894 replies to this topic

[invalidusername]

I guess it was right place at the right time with the bed!

 

Just a few NHS Mental Heath facts for you then Sir Hat...

 

• Psychotic Disorders have increased by 100% in the last 10 years from 0.5% to 1% of the population

• An average of 1 in 50 people have diagnosed Bi-polar

• Average of 16% of the population have diagnosed GAD and/or depression

 

• Summed up... around 1 in 5 people in the UK have mental health problems (excluding those than remain undiagnosed). The most prevalent health issues, and yet the mental health service is repeatedly given the lowest budget increases compared to physical health. Oh, and my home county of Kent has some of the worst rated MH services and some of the highest reported cases of MH disorders. I'm royally screwed...

 

Source: Mental health statistics for England: prevalence, services and funding - April 2018

[fishinghat]

That is about the same numbers I have seen for the USA. It is so common that for example most professional sport teams (high stress jobs) now have a psychiatric team for the players and coaches. There are several professional players in recent years that simply had to stop playing due to excessive anxiety they could not handle. This is just one example.

[invalidusername]

So here we are on DAY 10

 

I have had a good sleep and whilst I woke with the same random-thought anxiety, it is not as severe as yesterday. I don't have physical symptoms at all aside from a little head fog.

 

I feel very very uneasy about the whole week and concerned that just because I have had a better day that the stress of starting a new week tomorrow will kick everything off again. All that is on the cards for today is seeing a friend for a couple of hours.

 

My biggest concern is stress now. The smallest amount I feel will push me over the edge again, and I am walking very close to the edge.

[fishinghat]

Those symptoms are a good sign for he future. While not really a good day is somewhat less than a disaster. It should be somewhat of a rollercoaster but the highs won't be as high and the lows as low and the speed should slow down...with time.

[Vinpin]

Hi IUN,

 

Just read your entire thread .... and just wanted you to know that I not only rooting for you, but also going through the withdrawal currently too.

 

Was able to bring the Duloxetine to 20mg fairly quickly back in Feb, and since Feb have weaned down fairly evenly and progressively to 2mg now, with much invaluable advice from FH, Gail, etc. I felt much pain from physical symptoms and anxiety as well, and have not been well at all for 9 straight months. I am getting near the end I hop, but suspect I have some of the worse parts of the withdrawal to work through. I've been on Duloxetine for 12 years ..... so I've had no choice but to come off very, very slowly .... and even doing that I have had a myriad of symptoms and issues throughout the entire course.

 

Your weaning schedule does seem very fast, as FH and others have mentioned. I hope you (with the MH team) consider starting back on at least 5 or 10mgs of the Duloxetine to smooth out the withdrawal (and then go back off much slower), or cross-taper with LexaPro,Zoloft or something similar.

 

I also hope you can be as kind to yourself as possible during this trying time for you. I have read that when you're struggling, you should help and treat yourself as you would your own son or daughter, or a best friend, that is struggling - with much loving kindness and sympathy. I myself am going to try to lower my own expectations for at least the next three months, in hope that I can endure over the long run. I believe you will endure as well!

 

Best,

 

-VinPin

[invalidusername]

Anxiety took over as soon as I was on route to see my friend, and it took me about 45 minutes to calm down - but the point is, that I calmed down. Went to get some milk on the way home in a crowded minimarket, but ok nonetheless. Home now and enjoying the tolerable times. 

 

Not expecting it to pass completely, as I had anxiety (albeit very mild) before all this withdrawal started, but I am glad I climbed out of what was the worst day since my relapse started yesterday. The rollercoaster however has been barely moving from the very bottom since Monday. Either bad or very bad, and it is this that I want to pass as the longer I remain at this level, the deeper I end up digging the hole that I will need to climb out of.

 

A lot of what people say is that it can take 4-7 days for the withdrawal to get to its worst after last dose, then days 7-10 being the peak, and then some gradual relief. Obviously everyone is different, but now at day 10 should I put any stock in this rule? Or should I anticipate another week like I have just had?

[invalidusername]

VinPin,

 

Thanks ever so much for your message. So, 12 years?! Good grief. Yes, I can see the necessity in your length of withdrawal. I really feel for you. Here I am after three months, and you have gone nine months. I know we stick at it as there is no choice, but how the likes of 'Hat, Gail, yourself get through such torment is amazing knowing that the last 4 weeks for me has been the most difficult of my life - no exception.

 

As per my thread preceding this one, I didn't want to stop so abruptly. The first p-doc wanted me to go from 10mg to 0mg the day I sat in his office. I refused point blank and demanded to see another p-doc. This one told me to come off in a week, but again I said no. He was concerned that I would have another seizure (having had 4 already). But no sooner had I decided to remain on 10mg for at least another month, the team took my pills away. For what? To prevent a law suit again the doctor in case I have another seizure? Not giving two sh*ts whether I suffer severely as a result with all the other symptoms. 

