221 replies to this topic

[Vinpin]

Update on me:

 

Four weeks clear into 2 beads a day (1 bead every 12 hours) .... and I would say I am just "so-so". Week 3 was still pretty bad, but Week 4 was better. Interestingly, was away from home Thurs-Sun last week (week 4) for a niece's graduation in South Dakota, and I was doing fairly well up there. Then, back at home, awoke yesterday - and I was back to the light-headedness and woozy feelings, along with a headache that moved around to different parts of my head. Additionally, I'm feeling a lot of anxiety and nervousness throughout my body.

 

I've decided to go even slower in my tapering process. I want to have at least four straight weeks of no or minimal symptoms before I make the next bead change. Also, I am favoring going with 1 bead every 16 hours for my next change, instead of straight to 1 bead per day.....

 

 

Questions:

1.  I find that when I am take 0.5mg of Alprazolam it helps with just about all the symptoms - and that's really great. During this 2 bead stint, I decided to take two 0.5 mg tablets per day (1 tablet every 12 hours), instead of 1 tablet per day - so I am relying on it more. My question is - since this is an addictive drug, how concerned should I be that this increase will result in a more difficult withdrawal from the Alprazolam at some point in the future?

      2.  How common is it for Cymbalta withdrawal symptoms to subside for a week or so and then re-emerge? I'm discouraged that this week (week 5 on two beads) isn't as good as last (week 4 on two beads).... but is this "par for the course" at this stage of the game?

 

Thanks all,

 

-Vinpin

1.  

[fishinghat]

1. At that low dose there can be significant withdrawal BUT there are methods to wean off with little to no withdrawal. I have dome that several times. Certainly easier than Cymbalta.

2. Reoccurrence is par for the course. With tine the downs periods will be shorter and the up periods will be longer. Once comfortably stable you can go to 1 bead a day. Its all about time and patience.

[Vinpin]

Thanks, FH.

 

Since the Alprazolam withdrawal is manageable, do you recommend that I go back to taking one 0.5mg tablet of Alprazolam twice daily? Taking it twice a day isn't reckless or unsafe at this difficult stage, correct? 

 

I'm just so fearful of putting prescription meds in my body these days ..... all due to this life altering experience coming off the Duloxetine. However, I have been super nervous and jittery the last couple of days - I think the Alprazolam would be helpful.....

 

-Vinpin

[fishinghat]

It is not unsafe or unwise. If you get stable try to cut back to 1 tablet a day before you are on it too long. Remember that for most people they get use to it within 4 weeks or so and it takes a higher dosage to have the same effect.

[invalidusername]

Sorry, IUN - have been absent from the forum for a couple of weeks ....

 

Not sure what you mean by "frequency loss" - can you clarify?

 

-Vinpin

 

Vin - what I meant by that is whether you had any selective loss of hearing, eg, low end, high end, mid frequencies (peoples voices)?

[Vinpin]

Thanks FH.

 

IUN: In general, I have mild-to-moderate hearing loss in low frequencies, severe loss in middle frequencies, and profound loss in the high frequencies - with deafness in the highest frequencies that are typically beyond conversations (e.g, birds chirping....). I don't perceive any variance in hearing loss changes by frequency range when the brain zaps occur and then morph into tinnitus. But in general, it is definitely more difficult to hear overall when the "after zap" tinnitus takes place....

 

-Vinpin

[invalidusername]

Interesting... 

 

I have also just started having something similar, but milder, in the last few days. Sort of like when a loud explosion goes off and you have the dulled hearing and tinnitus. It is unlike lack of pressure as I get that during blood tests and there is no tinnitus with that. With tinnitus it is clear nerve based, but I am trying to understand how to auditory nerve might cause that rather than the inner ear. Serotonin levels do affect parts of the ear however, which contribute to  dizziness, so it is very plausible, but I just cannot find any information anywhere. I don't like not knowing what is going on!!

[fishinghat]

I have read several papers that describe serotonins influence on the Vestibular system.

[invalidusername]

Quite, but this is all to do with balance and so forth, and has no effect on perception of sound. That is the bit that is still the unknown...

[fishinghat]

https://www.ncbi.nlm...les/PMC4237057/

I think you will find this article may help clarify your questions about serotonin's role in the perception of sound. Let me kn ow what you think.

[Vinpin]

FH - excellent article, and very useful for me to know that Duloxetine (even though not, yet, on a list of ototoxic drugs .....), could very well have exacerbated an imbalance of neurotransmitter chemicals (serotonin) and, accordingly, my ongoing tinnitus issues. The connection I've personally found with the brain zaps and the resultant tinnitus makes me even more suspicious that Duloxetine is a culprit - again, despite not being on a list of ototoxic drugs.

