can see the light on the other side. I am able to do things I normally do every day without having any negative thoughts. It is still there, but I know I am not driving it.

 

The last two days, I HAVE been driving it. My thoughts are very bad now. They are all focused on not being able to get out of this mess. Now I know it is not just the switching of meds, I am very fearful. Without the full dose of either drug, I don't know how I will get through this....

 

My dizzy spells, fatigue etc stopped at the weekend. I still have similar, but these are bought on by my mood.

 

Feel desperate. I don't know if I should increase, and which one? 

[fishinghat]

IUN
 
Can you go on up on the citalopram?
 
Over the next two weeks you may need to go on up on the citalopram and off the Cymbalta. This staying on the fence may not be helping any. Even with that it may be weeks to fully stabilize.

[invalidusername]

Hi FH,

 

Thanks for such a quick reply. It is so good to know you are there. I am very fortunate to have my wife, but as you know, she is also suffering - and today she is also very bad. Not a good place to be at.

 

"This staying on the fence may not be helping any"

 

This was a concern. Whilst I know slow is better physically, but mentally, it is very difficult. My depression is not stable, so I am not coming off because I am better, I still need the support of a drug of some flavor. I have had 10mg of Cit in my system for a while now, but will the 20mg still take longer than 2 weeks to kick in? Do you think I should go 30 Cit and balance this out with a drop to 10mg Dulox first, or just a straight 14 day taper? 

 

Do you also think this has anything to do with the morning/evening switch I started on Friday?

[fishinghat]

"Do you also think this has anything to do with the morning/evening switch I started on Friday?"

That is so hard to say. There are so many variables.

Cit can take up to 4 weeks to fully kick in. That is why so many drs recommend to get the switch over done in 4 or 5 weeks. You will have withdrawal (normally) but the new AD will be slowly kicking in right away.

One thought, both Cit and Dulox regulate serotonin. That's OK BUT Cymbalta also regulates norepinephrine. When you take it your anxiety should drop and 24 hours later the Cymbalta is 75% gone and the anxiety should be elevated. Depression is inversely related to depression so it should be at its highest about an hour or so after the Cymbalta. Does that pattern fit?

I don't kn ow what to day IUN, I wish there was a clear answer.

By the way do you take Benadryl (diphenhydramine)?

[invalidusername]

I understand - always many variables. I started my switch on 3rd September from 60>30mg Dulox and still on 10mg Citalopram. The week that followed was absolutely fine, and then my mood went haywire. Went 30>20mg Dulox and 20mg Citalopram on 23rd September, so I am on week 6 of the cross-taper, so over the 4-5 weeks.

 

My anxiety did drop on Cymbalta, and is hasn't been at all bad, and when it creeps back in, it is stopped in its tracks by either drug soon after I take it. But Citalopram seems to do nothing for my depression. This is what initiated the switch in the first place. 

 

"Depression is inversely related to depression"

 

Did you mean anxiety is inversely related to depression there? They rarely occur at the same time, but as I said, depression is the real problem. I would really like your advice on this as I worry that I am going back to square one, but worse off than I was. What Dulox has done to me while on it, and coming off it, has really worsened my depression, and if Citalopram isn't going to keep me going, then.... I don't know.

 

Unfortunately cannot take Benadryl as allergic to antihistamines (and Ibuprofen, aspirin, paracetamol.....  list goes on)

[invalidusername]

There was talk that the Citalopram may not have been working due to stresses over the last 12 months. The wife had been waiting for an Immigration Tribunal Hearing. Threats of her having to leave the country for months. The successful conclusion to this (start of August) did coincide with me feeling better when on the Dulox. I should have stayed on the Citalopram to see if I improved after the court, but no... I was told to change. Such a mistake...

[gail]

IUN,

I understand your situation of depression, I also wish that I could take it away. I'm battling my own at the moment, not related to Cymbalta.

Every day I pray to God to deliver us from this monster. Let's hope that we feel better soon.

[fishinghat]

"Did you mean anxiety is inversely related to depression there?"

Ooopps.

Yes I did.

Lets try this again.

Anxiety is inversely related to depression so it should be at its highest about an hour or so after the Cymbalta. Does that pattern fit?

So possibly the depression is from the control of norepinephrine by Cymbalta. In our bodies dopamine is converted to norepinephrine and then to adrenaline. So if Cymbalta blocks the reuptake of norepinephrine then the dopamine levels will build and may cause some depression. If the Cit is not taking care of the depression then you may need a stronger dose. Strong enough to offset the elevated levels of dopamine by Cit by decreasing the serotonin levels. Both serotonin and norepinephrine are stimulating neurotransmitters. The maximum effective e dose is 40 mg on the Cit.

Now I must say this is based on some logic but still falls under the category of an educated guess.