 

I agree with you completely about the cross-taper AND the few extra beads of Duloxetine if this week doesn't show some relief. But trying to get the MH team to agree is almost impossible, so I may have to sever ties and end up sticking with my GP, as he at least understands, and knows me for the intelligent person I am with regards to getting myself better, unlike the MH team who demanded I stop going on this forum with immediate effect. I kid you not. I have the letter somewhere.

 

Self-compassion - yes. You are right I am sure. We need to be really kind to ourselves throughout this all, and realise just how much we are going through. I am doing my best to offer support to all on the forum in the same way I am so gratefully receiving it. I'm here for the duration, so very pleased to meet you.

 

All the very best,

 

IUN

[Vinpin]

Thanks IUN,

 

What you said about your MH Team is interesting - on several accounts. With regard to your seizures - FH may know, but I don't recall folks seizing on Duloxetine while ramping up on it, nor when they're on a steady dosage. What seems to be more of a problem is folks suffering through what many will describe as "brain zaps", when coming off the stuff. Even medical literature is now acknowledging the zaps. The zaps are no joke. Mistakenly about a year ago, I decided to just stop by Duloxetine cold turkey (60mg to 0 mg). I thought my life was ending ..... and the most significant issue was the brain zaps, which in my case were more like convulsions. When they happened, I thought I was about ready to lose consciousness. Very, very scary. I found this site .... and realized what a mistake I had made. I went back on the 60mg, stabilized, and then tried 30mg. There were some issues doing that, as well as going down to 20mg - but at least those downshifts were manageable. For me, problems really started when I went < 20mg. I took it slow, based on much of FH's & Gail's advice.

 

Your seizure comment is also interesting, regarding the lawsuit side of things. I would hope doctors in general aren't truly driven by the threat of lawsuits, since 1) patients' best interest would always be placed first by an ethical doctor, and 2) malpractice insurance would be a sufficient safety net for docs in the very rare occurrence of a direct patient lawsuit. That being said ..... I may be naive on both accounts .......

 

About the "MH Team" and their demands about this site ...... on first glance by medical practitioners in general, that might seem like sound advice in theory. After all, how can you know for sure what all of us on this forum say is correct, or at least helpful? But, then consider the flip side of the coin ...... look at what we, as Cymbalta/Duloxetine users, are up against:

 

• Eli Lilly, with the FDA's approval, makes misleading claims (the "1% or greater" fiasco....) about the incidence of withdrawal symptoms in patients who abruptly stop the medicine (when studies show > 40% of patients have withdrawal side effects)

• Eli Lilly and the various generic manufacturers don't make capsules in less than 20mg dosages, making the tapering off process anywhere from difficult to downright dangerous, depending on how patients choose to move forward

• I could be wrong, but to the best of my knowledge, Eli Lilly has not provided practitioners in the medical field any specific guidelines on how to taper patients off Cymbalta, based on patients' length of time on the medicine, their current dosage, and patient feedback along the way.  Many doctors wean their patients off far too quickly, and others don't advocate weaning at all. Some doctors even have different recommendations for how to split dosages (bead counting vs. dissolving/drinking in parts). Therefore, in the end, patients are left to figure it out themselves.....

• Are patients really suppose to favor trusting a practitioner over a forum ..... when a practitioner (or, worse yet, a medical group or insurance company) could be "in the pocket" of a pharmaceutical company that provides free samples and incentives (lunches, $$$?, whatever else), and at the same time, is using patients as de facto guinea pigs - because the FDA hasn't required appropriate clinical trials that report back on the incidence of withdrawal symptoms from longer term usage? 

• There aren't any reasonable recommendations/advice from practitioners on how to remedy, relieve or at least mitigate each of the horrible withdrawal effects (e.g., how many times have forum participants been told by doctors to take Tylenol or Ibuprofen for the headaches, when instead a better remedy is simply a 30 minute walk in bright sunlight to boost the production of Serotonin, Endorphins & Epinephrine?)

 

I'll get off my soapbox now ...... but really, this (and all) forums work very, very well when a forum visitor reviews many, many different threads to examine what's worked and what hasn't. This allows a forum member to generate a relevant consensus, and draw appropriate conclusions on what will work best for them. In doing this, it also becomes more clear what members offer the best, most consistent advice.........and for those members, we have an immense gratitude for their efforts that, honestly, can never be adequately repaid..............................

 

Best to you IUN,

 

-VinPin

[fishinghat]

Actually Vinpin, seizures during use and during withdrawal are well documented. There is a lot of specific research on the matter in Summary of Cymbalta Withdrawal.

You are right on with your comments but a few points of clarification.

"Eli Lilly, with the FDA's approval, makes misleading claims (the "1% or greater" fiasco....) about the incidence of withdrawal symptoms in patients who abruptly stop the medicine (when studies show > 40% of patients have withdrawal side effects)"

Actually that was a court order in the original case of Cymbalta not disclosing withdrawal information to FDA during the original approval request. Eli Lilley was fined 13 Million dollars for withholding information from the FDA. Sounds like a lot of money? During the first 7 years of production Eli Lilley sold 9 BILLION dollars of Cymbalta a year.

