48 replies to this topic

[Tiredcymbaltamom]

I need assistance in weaning off cymbalta.  I started 1-2 weeks ago to wean off.  I started cymbalta about 10 years (?) ago.  I stayed on 30 mgs although my doctor wanted me on 60.  I didn't want any of the side effects including zoning out.  I started taking it for fibromyalgia.  Now I'm trying to get off of it because I've wanted to for a long time and I'm having surgery and won't be able to take pills anymore after the surgery. My doctor said open the capsule and then take out half the beads and then close it.  He didn't say how long to do that so I did it at that amount of beads about 3 days.  After that,  I felt much clearer in my thoughts and was encouraged with the success.  Then yesterday I tried taking out more.  I was using a scale.  But I must have taken out too much.  I woke up feeling a little ill but by evening I was so sick feeling I started to cry.  Not emotional from the medicine either.  I just felt so bad and really felt like I might need to go to the ER. It started with a headache and then dizziness and then nausea.  By the evening I felt as horrible as I remember ever feeling including having my chest feel like it was going to explode.  Finally out of desperation I took another capsule and opened it and put enough only to bring me up to what I was approximately before when I felt better.  Making sure what I took yesterday morning plus the additional amount was equal to or a little less than yesterday.  After a couple of hours of laying down, the edge was starting to come off of how I felt.  I felt ready for ER before the additional amount, then after a couple of hours I just felt horrible.  So now where do I go from here?  I was thinking I would keep the beads up to the level I ended up with by yesterday evening.  This morning I still feel a little dizzy and all a little on all the above but not horrible.  Just enough to be annoying.   

So my questions:

1) Should I just try to stabilize on this level for a few more days?  I get the half life of these pills but it certainly seems not completely relative to what I'm feeling and trying to wean off.  

2) Here is my other issue.  On feb 15th I can't take the capsule anymore.  My doctor said to open it at that point and  put it in pudding or applesauce.  That seems to go against some of the readings I have read on the internet about keeping them in the capsule.  But I can't do that.  So do I have a week to get off this medicine? 

 

Any help would be appreciated!

[invalidusername]

Hi TSM and welcome!

 

Long story short - you have come down way too quick - waayyyy too quick. Your doc was right in saying to open the capsule and take out beads, but not half - not even close after 10 years on it. Like I say to a lot of newcomers, if you are a smoker and lets say you were 40 a day, then all of a sudden you are 20 a day. How would you feel? Exactly!! 

 

Now consider that cymbalta is more difficult to come off than heroine according to the FDA.

 

Go back to what you had first off and try to stabalise if you can. Others might tell you to go back to square one - which is viable, but that much is up to you, but for sure, you need to go back up.

 

Might have missed something, why do you have to stop on Feb 15th?

 

Forget the pudding and applesauce!! 

 

IUN

 

edit - if you "have" to come off this drug in a weeks time, then a very quick taper is called for, but I won't lie to you, things will be rough - strap yourself in...

[Tiredcymbaltamom]

Thank you for your quick reply.  I am having hiatal hernia surgery the 15th.  After that no pills/capsules of anything and they want that the rest of my life.  This is a thoracic surgeon who is the top of his line in this field telling me this.  So, the pudding/applesauce idea, what would happen if I do that?  How does that react in my system?  Is it just a shot of it instead of a stead dose over hours?  Sorry I give to many words to tell a story.   So if the pudding/applesauce idea is not going to work and I have to be off pills, then unless you can think of something else, I will have to quick taper.  If I stayed where I am for a day or two more, and then cut that in half?... I don't even know what to do with this.  My doctor is usually an out of the box thinker.  But this area makes me question if he stepped out or is just too difficult to know.   What is your thoughts?

[invalidusername]

Ah - OK. Understand now. 

 

I will be honest, this now goes over into the area of expertise which call for our resident expert, FishingHat. I would not want to say the best course of action considering the surgery, but he will know what to do. 

 

I expect he will be along shortly...

[Tiredcymbaltamom]

Thank you.  Thank you.  I appreciate your quick replies.  It calms me.    I will wait for FishingHat.  

[gail]

Welcome TCM,

First thought, can the surgery be reported? IUN is right, Fishinghat knows a lot about these things and he should come around soon. Hang on!