[invalidusername]

Gail - thank you for your kind words. It has started to make me cry. Just so very tired of it all. I pray every day, and I know that there was a plan in place for me when I came down here, but I really need an exit button on this part. Bless you Gail. You will also be in my prayers.

 

Fishinghat - I am looking back over my notes. After 2 weeks of dropping to 30 Dulox, I had 8 days solid of bad morning/afternoons (my 11am-5pm), but they all resolved by evening (around 7pm) and from then on were fine. I then had a more stable week when I first dropped to 20/20, but mornings were still not great, but I picked up a lot earlier. This was all when I was taking Dulox in the mornings.

 

Last week a similar one, but a bit more depression in the mornings, and then I switched am/pm last Saturday. Same pattern for 2 days, then Monday was very bad anxiety, yesterday was a mix of both depression/anxiety but managable, and today has been all about suicidal depression... and since I have been writing this, I can feel anxiety coming back. Guys, this is very worrying...

 

Please let me know what you think. 

[fishinghat]

I just don't see you gaining much ground. If it was me I would go straight to 40 mg on Cit and drop the Cymbalta and try to hang in there for a few weeks to see if the Cit kicks in enough to bring relief.

 

No good reason why that approach other than those who do cross-tapering slowly often wind up in a chaotic state. Can't guarantee it will work but...

[invalidusername]

I think you are right. 

 

Today I have eaten well, drank plenty, worked my full hours, been out for a good walk, done the grocery shopping - and nothing has changed with my mood. Goodness knows how I have managed it, but this just is not right.

 

As hard as I have tried to do this slowly to ease the physical effects, I need to sort this out. I will admit that I took the dulox earlier this evening (2.5 hours ago) in desperation. It has hardly touched me. I just don't think 20mg does anything for depression. 20mg Citalopram is the minimum therapeutic dose, and if it is likely to take longer than 2 weeks to kick in, I am sitting on a very low dose here.

 

I have never been suicidal ALL day before. The closest was when I first came off Citalopram last year in 2 weeks under doc's orders (which put me back in to square one). I pray that this won't be the case again...

 

...and all because of the pills that bought this site into being. 

 

I'll keep checking in. 

 

Liz, Gail... good old FishingHat (you inferred the old!), thank you for leading the proverbial blind lamb.

[fishinghat]

Keep us posted.

[gail]

Hi Scrat,

I hope you don't mind me calling you by Scrat. He's Fishinghat s favorite and also my brother loves him dearly.

I was about to advise you to do the same thing, jump to forty and give the rest of Cymbalta to Scrat...i can see his long nose sniffing it and go Beurk! I re!ated some time ago that while on Cymbalta, I had suicidal ideation once while on it and once in withdrawal. It scared the shit out of me. Seems it's doing the same to you.

I have been on seven antidepressants and none ever done this to me. Don't worry, it will pass. In the meantime place your hope on the 40mg citalopram and hope that God is in it...

We will follow you all the way Scrat! With love, Sid...

[invalidusername]

Thanks Gail. 

 

It does worry me to do this jump so quickly while the Citalopram is still building up, but it is the lesser of two evils in my case. I am very relieved that I feel a little better today. Again no reason, just do. I had to pop a couple of Valium's to sleep last night. It was just horrific. Just like you say. Still very anxious that it will return, but that I must expect as it is only the next day. I have the withdrawal hangover....

 

Still - there must be the end of these pains in sight. I've taken half the band-aid off, just got to rip the last of it and feel the sting for a bit.

 

Much hugs Sid!

[invalidusername]

OK - so I have taken the plunge is so much that I am now 30mg Citalopram and 10mg of Dulox. I know I am going to feel the hit, but nothing can be worse than Tuesday. Although yesterday was a bit of a respite (and very welcomed), today was a bit of a struggle. Thoughts got me as soon as I woke. But I carried on with my day and just had to stick it out. Again, full day of work, did shopping etc, but the underpinning depression is still there. If I gave it attention, it would immediately hit me. It is such a struggle. I long for the days when I could have 24 hours of relaxation and happy thinking. Just one day. Just once. 

 

Sigh. 

 

Thinking of you all.

[fishinghat]

"Again, full day of work, did shopping etc,"

You know the harder you push it the m ore stress and withdrawal symptoms you will have. It will also cause the withdrawal to last longer. You need to stay busy to stay distracted but with none stressful activities like reading a book, watch TV, listen to some relaxing music etc. Be as easy on yourself as possible.

[invalidusername]

You are right. The issue is that I need to earn money to pay bills and so forth, and get the shopping due to agoraphobic wife. It is a struggle, and I worry I am near breaking point. I am putting in boundaries as best I can. Maybe I need to be a little more stringent. 

 

One thought I wanted to run by you fishinghat. It hasn't escaped my notice that I went downhill three days after the morning/evening switch. I said I wouldn't do, and in hindsight, I should have stuck at it. 