 

"I could be wrong, but to the best of my knowledge, Eli Lilly has not provided practitioners in the medical field any specific guidelines on how to taper patients off Cymbalta"

 

Totally correct but I wanted to add a subnote. After the original court cases on Cymbalta withdrawal the courts refused to reorder training of prescribing physicians on the new information on withdrawal. Instead they directed FDA to add to the drug inserts a black box warning about the withdrawal. Of course the drs were not made aware of that.

 

"...because the FDA hasn't required appropriate clinical trials that report back on the incidence of withdrawal symptoms from longer term usage? "

 

Actually long term use studies are NOT required for any medication. All approval is based on 8 to 12 week studies. The justification by the Congress when they wrote the laws was that long term studies (eg. 2 years) would delay medicine from getting to the market place and helping people as well as being an excessive burden in cost and would greatly raise the cost of medication.

[invalidusername]

There is a lot of good points here - and my thanks to you both. A majority of the points you have rightly elaborated on Vinpin, I was aware of - but your take on them bought new light, which is very useful, and in fact can be used to defend my position against the medical community. So for that, I thank you.

 

And 'Hat what you said about long term studies I was also not aware of. Like I have said before, it is all about money. I recall that the withdrawal findings said that after 2 weeks, 40% or so were still in the throws of symptoms. Why on earth there isn't a protocol in place which stipulates that anything above a certain percentage should be investigated further I don't know. This is a significant figure for test subjects to still be experiencing after a 10 week trial.

 

I have experienced brain zaps before with the Citalopram. Every day when I forgot a dose, they would be there, and then when I started taking liquid iron at the same time I had a load because the iron was absorbing most of the Citalopram before it hit my liver!! Had to work that one out on my own... But strangely enough, aside from a very slight one here and there, I have not have any zaps at all coming off Duloxetine. 

 

As 'Hat mentioned, the seizures are very real, and have since been added to the list of possibles when withdrawing - or it has at least on the patient information leaflet in mine. These have given rise to three trips to A&E since September. 

 

I explained in a lot of detail about the site and how I approached it. What we have here is, to no exclusion, the best resource available for coming off these pills. I am a researcher with a background in the hard sciences and told them that I am more than capable of interpreting fact from fiction, and being that it is my body, the best for what I feel should be done. 

 

As you say, knowledge of this drug is not distributed nearly as much as it should be, and ignorance is not an excuse. The p-doc said he doesn't recall having seen anyone having severe problems coming off Duloxetine, to which I asked how many that was. He avoided the question. At which point I told him that under the circumstances, the forum is the best source of information available - especially stacked against one persons opinion and experience. Obviously, I approached this with the greatest of respect towards his position, but just because he had 5 years of medical school does not mean he has followed up on the necessary quota of drug interactions, findings, law suits and so forth. 

 

The bottom line is that people like yourself, 'Hat, Gail and me know more than the average p-doc about the drugs we are taking because it is our best interest to get better. For the p-doc, getting close to a 6-figure salary can cruise home in their lease car and dine on a slap-up meal and forget about it. They can hide behind so many anomalies within the MH regime simply because it is not nearly understood well enough. If a nurse does not plaster someones leg properly, they are in for the high jump as we know everything there is to know about plastering, but for a p-doc, he deals with an organ that we have barely touched the surface on, so all manner of subjective excuses can be pulled to cover his insubbordination from duty, or lack of knowledge. Granted not all will be like this, but I have certainly seen my fair share.

 

So, who is next for the soapbox??

[Vinpin]

Thanks FH for setting the record straight, especially on the seizures - didn't know that it was an issue during ongoing use as well. I will look at "Summary of Cymbalta Withdrawals".

 

Do you know the incidence of patients experiencing first time seizing when put on SSRIs, excluding those without a history of seizures? I found an article that claimed it to be 0.4% for SSRIs in general .... but am wondering what it is for Cymbalta and/or Duloxetine specifically.

 

I've worked on the statistical prep end of clinical trials a couple of times awhile back. I vaguely remember that 8-12 week period FH is referring to. Too short a time. But maybe more importantly, clinical trial sample sizes many times are so incredibly tiny. When just 1 or 2 research subjects can tilt the primary study outcome definitively one way or another, then you know the sample size is too small!!!

 

I'm interested in what has (and has not....) been done studywise by anyone in the medical community to cite the withdrawal symptoms we know of. Going on Google tonight ...... there's alot about the Cymbalta/Duloxetine efficacy....but not so much about discontinuation syndrome - especially for Phase IV Clinical Trials. As I understand it, its during Phase 4 that a drug's discontinuation syndrome would be studied post-release, to ensure continued safety and monitoring of withdrawal symptoms. FH: Do you have any info on this for Cymbalta/Duloxetine? Were research findings that were part of Phase 4 in the Clinical Trial process leveraged by the FDA as evidence justifying the $13 million fine? Or, did that justification come from other research at another point in time?