[lady2882Nancy]

There is no reason that you cannot use the pudding or applesauce instead of the capsule, There have been many on this site who came done from 20mg by using applesauce and I would expect that the pudding would work the same. The idea is to protect the stomach and throat and both of those will do it.

[invalidusername]

My concern about this is the capsule which is coated against stomach acids - as are the beads... but the jury is still open on why they are both coated.

 

However....

 

If it is a question of taking them or not, then absolutely, the sauce is the way to go. I didn't realise the surgery element in our friends story here when I first replied as others have used this instead of capsules when they couldn't be bothered to find the right ones

[Tiredcymbaltamom]

It is crazy that this is so difficult to do.  And doubly crazy that there is no help from the company who makes this.  That says a lot about them.  I so appreciate this website and the help of those who have replied.  I don't feel so uptight.  Mainly now is trying to deal with how to wean off and if I have to do it in a week or not!

[invalidusername]

Eli Lilly don't want you off their drug because they would loose your money my dear!!

 

This is why they don't help. If they did, they would be forced to admit how bad their drug is for withdrawal.

 

If there is any way you can do this long-term and not in a week, we need to do it. We don't want you to suffer...

[gail]

Thanks ladyNancy for your input. I trust your judgement and if it can be done this way, well we are in great relief here.

And Fishinghat, are you on vacation? You input is real valuable here. Joke, he's not on vacation.

He'll show himself today. TCM, no worries.

[Tiredcymbaltamom]

Thank you.  Everyone.    I also bought some L-Theanine  and L-tyrosine based on another post regarding helping the withdrawal side effects.  I still a little bit of the dizziness and nausea although it is a little less than yesterday.  So hopefully that's progress.  If my situation were more normal and without the surgery issue, how long do you have to stay on the step downs in order for you to not have withdrawal symptoms or oat least severe ones?  Just FYI, I can't for some reason reply to the posts on my iPhone so I have to wait till I am home to read it on my computer to reply.  :-/  It's a drag.  I can read your replies on my email but i can't reply to them.  Thank you again for all you help.  I really appreciate it.  

[gail]

Hello,

If it weren't for your surgery, you would be bead counting. Real slow, it takes about one year to withdraw, let's say, comfortably. It's slow process. Some may take six months others more than a year.

Along the way, if it's too rough, you cross taper with another antidepressant. We're far from there. Be assured that we'll be with you all the time it takes.

Bead counting would be like today, you remove two beads, tomorrow four and six and so on. You can start if you want now. See you later!

[Tiredcymbaltamom]

Do you know how many beads are in one?  I might pick up where I am now and see how long that would take me.  There are a lot so if you don't know I will just try to count tonight and get a starting point.  So changing each day down the small amount is not so overwhelming if it weren't for the surgery.  I can't change that unfortunately so forward we go. :)Thanks  

[fishinghat]

Hi TCM

Sorry I couldn't post earlier. We had a tornado watch and a flood warning and then an ice storm and was without internet until about 30 minutes ago. No stress here.

First of all lets address the applesauce pudding thing. The reason the FDA does not recommend that is the twice over coating on the capsule and beads is to keep the stomach acid from reaching the Cymbalta. It has been discovered that Cymbalta is converted to a chemical that is fairly toxic.


https://dailymed.nlm...f2-c185fbad64ba

Excert from the drug insert for Cymbalta.
"Do not open the capsule and sprinkle its contents on food or mix with liquids. All of these might affect the enteric coating."

Now, having said that Lady Nancy is right. A great many of our members have taken the beads with applesauce or other soft food. Be sure not chew the beads though.

Next - Feb. 15th? Holy Moly. That is a week away. I know you said you can not take capsules but can you take a regular pill like the L theanine?
Between now and the 15th I would focus on taking partial capsules of Cymbalta to help minimize the withdrawal symptoms. You could make up some capsules with about 5 mg Cymbalta in them and use them as necessary to achieve some relief until the surgery.

[fishinghat]

In the Medical Support section is a thread called Summary of Cymbalta Withdrawal Information and covers all sort of technical info on Cymbalta but more importantly it also discusses what members have tried and what success they have had with it. You might consider looking through that as well.

[invalidusername]

Glad we have found a reason for the capsule conundrum now Hat!

 

TCM you might trying picking up some apple cider vinegar. It helped a lot with others, and with me also. But more is not better - only a few drops, otherwise it can upset the stomach!