 

Even more interestingly to me .... I'm even more convinced that my hyperacusis (my perception of sound as too loud and distorted, even though it is not) is resultant from the long term, 12 years use of Duloxetine. The paper's authors focused on tinnitus - undoubtedly because it is a more common audio-logic issue .... but it doesn't seem to be much of reach that Duloxetine's altering of my neurotransmitter chemistry could have caused my hyperacusis. I've had hearing loss my entire adult life .... it started way before I began Duloxetine. BUT ...... the hyperacusis began about 7 years ago, and reached a peak about 6 years ago, to the point were I became disabled from my occupation. I was on the Duloxetine for a full 6 years before the Hyperacusis reached a crescendo and disabled me.

 

During my intense withdrawal stage currently, my hyperacusis is currently at an all-time high. When I'm in the midst of a "bad spell" from the Dulox withdrawal, it is incredible how intense the hyperacusis can be. A low volume sound from a whole other room in my home can startle me. My spouse must speak softly, clearly and close enough to me so my lip-reading can assist. My hearing loss per se has not worsened during the my time on Duloxetine, but the Tinnitus and particularly my Hyperacusis certainly has......

 

Unfortunately, the prospects of establishing a scientific link between Dulox & Hyperacusis are very, very dim. Not only because Dulox is not on a list of otologic drugs, but also because there is not enough interest in Hyperacusis to fund a study ... nor are there enough test subjects with Hyperacusis to generate a sufficient sample size for a research study.

 

-Vinpin

[fishinghat]

While subjective, our members have well established that Cymbalta withdrawal causes hypersensitivity of the nervous system. Members have consistently listed that tinnitus, arthritis, neuropathy, migraines, and many more conditions that were present before Cymbalta where greatly heightened during withdrawal. I think your opinion that this is Cymbalta related is probably correct.

[Vinpin]

Well, it's been a horrific week - unexpectedly so, since the two prior weeks were decent enough. Not sure what changed - was still on one bead every 12 hours. Been at that for almost 5 weeks now.

 

Besides having all the side-effects we've all documented and suffered through - I couldn't believe how intense my feeling of "losing it" was last night. I felt somewhat light-headed again, but more specifically, I was nervous as hell - full blown with trembling, and felt as though I was going through a nervous breakdown or panic attack (not sure of the difference....). I was alone last night too .... so it was very scary.....

 

Besides my regular 7pm bead, I took another at 9:30pm and 0.5mg Alprazolam as well, just to calm down. I was tired enough to fall asleep at 11 .... but woke up at 7am with a very, very intense headache in the front portion of my head. I decided to take 2 beads instead of my regular single bead at 7am and another Alprazolam. It all helped somewhat, but not sure what tonight brings. Also,  I've succumbed to the realization that my body is not ready for 2 beads a day, and I'm going back to at least 3 beads a day (1 every 8 hours). If that does't get me stable in a few days, then back up to 4 beads. Whatever it takes to stabilize .... that seems more important now that coming off this damn poison .....

 

I can't keep living like this. I'm so desperate, would even consider an in or outpatient drug detox facility, if I knew a good one. I realize they'll just up my Duloxetine and/or put me on a cross-taper, plus maybe valium or some other drug to numb my senses ... but I'm so desperate now. Its horrible that I have no good medical treatment option available .......

 

-Vinpin

[fishinghat]

If you have to go back to 3 beads or 4 beads to stabilize that is Ok. You are so close don't give up now. You have millions of nerve cells that are still covering from the earlier Cymbalta withdrawal. If you are stable at 3 or 4 beads for a couple months that is OK. It gives time for your nerves to heal further.

[Vinpin]

Encouraging to hear .... thanks FH. I'm not sure I could be achieving all my progress without your input ...........

[invalidusername]

Interesting paper, but still doesn't cover the role of serotonin in relation to the auditory system, other than the fact that it is party to its neurological make up, along with the other usual suspects of the amino family. The issue is that glutamine could easily be effected along the same lines and have influence rather than the serotonin, as we know that when one amino is balancing out, the others will join in the act of re-establishing the "norm". It really is a can of worms, and there just isn't the call for it. As the paper opens with... so very few studies. The sole reason being its potential recognition. Authors want widespread recognition and with very little going on in this particular area, funding won't be granted.

 

Sorry to hear about issues of late Vin. I don't think a label will help none too much with what is occuring, but a nervous breakdown is a term usually used to cover an amalgam of conditions (depression, stress, panic etc) which causes the person to suffer to a degree that life is just not sustainable as it once was. Sounds like you had an anxiety attack. These generally have such an intense feeling of continued nervousness which can include shaking. An attack can last quite some time, whereas a panic attack will include a lot of sweating, fast heart rate, palpitations, but generally only last a few minutes at most. I think you are right in maintining stablility for now, but you are such a rare case with this stuff. I don't know what a detox place would do. 