 

Well IUM,it is absolutely true: follow the $ trail .... that always explains quite a bit. Briefer, less thorough clinical trials. Growing demand for Antidepressants in a world exploding with a population of more and more depressed souls. Doctors with less time, more patients - and no incentive to research drug interactions and discontinuation effects. And then there's the Opioid crisis .... even worse than the mess we're discussing here ... because the FDA won't properly regulate (or better yet, bring to a grinding halt) the Opioid drug makers through smarter, prescription-based summary data analysis. All explained by the $ trail. So sad, really.......

 

Curious though ..... knowing more about all this somehow makes me feel better ......

 

-VinPin

[gail]

Ah! You guys know so much! You amaze me. I'll blame my ignorence on 2 cerebral concussion that I had when I was 3,10, and one 13 years back. Makes sense! Love you guys.

[fishinghat]

"Do you know the incidence of patients experiencing first time seizing when put on SSRIs, excluding those without a history of seizures? I found an article that claimed it to be 0.4% for SSRIs in general .... but am wondering what it is for Cymbalta and/or Duloxetine specifically."

This varies a lot. My suggestion is to do a search for any ssri you are interested in using the name of the ssri, the word seizure and the term ehealthme. Ehealthme is a website that tabulates all the side effects reported to the FDA. So if you were to type in "Cymbalta seizures ehealthme" you would get this as part of your response....

"105,030 people reported to have side effects when taking Cymbalta.
Among them, 1,187 people (1.13%) have Seizure"

[fishinghat]

"there's alot about the Cymbalta/Duloxetine efficacy....but not so much about discontinuation syndrome - especially for Phase IV Clinical Trials. As I understand it, its during Phase 4 that a drug's discontinuation syndrome would be studied post-release, to ensure continued safety and monitoring of withdrawal symptoms."

The discontinuation syndrome found in the phase 4 study by Eli Lilley is what was falsified to the FDA. The court made the decision NOT to require Eli Lilley to release this information to the public due to a small sample size. Instead they opted to insert the warning in the drug insert.

[fishinghat]

Info on Cymbalta and seizures - Page 1
From Summary of Cymbalta Withdrawal.


Cymbalta, Seizures and Sodium

https://www.ncbi.nlm...les/PMC2963463/
We believe that this is the first reported case in which a person developed duloxetine withdrawal seizure secondary to deranged electrolytes after abruptly stopping duloxetine.
Her sodium was 134, potassium was 2.5, chloride 86, glucose 110, calcium 9, and magnesium 1.5.

https://www.ncbi.nlm...les/PMC3229538/
Although the risk of seizures with antidepressants is generally very low, the association with overdose is well established. However, the molecular mechanisms by which antidepressants cause seizures have not been clarified. GIRK2 knockout mice exhibit spontaneous seizures and are more susceptible to seizures induced by pentylenetetrazol than wild-type mice. The risk of seizures in overdoses with sertraline, duloxetine, mianserin, and venlafaxine significantly increases, and amoxapine overdose is more likely to cause seizures. Brain levels of the drugs in overdose cases may be considerably higher than levels during treatment at therapeutic doses, suggesting significant inhibition of neuronal GIRK channels by the drugs. Additionally, other types of K+ channels are inhibited by antidepressants at micromolar concentrations, that is, the two-pore-domain K+ channel, TREK-1 for sertraline and voltage-gated K+ channels for amoxapine and mianserin. Therefore, the inhibition of GIRK channels by the drugs after overdose together with the different types of K+ channels may contribute to increased seizure activity and the occurrence of other neurological side effects by increasing neuronal excitability.
Note - GIRK2 is a K+ ion regulatory mechinism.

https://www.ncbi.nlm...pubmed/16534127
Duloxetine-induced syndrome of inappropriate antidiuretic hormone secretion and seizures.
Description of antidiuretic hormone
Kidney
Aantidiuretic hormone has three main effects:
Increasing the water permeability of initial and cortical collecting tubules and inner medullary collecting duct in the kidney, thus allowing water reabsorption and excretion of more concentrated urine, i.e., antidiuresis.
Increasing permeability of the inner medullary portion of the collecting duct to urea by regulating the cell surface expression of urea transporters, which facilitates its reabsorption into the medullary interstitium as it travels down the concentration gradient created by removing water from the connecting tubule, cortical collecting duct, and outer medullary collecting duct.
Acute increase of sodium absorption across the ascending loop of henle. This adds to the countercurrent multiplication which aids in proper water reabsorption later in the distal tubule and collecting duct.
Note - This could severely impact sodium and potassium levels in the blood stream.
From article - "We describe a woman who developed severe hyponatremia on exposure to duloxetine and recurrence on inadvertent rechallenge, suggesting the causative relationship of this drug to hyponatremia. "
Hyponatremia - is a low sodium level in the blood.