 

I really wish you could postpone your surgery

[Tiredcymbaltamom]

Thank you all.  I will check out the Summary of Cymbalta Withdrawal Information.   Not to get too bogged down with my health issues, but I have lupus and it is affecting my lungs.  I also have had bile reflux that they have had trouble controlling and they think some of the scarring in my lungs might be from the bile getting in there.  I also have barretts in my esophagus which also makes it important to fix the hernia that allows the reflux so much.  So I'm really needing to get the surgery sooner than later. I have found l-tyrosine in powder form and l-theanine in chewable tables.  Right now i'm taking capsules while I can.  

 

Regarding the beads in the applesauce, I spoke with someone at my pharmacy that said the problem with opening the capsule is it needs to get farther down the digestive system in order for the medicine to deliver correctly.  I am amazed at how much information is that our and I seem to leave more new things about this crazy medication.  There was apparently a 10 mg tablet form of cymbalta but they discontinued it.  The lady at the pharmacy was also trying to see if there was an alternate medicine that I could go to that I could crush or break but they said because it's for fibromyalgia and not depression it wouldn't work.  

 

Ok I'm off to do my reading for the withdrawal information.  One more question.  I'm noticing these last two days, especially noticed it today, that when I go to take my doctored pill I have a little nausea and a little dizziness.  But about an hour-two hours after taking it (today I was late getting it) I started having a bad headache and felt worse.  Do you think it's because my capsule isn't sealed anymore from where I opened it?  I put the capsule back together before taking it.  Maybe I could go lower on the dosage?  Added note:  I take diphenhydramine at night.  Maybe that is why I feel better more in the morning after I have taken it.  This information is after looking at the document recommended by Fishinghat.  OK.  Thank you all.  

 

To Fishinghat, thank you for your input especially after such a crazy day.  

[fishinghat]

Something to consider... I know you will not be able to take capsules after the surgery but if you can take a regular pill then there may be a solution to the horrible withdrawal. Many on here switch to an ssri like Zoloft, Lexapro or Prozac to help alleviate the withdrawal symptoms. It will not help the fibro but they do control serotonin like the Cymbalta and could help with the withdrawal symptoms. There will be a pretty rough time until the new medicine kicks in though. Once the surgery is over you can then wean off the ssri slowly and have a less stressful withdrawal.

[fishinghat]

By the way, did the dr tell you why you can not take capsules any more? I would imagine it is do to the risk of Pharmacobezoars.

[invalidusername]

Pharmacobezoars... just what I was er, thinking

 

Maybe our friend could try 5HTP to kick things off quicker as there will be no taper? Not ideal, but then again, neither is waiting 6-8 weeks after surgery for an SSRI to kick in. Man, do these things suck...

[KathyInFL]

By the way, did the dr tell you why you can not take capsules any more? I would imagine it is do to the risk of Pharmacobezoars.

 

I had to google that, I was sure you were making that word up!

 

TCM, good luck to you! I'd listen to Hat and IUN, they know their stuff!

[fishinghat]

Yes, IUN, I guess I would start with the L-theanine first and if that is not enough then go to 5htp or l-tryptophan (not both). TCM will be on some pain medication for a while after her surgery so she will need to be careful on her compatibility issues and as she comes of the pain killers her response to the ssri or supplements may change.

[invalidusername]

Yes - absolutely not both - agreed. 

 

Given the pain killers, I do think it would be better to think nootropics/adaptogens so that we are aware of what is being targeted in the brainium, rather than the "anything-in-the-frontal-cortex-goes" approach of the SSRI!!! I fear for her playing a guessing game with the potential side effects. At least with a non-medicinal approach she can stop with minimal effort if things go pete tong.

[Tiredcymbaltamom]

Thank you all.  I tired to reply on my phone but didn't have the "reply to this topic" option.  Regarding Pharmacobezoars, which I too had to look up, that is correct.  I even received that information in my surgery preparation file they gave me.  They didn't use that word though.  Probably saving people the need to look it up.     In regards to the taking of other medicine in tablet form, If it can be crushed, I can take it.  The last discussion I had with my doctor's nurse was asking if there was something I could go on that I move directly to, that would let me wean off by crushing, and that would allow me to get off cymbalta this week.  I'm waiting for a response now.  That discussion happened yesterday late afternoon.  

 

I tend to be a person with multiple plans in case one direction is cut off.  So, thinking of your comment, Fishinghat, regarding the 5-htp or the I--tryptophan, I have started taking  l-tyrosine in powder form and l-theanine in chewable tablets.  Would you recommend adding one of the two you suggested to that?  