 

As you know, I have quickly become anti-meds given the nightmare I've had over the last 8 months. Meds can help in some circumstances, but the use of psychotropic meds has just got out of hand. When prozac was marketed, it was 6-9 months treatment, but who is to argue when it does further? Doctors want you well, so they throw more pills, pharma's want more money so they develop more ways of numbing the issues rather than fix them. It is a joke. At least with natural meds you can switch doses and treatments with nothing like the side effects and withdrawals that meds bring...

[fishinghat]

"It really is a can of worms, and there just isn't the call for it. As the paper opens with... so very few studies."

Truly spoken.

[Vinpin]

Update on me:

 

Still struggling quite a bit. Went up to 3 beads eight days ago, and still not as stable as I'd like to be . My symptoms seem to be worse the day of a harder workout (which I'm going to have to cut back on), and also the day after some more engaging social activities. For example, yesterday was my spouse's birthday, and I decided to have friends join us for a birthday dinner at a restaurant, and then over to the house to have birthday cake, which I had baked from scratch that morning. That was a full day .... and even though I did OK through it, today I woke up with a tremendous headache and painful hearing super-sensitivity.

 

Not sure what to do next. I'm wondering whether my brain and sensi-neural system are permanently damaged, and will NEVER get better (after almost 18 months of withdrawal, one loses hope easily.......). After all, how many people on Cymbalta/Duloxetine for 12 continuous years actually make it off altogether?

 

I wake up in a distressed physical state, and then my condition just triggers depressive thoughts as the day progresses. I am not able to tackle larger projects, such as my mosaics and an analytics blog I wanted to start. Just keeping up with life's daily routine and errands is a great challenge. I am just a shell of my former self, and it is excruciating to see my life unravel in this manner.

 

Apologies for all the negativity .... but thanks for listening,

 

-Vinpin 

[invalidusername]

Hi Vin,

 

You did really well with all the stuff for your spouse - and inevitably, you ask yourself whether you overdid it. I understand completely. I am trying to get it into my head that if I managed work, a walk and a bit of shopping, then this is a day well done given where I am, but I am always holding myself up against the ratrace who go out, go on holidays etc. 

 

There has been talk here over the last few days about how physical effects mental and vice versa. I have learnt that the former is very true in my case, and I sense the same to be for you. I had three clear days without any physical symptoms last week, which led to a good weekend, but alas, headache on Saturday, fog all day Sunday (in bed), same yesterday, but forced myself out, and today a massive dizzy spell (again, all day in bed). My mood held up for the weekend, but it started yesterday evening and just as you say, the morning hit and oh, bloody hell, now I'm dizzy as well? I find myself getting very angry with pills, doctors and the like, but where will it get us?

 

I sincerely hope that your 3 beads pays dividends in due course and that you can find some respite. To keep going thru it and on with life is the best approach - and for that you have done well. Hope your partner enjoyed the day!

 

Matt

[fishinghat]

My withdrawals have had the same emotional context as you two. I want to do this and that but I can't. I remember my original therapist did such a great job in training me. Set a pace. At first for me after mu nervous breakdown it was to be active for 5 minutes and then rest 45. As time went on I would be active for 15 and rest 30, After two years I was at 45 minutes on and 15 minutes break. From that experience I was left with an instinctive feeling when I needed a break. Now I work as needed, preferable at a normal pace and take a break when my body says too. After 18 years of anxiety problems I have become well in tune with my limitations. We use to have a member called This Moment. He use to say there was the old me and now there is the new me and you just have to learn to adjust to the new me and its limitations. Yes, things get better after the withdrawal is over but there will still be things to adjust to.

[invalidusername]

Puts it in perspective...

 

I append my previous post in saying that I hold my (new) self up to my (old) self. Notice what I used to do and gun for that without recognising the much needed breaks.

[fishinghat]

It is just like a major pulled muscle. Sure you want to get back to jogging like you use to do every day BUT if you do that your muscle will never get better and will hurt even more. You have to rest it and when it feels better then start back very slowly.

[Vinpin]

Thank you both for your posts.

 

I will keep trying to adjust my expectations, limit what I do and come to terms with what I cannot do....... I guess the best thing is that I still have a passion to do things and live my life. I am not suicidal, and for that I should be thankful .......

 

-Vince

[invalidusername]

Absolutely. Wherever you are, things could be worse off. This is the way to go.

 

Just been writing about you in LDN's thread as he also has over-sensitised hearing and has gone thru it today. So, along with things not being as bad as they can be, you are never alone.

 

Take it easy Vince - we'll get there.