 

http://www.ncbi.nlm....pubmed/22306002
Generalized tonic-clonic seizure secondary to duloxetine poisoning: a short report with favorable out come.
Note - Tonic–clonic seizures (formerly known as grand mal seizures) are a type of generalized seizure that affects the entire brain. Tonic–clonic seizures are the seizure type most commonly associated with epilepsy and seizures in general, though it is a misconception that they are the only type.

https://www.ncbi.nlm...les/PMC2963463/
Duloxetine Withdrawal Seizure
She came to the emergency room with complaints of nausea, clear liquid vomitus, anxiety, “electical sensation” inside the body, restlessness, decreased liquid intake, abdominal pain, and decreased sleep. She stopped taking her duloxetine two days previoiusly. She had two generalized tonic clonic seizures 20 minutes apart in the hospital.

https://www.accessda...s011s013lbl.pdfFDA
Hyponatremia — Cases of hyponatremia (some with serum sodium lower than 110 mmol/L) have been reported and appeared to be reversible when Cymbalta was discontinued. Some cases were possibly due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The majority of these occurrences have been in elderly individuals, some in patients taking diuretics or who were otherwise volume depleted.
Note this article links Cymbalta to Hyponatremia caused by inappropriate antidiuretic hormone secretion.

 

Medical research articles linking Cymbalta to Hyponatremia
http://www.ncbi.nlm....pubmed/23075738
https://www.ncbi.nlm...les/PMC3285747/
https://www.ehealthm.../hyponatraemia/
https://www.ncbi.nlm...pubmed/25538343
https://www.ncbi.nlm...pubmed/25911354
https://www.ncbi.nlm...pubmed/18562431
https://www.ncbi.nlm...pubmed/17224730
https://www.ncbi.nlm...pubmed/17502788

[invalidusername]

'Hat - wanted to catch you while you are here.

 

I have woken up absolutely petrified of doing anything. I can't think about work, shopping, even going outside for fear of the stress it will cause me. I am so scared about where this will take me. Being self-employed, if I do not earn any money, I am in so much trouble.

 

I cannot get through to the Mental Health team to discuss medication, so I have a call with my Doctor in just over an hour.

 

Should I be asking for Lexapro... and some Duloxetine to level out??

[fishinghat]

Page 2

Comments by Members

Grand Mal Seizure And Mouth Spasms ?
Posted by justsayno on 02 April 2017 - 07:58 PM in How to Find Support
Was trying to work it out tonight. Looking for any patterns / similarities etc
Only obvious thing being that both seizures occurred after a dosage drop from 40 to 30 mg.

Grand Mal Seizure And Mouth Spasms ?
Posted by justsayno on 01 April 2017 - 02:26 PM in How to Find Support
Hi Gail
Far as I am aware No. In 28 years I've never had any seizures until I began taking Cymbalta.

Bead Counting Advice Doesn't Jive With My Capsule Contents
Posted by PtldFrank on 04 September 2016 - 04:44 PM in Weaning Off Cymbalta
Vinpin,
Regarding seizures, that's a subject I do have personal experience with. The good news is that I'm seizure free for more than 10 years. The bad news is that I had half a dozen gran mal seizures in the 12 years prior, starting with wellbutrin. I tend to believe the seizures all came from the various meds (15-20 combinations) I went through. The only thing that seems to have stopped the seizures is the anti seizure medicine Keppra.

Involuntary Cold Turkey From 120Mg
Posted by Cassandra on 13 February 2015 - 10:32 AM in What are you feeling?
Hello world, this is Cassandra. It's been a rough month since I quit cymbalta and I think it'd be best to start from the very beginning.

I have been experiencing major depression as long as I can remember, at least from the age of 9 which is where my earliest memories are. I was put on my first antidepressant--celexa--5 or six years ago. I had been depressed before but when I started medication it just got worse. Five/six months ago I was put on cymbalta, first 60 mg then 120, and it got worse. I became violently suicidal and after a course of 12 ect treatments I attempted suicide by taking 2 bottles of cymbalta at once (my insurance had just switched me to where I could only get my meds in a 90 day supply--bad, bad idea to give someone who's suicidal a giant bag of meds.)

I woke up having seizures that went on for hours, and then on and off for a few days. When I got to the hospital, I was hallucinating, and couldn't stand or eat for days. I learned how to walk again and a month later I can ride my bike again.

Listing The Positive Events Daily Through My Cymbalta Withdrawl
Posted by FiveNotions on 24 December 2014 - 09:42 AM in ARE YOU NEW HERE? Words from the wise about Cymbalta
I was just talking with a friend about where I was last year this time ... compared to this year ... and it seemed more than worthy of a post in our "Positives" thread ...