 

So, with a half-life of 12 hours (at best), I am getting the best of the Duloxetine while I am asleep. I am taking it at 11pm, thus waking when more than 50% has left my system. Taking the Citalopram at night would not have the same effect. So, I am thinking that by switching my 20mg Dulox from 11am to 11pm, I have in effect, lost best part of the effects of this dose.

 

What do you think?

[fishinghat]

One way to find out, switch back and see what happens. If I remember right you were having bad depression in the morning (???) the other way though. Is that pattern changed now?

[invalidusername]

Before the switch, I had depression in the morning, but 90% of the time, it would abate as the afternoon went on.

 

Granted I only have this one week to go on, but the mornings have been worse, and i'm still sat here very unsettled - but this is also the anxiety creeping in, as it tends to have done this week around 9pm.

 

I was once told by a MH nurse that Citalopram works better taken at night. I never really read much into it as we all know it will affect people in different ways. 

 

My thoughts are that by taking Dulox at 11pm, by the time I wake at 11am, there will be 40-50% left in my system (at most). Thus, if I took 20mg in the evening, I would have 10mg (again, at most) in the morning when I wake. So if I switch now and start taking my 10mg Dulox in the morning, in theory, there will be nothing to loose... but I will have the benefit of more Citaolpram. 

 

As you say - one way to find out, but I think the reasoning is sound. I just want the next few weeks to be as painless as possible. I may be overthinking, but other than yourself and others on the forum, I have no help!!

[gail]

Hi,

Enlighten me here please. I read that you had jumped to 30 citalopram and dropped to 10 dulox.

Am I right or wrong, have I missed something along the way? I long for the day that there will be no more dulox for you and a bit of peace here and there.

I lost the post about CBD oil, I was asking you in what way did it help you and your wife! Thanks Scrat, Sid has a curious mind and also a mind for details.

[invalidusername]

Hi Gail - your presence here brings me a little peace. I am very anxious today.

 

Yes, I have today made the jump from 30 citalopram and 10 dulox. I have also switched the citalopram to the evening and dulox to the morning. So today I am working on no Citalopram until the evening. Trying to bear this in mind as my anxiety is getting quite nasty. But trying to fight withdrawal anxiety as we know is always a loosing battle. 

 

I am unsure whether I should just bead count from here, or try to stabalise on 10mg of Dulox... or drop to 5 and slowly from there. I have 24 empty capsules left, and lots of balls (*snigger*), so I have options of which I would value advice. I worry the 30 Cital won't fully kick in for at least 3 weeks, but I am also very keen to get shot of the Dulox in case it's very presence in my body is doing more harm than good.

 

Regarding the CBD oil. We hijacked Pat's thread on Zoloft, so my reply is in there, but I think we should talk about it here... or maybe I will start a new thread. Yes, I'll do that in a moment. I think it would be useful.

 

[EDIT] I will do a little write up actually, and then post later on. I think it needs to start with some info before launching into a discussion without a suitable preamble...

 

How are you today? I have been asking the powers upstairs for your aid...

[fishinghat]

I looked at the drug insert data from the manufacturer and they said in clinical trials that there was no difference in performance between taking it in the morning or evening. For whatever that is worth.

[fishinghat]

Remember that citalopram has a 1.5 day half life so it takes it 9 days to be 99% out of the body. Shifts in schedule then may take 8 or 10 fays to get a stable blood level.

[gail]

Hi Scrat,

Should it be to tough, you can take the Valium. Valium is easy to get off, with patience!

Thank you for your kind words.

Heading to the store to get ginger ale, so much nausea and the only pills that can help are 300.00$ a month....I might get them just the same, it ruins my day when it's not the pain!

[invalidusername]

That is certainly worth knowing - thank you.

 

It makes sense really, the longer the half-life, the less it will be affected at difference times. Therefore, this corroborates the importance of switching the Duloxetine. Very short half-life and I am sure that taking such a small dose at night will relinquish the user of a majority of the benefits. Might not be the case for doses of 60mg up.

 

But if nothing else, taking the Citalopram in the evening will keep it regular. When I take in the morning, I might wake up late and miss by an hour. Not a great deal, but if by taking it in the evening I can keep it to the minute, it can only be of benefit.

 

Any thoughts on my last few days of the Dulox?

[invalidusername]

Bless you Sid. I drink Twinnings Lemon and Ginger, or if the supermarket has some root, I will make it from that. Does help....

[fishinghat]

I would stay with your current dosing schedule for about 7 to 10 days and then stop the Cymbalta and go to 40 on the Cit. What do you think?

[invalidusername]

Yes, I am thinking that.

 

Stick with the 10mg for a few days, and then judge from there. My body will tell me how to proceed I'm sure.

 

Had a much better day today thus far despite some nasty anxiety early on. Let's see how it does from here on. 

 

Scrat will keep posting