[Vinpin]

Hi all:

 

Update on me:

 

I had a three day "relief" period where I felt significantly better, this past Saturday - Monday. But then, a bit of a mishap .... forgot to take 0.25 mg (half a tablet) of Alprazolam on Monday night. Went to bed without it, and woke up Tuesday morning with a headache and head pressure. Since then, I've had a relapse of the bad headache, disorientation & dizziness, and the "sea legs" effect when moving around, plus terrible tinnitus and hearing sensitivity. Also continue to experience the brain swooshes -- although to be fair, for the last couple of months they haven't been as severe and don't scare me as much.

 

In retrospect over the last 18 months, I thought I was going nice and slow, but in fact was probably weaning off the Duloxetine too quickly. I was not ready for only 2 beads a day - still on 3 beads a day right now, and will try to wait it out for some stability (something like I had Sat-Mon), and then stay at this level for a good period of time.

 

FH & IUN: Concerned about FH's posts about long term Benzo usage linked to Dementia. I already feel my memory has been severely compromised during my withdrawal - and I've been on my Alprazolam continually for at least 2-3 years, without knowing this. Now given this - is it recommended to try to wean myself off of the Alprazolam completely before resuming my Duloxetine bead drops? Also, is it acceptable to take two unequal doses (0.5mg and 0.25mg, respectively) of Alprazolam in a given day each day? Or, would it better to make each dose equivalent so that it is more evenly dispersed in my body over a given 24 hour period?

 

Here is my current daily medicine regimen, as of this week (maybe it will help with answering my questions.....):

 

7am - Duloxetine (1bead)

7am - Vitamin D2 supplement (50,000 IU)

8am - Pantoprazole (40mg)

10am - Suntheanine (100mg)

2pm - Alprazolam (0.5mg)

3pm - Duloxetine (1bead)

6pm - Suntheanine (100mg)

7pm - Omega 3 Fish Oil

10pm - Alprazolam (0.25mg)

11pm - Duloxetine (1bead)

11pm - Melatonin (5mg)

 

Thanks everyone,

 

-Vince

[fishinghat]

""still on 3 beads a day right now, and will try to wait it out for some stability (something like I had Sat-Mon), and then stay at this level for a good period of time."

Right on!!

"is it recommended to try to wean myself off of the Alprazolam completely before resuming my Duloxetine bead drops"

I wouldn't. I would just stay at the same dosage until off the Cymbalta. By the way studies show trhat by the end of 4 months people are tolerant to benzos and they do little good. Your dosage is fairly small so I would stay where you are for mow.

"Also, is it acceptable to take two unequal doses (0.5mg and 0.25mg, respectively) of Alprazolam in a given day each day?"

Yes, many drs will prescribe a low dose during the day and a slightly higher dose at bedtime for sleep.

"would it better to make each dose equivalent so that it is more evenly dispersed in my body over a given 24 hour period?"

That will be necessary when weaning of the benzo but not now.

[fishinghat]

I don't see any issues with the med schedule but I would make one suggestion. Research has shown that any dose of melatonin at 3 mg or more may actually interfere with sleep and the recommended dose is 0.3 mg. Something tp consider.

[Vinpin]

Thanks FH,

 

My gosh - I didn't know I was overdoing it on the Melatonin!

 

Maybe I will just cut back to 1mg per night for now. Can I just make the switch in one night, or ..... do I have wean my way from 5mg to 1mg?

 

Also .... do you have a personal favorite among brands that are in the marketplace???

 

Thanks,

 

-Vince

[invalidusername]

Hi Vin - normally the unequal doses question would be dependent on the half life - as a general rule, the longer the half life, the more likely split doses will not be an issue, but Alprozolam is around 11 hours, but as Hat is much more clued up on that area, his will be your answer.

 

Regarding the melatonin, again Hat is on the money there and I know from experience. 5mg is too high a dose. You will be fine to cut right back to 1mg immediately. I had horrible depressive symptoms after I took a dose of 5mg - and it is often reported on the internet where others have suffered the same fate. I posted something recently in NM's thread as she has the same reaction. 

 

On an aside, you might be interested to know that those weird ear symptoms you were getting, I am having something akin to them myself at the moment. I had quite mild tinnitus, but enough to notice when the noise changes. What happens is when I get a head jolt - which are very very mild (possibly due to all the Omega 3), it is as though someone has hit a reset switch on one of my ears. It all goes quiet (no tinnitus noise - but I can still hear background noise), and then it gradually fades back the tinnitus after a few seconds. Quite bizzare - but I have had ear issues for a while, so it doesn't bother me nearly as much as other recent symptoms.

[fishinghat]

As usual, IUN is right, no need to wean on the melatonin. Are you taking it every night?