Last year this time I was about 19 days into hard, cold turkey withdrawal ... I was overwhelmed with vertigo and nausea, confined almost totally to bed, and crawling to the bathroom to puke ... at one point, I just took my blanket and pillow in there and slept/lay curled up on the floor (less far to travel) ... I was unable to eat any solid foods, not even crackers ... and was living on broth and herb tea and water (didn't make for much to puke up, but I still did) ...
I was having constant muscle spasms, and had a couple of seizures (at least I assume that's what they were, I just blacked out and woke up on the floor) ... I was having auditory and visual hallucinations, constant cold, dripping sweats, and horrid general body aches and pains .... couldn't sleep much at all, just an hour or so at a time ... I hadn't showered, washed my hair, changed clothes, or changed my sheets, once ... and I simply did not care …

Article: Duloxetine Withdrawal Seizure [Cold Turkey Withdrawal]
Posted by FiveNotions on 03 January 2015 - 09:32 AM in Cymbalta in the News
I think I had at least 1, possibly 2, seizures during hard, cold turkey withdrawal ... but don't know for sure, was alone and woke up on the floor ... yet another reason not to quit this poison cold turkey!
Duloxetine Withdrawal Seizure [full text]
Psychiatry (Sept 2006)
http://www.ncbi.nlm....les/PMC2963463/

From the article:

Much has been written about the use and side effects profile of duloxetine (Cymbalta®). We report a case of a patient who had generalized tonic clonic seizures after abruptly stopping duloxetine.

Case report. Ms. X was a 59-year-old Caucasian woman with a diagnosis of major depressive disorder recurrent severe without psychotic feature. She was stabilized on duloxetine 90mg p.o. daily.

She came to the emergency room with complaints of nausea, clear liquid vomitus, anxiety, “electical sensation” inside the body, restlessness, decreased liquid intake, abdominal pain, and decreased sleep.

She stopped taking her duloxetine two days previoiusly. She had two generalized tonic clonic seizures 20 minutes apart in the hospital.

Urine drug screen was negative. Urinalysis was negative. Complete blood count (CBC) was normal. Her sodium was 134, potassium was 2.5, chloride 86, glucose 110, calcium 9, and magnesium 1.5. Her blood urea nitrogen (BUN) and creatinine were normal. Her liver function tests were normal except mildly elevated alkaline phosphatase of 126. Computed tomography (CT) scan of her head was negative. There was no sign of infection at the point of admission. She was stabilized and was then started on a different antidepressant due to her history of nonadherence. She had no further seizures during her hospital stay.
Seizure?


Posted by sarahb on 04 April 2014 - 10:59 AM in What are you feeling?
My mother has been on Cymbalta I think 90mg and she recently started having seizures. I wonder if there could be any correlation. I'm the one who was on it 5 days and found your group and has decided to get off. Now my thoughts are with my mom. I know different things about her health are shorting her health but I hate to think what this drug is doing to her and God forbid she needs to get off.

And Here I Am- Am I Screwed Forever?
Posted by jenniesue on 09 December 2013 - 12:49 PM in ARE YOU NEW HERE? Words from the wise about Cymbalta
The DVT/Blood Clots were after I lost a pregnancy. Yes I was placed on Cymbalta for pain. The seizures I had started within 2 weeks of taking Cymbalta. Yes I have discussed all issues with my Dr. and they give me a diagnosis of something else, and have told me just keep taking the Cymbalta. Where do I start to get off of this evil med? I go to see my Dr. Monday Dec 15.

Seen The New Commercials?
Posted by Pixi on 10 June 2012 - 02:32 AM in Cymbalta in the News
I'd thought I was unsubscribed...but this thing emailed me for a reply so here goes. I can't believe it's almost a year to the day since I made the post on here. That means I've been totally Cymbalta free for 6 months! I took my healthcare into my own hands & I'm glad I had the fortitude to go through this & come out as well as I have.

I'm taking nothing for depression/neuropathy and still having the odd brain zap & dizziness - my "Cymbalta moments" as I call it. . Still having seizures at night, bouts of horrible dementia and just wish I'd never listened to the Doctors & allowed myself to be their labrat for this evil drug. Depression is still much better off it and bladder control is almost back to normal. The ONLY way to go is wean slowly, count the grains even tho it's tedious - over months, even if you're only just on it a few weeks, start to cut it down really slowly - your brain is way more delicate than you know. This shit does pretty weird things to you - that's how it's supposed to work - alter your neurology. Don't let them mess with you. It caused me DID/MPD, made my diabetic neuropathy 100 times worse & a host of other shit I've probably posted about elsewhere on this forum.

Seizures From Cymbalta
Posted by Namaste on 02 May 2012 - 02:04 AM in Weaning Off Cymbalta
Doctor changed celexa to cymbalta And was ok with it for a month and
I started Having hives, itching and bruises. My doctor stopped cymbalta and gave me prednisone. Then i started having seizures where i was fully aware of what was happening so I'm now on lamictal for seizures. Anyone of you having the same experience?
My Chapter Of Hell
Posted by distill on 06 December 2011 - 02:55 AM in ARE YOU NEW HERE? Words from the wise about Cymbalta
I have already wrote this once, but if I can help out another person then I've done what I set out to do.

I know some people have done great while taking it but the withdrawal is what gets them. I was not depressed, I was injured on the job crush three disc in my lower back. I was put on it for sciatic help.