 

And I'm not sure if any pain killers I will go on.  I don't tend to like pain killers as they make me feel really ill.  And one additional side effect of my surgery will be that I can't throw up.    So I am really not sure that I even want to attempt that.  I had a hysterectomy and it was not very painful except I had a bad cough because they started with gas.  The coughing made something difficult that I thought else wise would have been a piece of cake.  

 

You all seem to have a lot of information and experience which I am so thankful fo.  In my case, should I just try to take a little more out of the pills to wean down to almost nothing by friday and then supplement with  l-tyrosine  and l-theanine with maybe 5-htp or tryptophan?  I know I need to still function up to a certain point till this stuff is out of my system, but I am also ok to attempt a "rip the bandaid off" to a certain extent.  I did feel like a trip to the ER might have been needed (or at desire for someone to knock me out) a few days ago, so I think I could take a few inches before that!    

 

One more question, I seem to wake up feeling ok but then after I take the pill, about an hour or two later, I feel awful for the rest of the night, i.e. dizziness, nauseated, headache.  Do you think that is because my system isn't getting the amount of the medicine it wants?  Or could I go a lot less and see if I get any reaction and try to supplement with the above items.  

 

​Thank you for your help.  I'm sorry it takes me awhile to get back to my computer to reply.  I do read your replies on my iPhone.  

 

Thanks.

[fishinghat]

"So, thinking of your comment, Fishinghat, regarding the 5-htp or the I--tryptophan, I have started taking l-tyrosine in powder form and l-theanine in chewable tablets. Would you recommend adding one of the two you suggested to that?"

If the l-tyrosine and/or l-theanine is going to help you should be able to tell within a couple days. I would see how much help you get from that first. If you need more relief then you could move on to either the 5htp or L-tryptophan.

"One more question, I seem to wake up feeling ok but then after I take the pill, about an hour or two later, I feel awful for the rest of the night, i.e. dizziness, nauseated, headache. Do you think that is because my system isn't getting the amount of the medicine it wants?"

Strange, taking a dose of Cymbalta usually brings some relief from the withdrawal within an hour or so. What dose are you on right now?

[Tiredcymbaltamom]

The first day I had the really sick feeling, I added more and it seemed to bring relief.  That's why I was wondering if my system isn't getting the amount it wants.  

 

I have 30 mg pills and a jewelry scale.  I weight the pill first in ounces and it is usually .0070 (or .0069 or .0071)  .0070 is the average.  Right now I'm have the pills emptied to weight .0033 on the scale.  The first days I weighed and i felt good for 3-4 days I was doing .0028.  So I don't know if after a couple days I went through withdrawals and now I'm in a somewhat constant state of withdrawal, or if .0028 was good and I should have kept going or at least stayed there.  I moved up my amounts to the .0040 range after I felt the worst, but now I'm just constantly feeling a little yucky until I take the pill and then I feel awful.... but at least not ER yucky.  

[fishinghat]

Just listen to your body. I know you are in a rush but if you change too many things at a time and you develop bad symptoms you won't know if it is the withdrawal, the L-theanine, the L-tyrosine, 5htp, etc. One change at a time. After 2 or 3 days you can consider another change.

[Tiredcymbaltamom]

I agree.  And I appreciate your thoughts.  I have already started the l-theanine and l-tyrosine.  I will hold here along with my cymbalta levels and see what the next 2-3 days bring.  

 

Questions:  

Would you think based on your knowledge that 2-3 days I should be good meaning if I'm good, I could continue to reduce?  

 

Does it take 6 months to a year for people to get off because it takes that long to wean off the medicine?  Or does because your system doesn't acclimate well even after the medicine is out of your system?  

 

Thanks again for your help and input!

[Tiredcymbaltamom]

A quick update: I took my medicine after my last message along with the two supplements and I had also taken melatonin and 25 mg 5 htp before Fishinghat had suggested to not put too many oars in the water.  It is normally for sleeping but I took only a fraction of what is suggested for sleeping.  After multiple hours after taking my cymbalta, I have had any negative effects; no nausea, no headaches, no dizziness.  Tomorrow I will try the exact same thing and hopefully will have the same results.  Maybe with the supplements I can reduce by Friday.  That's what I'm praying for. Thanks again.