I had a house, cars, and my best friend for a fiance. Within two weeks of taking it I lost my mind. Manic aggression, seizures, nightmares, etc. I did things I never wouldve done before this. Its like i either knew what i was doing and didnt care or i flat out dont remember. We were losing the house and my demeanor drove her away. Workers comp denied paying for all psychological meds and I flat out couldn't afford $400 for 90days. That was in January of this year.


Neuropathy As A Side Effect?
Posted by cookie on 28 November 2011 - 11:57 AM in Weaning Off Cymbalta
Dear Pixi

I took cymbalta for depression, other than than I was a pretty healthy person. After 6 years of taking it, I have sugar problems and now I am experiencing prickling sensations and pin & needles. I also have problems remembering names. I also experienced seizures and problems with my joints which I never had prior to the medication

Check In On Your Progress Here!
Posted by CindiEponabri on 16 October 2011 - 01:31 AM in Weaning Off Cymbalta
1) Method you're using
Counting bead method, kinda... I take out about 1/4 of the beads out of one of the two capsules for each day's dosage, for a week. The following week it will be 1/2 of the beads of one capsule.

2) Starting dose
120mg

3) Current dose
105mg (roughly)

4) Withdrawal symptoms you're having
more pain, anxiety, dizziness, tired, nausea, cold/flu symptoms, nightmares, itching,


5) Things that have improved.
Seizures.. we had thought they were being caused from the Oxycotin, but now I see it was from the Cymbalta, because for the most part they are now gone. I have a little one every now and then.

My Story
Posted by cookie on 26 July 2011 - 02:25 PM in Weaning Off Cymbalta
Dear Imdone:
.....However I learned to differentiate the initiall symptoms from withdrawals. I took the medication for severe depression. When I reduced dose I started experiencing asthma, itching, joint pain, problems finding words to talk and comprehending language, dizziness, vomiting, seizures, facial tics, sensitivity to noises and light, tremors, allergies, sore throat, etc which I definitely didn´t have when my depression appeared 6 years ago.

JG2
I'm new to this forum.... hope this is how it is done.

I took 15 weeks to get up to the 30mg dose of Duloxetine (Cymbalta) but I started to get suicidal thoughts, big mood swings, abnormal arm and leg movements with crossed arms outstretched etc. So my DRs decided I needed to come off the medication, and then I started to feel weak and fall and get what seems to be seizures with big muscle spasms causing my body to arc and my limbs to shake, but my Dr tells me they aren't true seizures... just related to the medication! This happens 2 to 4 times a day, and is a horrible experience. I don't lose consciousness, and I can tell when one is coming on due to a tingle in my legs, and a headache and nausea...
i'm down to 20mg per day, about to go alternate days....
Anyone else had this severe reaction and did it go quickly after you finished the medication tapering?
My last adverse reaction took over 3 months to be out of my system after the last tablet. I'm very sensitive to these meds. They probably won't prescribe another, but I'm worried about these seizure-like things continuing much longer.

[fishinghat]

'Hat - wanted to catch you while you are here.
 
I have woken up absolutely petrified of doing anything. I can't think about work, shopping, even going outside for fear of the stress it will cause me. I am so scared about where this will take me. Being self-employed, if I do not earn any money, I am in so much trouble.
 
I cannot get through to the Mental Health team to discuss medication, so I have a call with my Doctor in just over an hour.
 
Should I be asking for Lexapro... and some Duloxetine to level out??

I would say yes. Start with a small dose of Cymbalta like you were on a few weeks back and stabilize and then taper from there slloowwwlllyy. Keep the Lexapro until you see how you do on the Cymbalta wean.

[invalidusername]

OK - so maintain the Citalopram at the 30mg as it has been for the last 5 weeks, and go back to my 60 beads before all this started?

 

The switch to Lexapro is for sure on the cards as the Citalopram just does not work anymore. But do you suggest I not taper this while I am stabalising back on the Duloxetine?

 

I agree that the drop from my 60 beads needs to be very very slow now, but without the support of an SSRI that works, I worry I still might hit the same rocky ground I am in at the moment. Would there be a point at which I should consider the taper to Lexapro whilst reducing the beads?

[fishinghat]

"The switch to Lexapro is for sure on the cards as the Citalopram just does not work anymore. But do you suggest I not taper this while I am stabalising back on the Duloxetine?"

"I agree that the drop from my 60 beads needs to be very very slow now, but without the support of an SSRI that works, I worry I still might hit the same rocky ground I am in at the moment. Would there be a point at which I should consider the taper to Lexapro whilst reducing the beads?"

Stabilize on Cymbalta first, do not tough the Citalopram dose at all. Go to Lexapro only if withdrawal gets bad. If you decide to do Lexapro you will need to drop the Citalopram as you go up on the Lexapro. Taking Citalopram, small amount of Cymbalta and the Lexapro at the same time would be to much of a risk of serotonin syndrome.

[fishinghat]

Page 3

Drug insert from Eli Lilley for Cymbalta
https://dailymed.nlm...f2-c185fbad64ba

5.7 Discontinuation of Treatment with CYMBALTA
Discontinuation symptoms have been systematically evaluated in patients taking CYMBALTA. Following abrupt or tapered discontinuation in adult placebo-controlled clinical trials, the following symptoms occurred at 1% or greater and at a significantly higher rate in CYMBALTA-treated patients compared to those discontinuing from placebo: dizziness, headache, nausea, diarrhea, paresthesia, irritability, vomiting, insomnia, anxiety, hyperhidrosis, and fatigue.
During marketing of other SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures. Although these events are generally self-limiting, some have been reported to be severe.
Patients should be monitored for these symptoms when discontinuing treatment with CYMBALTA. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate [see Dosage and Administration (2.7)].


6.12 Postmarketing Spontaneous Reports
The following adverse reactions have been identified during post approval use of CYMBALTA. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Adverse reactions reported since market introduction ....., seizures upon treatment discontinuation, supraventricular arrhythmia, tinnitus (upon treatment discontinuation), trismus, and urticaria.
Medical Research on Seizures and Cymbalta.
Other info on seizures,

[invalidusername]

I fully understand your position here on SS, but I can safely say, that the withdrawal has got to quite a intolerable stage. 

 

I am between a rock and a hard place. If I don't work, I don't have the money to support my wife's visa and she will be deported (I need to evidence £19k/year to be deemed suitable to support her), and knowing this I push myself to work making my stress worse. It is a VERY serious and worrying cycle. Hence the need to do something asap.

 

But 5.7 says it all. I think I need to start by going back to 10 mg to see if I stablise.

 

So final question, assuming I begin the 10mg Duloxetine again tomorrow (along with my 30mg Citalopram), when should I anticipate some improvement? And how long should it be given before upping to the next dose of sat 15 or 20mg?

 

Thank you so much 'Hat 

[invalidusername]

There is the possibility that I could do a direct switch from Citalopram to Lexapro as documented in journals, but most footnote to say that if there is a suspected risk of withdrawal that it should be done as you have suggested over a period of 4 weeks or so.

 

I think we can safely assume that I fall under this category and need to do the gradual taper. But if I can see some direction, I will feel a little calmer I'm sure

[gail]

Fishinghat, Scrat has never been able to stabalize, even on 20mg. In The last months that I've read his posts, since September, it's anxiety, depression and so on.

With that in mind, couldn't we skip those few beads and get on with the Lexapro? Thanks Fishinghat!

[Vinpin]

FH: Thanks for all the great background info on seizures. Did want you to know I did look it up in your "Summary of Cymbalta Withdrawal" thread as well...(yes, someone is leveraging all the great info you put together!!!!!)...........(-;

 

IUN: Please, please hang in there! I believe you can resolve this mess you are in!

 

-Vinpin

[fishinghat]

IUN
It takes about 24 to 48 hours to start getting benefits and around 4 days to really kick in (usually). Wait a week before deciding if you want to go up to 15.

Gail - That is a good point. IUN has already stopped the Cymbalta and it is out of his system. He could try just cross tapering from the citalopram directly to the Lexapro. Good idea. Your choice IUN. The withdrawal you would experience during the cross taper would not be any worse than what you are going through now.

[invalidusername]

Guys - you are not going to believe this...

 

I have seen my doctor and he can't give me ANYTHING. No Lexapro, no more duloxetine. It has to come from the MH team. 

 

I was promised a call from the MH team by lunchtime. Never happened. I called at 2pm and was promised a call straight back.

 

4pm - still no call. So I called back and made it quite clear that this was pushing me over the top. Again I was promised a call back before they went home for the day at 5pm.

 

Guess what? No call. 

 

I am climbing the walls in anxiety and all this stress is just adding to it. I'm just gonna cry for a bit I think.

 

FISH - I can't think straight, but if I get as far as getting some meds, in your experience, what sort of timeframe could I expect relief via te Lexapro route compared to the beads route...? Obviously I am tempted to go for the quickest being Duloxetine, but I know I need to do this right.

[fishinghat]

4 to 7 days for the Cymbalta and around 4 to 5 weeks for the Lexapro HIOWEVER some members do get relief from the Lexapro in as little as a week.

[invalidusername]

This all depends on what the MH team want to do. 

 

I am leaning towards the Lexapro as it will give a long-term solution, rather than going back on the beads will be holding me back from getting on the Lexapro. Just don't know if I can hold it.

 

One day at a time IUN.. one day at a time.

 

I do have the opportunity of discharging myself from their supervision, thus giving the decision making power back to my GP. I'm giving it tomorrow and if I do not get anywhere, I will do just that. 

[KathyInFL]

During the first 7 years of production Eli Lilley sold 9 BILLION dollars of Cymbalta a year.

 

Eli Lilly can make another 9 billion dollars if they could package 'Withdrawl" doses.... pills with 30, 29, 28, etc. MG. I guess if they did this, they would admit that it's very difficult to come off of cymbalta, and why would they admit to that?

 

IUN, why can't your GP give you anything? Too bad I'm not planning a visit, I could bring you a few capsules (I know, that's illegal).