1636 replies to this topic

[fishinghat]

I can't thin k of an over the counter drug that wouldn't also carry a risk of further set back.  Beta blockers work wonders for this but require a prescription.

[ForLyla]

Hey Gail

Saved your life during withdrawal?

Another Canadian!

[ForLyla]

I had a pretty good day overall but didnt feel good tonight. Do you guys think theres a certain amount of setbacks you can have where theres a point of no return or will we always keep bouncing back?

I have a week down from the start of my last setback... who knows how many more days left to go. Praying I only have a few weeks left like this. I'm looking forward to my SIBO breath test in 9 days.

[invalidusername]

Your mind controls the setbacks to more than the extent I think you realise. 

 

Just stop and consider how long you let your thoughts wander off about these problems.

 

There was an experiment done not so long ago whereby participants were invited to do a wordsearch. As soon as they had finished they could leave. That simple.

 

The control group were given random words to find. The test group were given words that pertain to old age. What the participants did not know was that they were being timed to see how long it took them to walk from the entrance to the door where the experiment was taking place.

 

On leaving, the control group took more-or-less the same time to reach the door as when they came in.

 

The test group took almost twice as long walking back as they did when they walked in before they started the experiment.

 

Something to think about.

[ForLyla]

IUN I agree that part of this is psychological. I believe they call it ebb and flow. I'm on vacation with my family right now. I didnt even want to come but forced myself on that plane and I'm glad I did. I still shake and my heart pounds but being in the sun and looking at the ocean makes me feel better. I was surprised how good I felt yesterday morning and afternoon despite a lack of sleep (6:30AM flight).

Any predictions on when I'll bounce back from this? The heart pounding is strange in this case compared to the others. It's getting progressively worse every day.

[invalidusername]

You did exceptionally well to get on the plane.

 

So when you say you "feel better" do any of the symptoms subside?

 

Do you have any warning of when the heart pounds etc come on?

[ForLyla]

The heart pounding comes on when I move and calms down about 70% after I've been still for a good while. It's the worst in the morning when I wake up. That's common for me but it usually dies off slowly over time. My other symptoms seem to be getting better but the heart pounding is getting worse.

My anxiety has generally been better on this trip and I'm not quite as dizzy or shaky. If that sensation of my heart thumping out of my chest went away I feel like this setback would be so much easier to deal with. Boy do I get frustrated when I see everyone having the time of their lives and how much I miss that feeling of happiness. Maybe one day.

[fishinghat]

Those are classic symptoms of anxiety (chronic adrenergic state. A beta blocker like propranolol, atenolol etc would bring that under control quickly. No withdrawal and could even be taken on an as needed basis.

[ForLyla]

FH so what does it do? Make you less anxious or just stop heart pounding?

I'd be too worried that it would interact with cymbalta.

[fishinghat]

It does not interact with Cymbalta and many of our members have used it.

 

As you are probably aware adrenaline causes significant effects in the body and brain. Well beta blockers like atenolol do not cross the blood brain barrier into the brain so has little DURECT effect on anxiety BUT it does block adrenaline receptors in the body. These receptors act to cause heart pounding, racing heart during flight or fright reactions. By reducing these symptoms it also tend to cause the patient to relax more and have reduced anxiety due to reduced stress.

[fishinghat]

Officially, beta blockers are not approved for anxiolytic use by the U.S. Food and Drug Administration.[38] However, many controlled trials in the past 25 years indicate beta blockers are effective in anxiety disorders, though the mechanism of action is not known.[39] The physiological symptoms of the fight-or-flight response (pounding heart, cold/clammy hands, increased respiration, sweating, etc.) are significantly reduced, thus enabling anxious individuals to concentrate on the task at hand.

 

 

Beta blockers inhibit these normal epinephrine- and norepinephrine-mediated sympathetic actions,[3] but have minimal effect on resting subjects.[citation needed] That is, they reduce the effect of excitement or physical exertion on heart rate and force of contraction,[70] and also tremor,[71] and breakdown of glycogen. Beta blockers can have a constricting effect on the bronchi of the lungs, possibly worsening or causing asthma symptoms.[72]

 

I would recommend Atenolol with propranolol as a second option as they have the lest risk of side effects.

[ForLyla]

Thanks FH. I think I'll try sticking it out for a bit and see if it goes away on it's own in the next few weeks first.

One thing I'm a little concerned about is that I'm in a pretty hot place right now and I carry my medicine with me. I keep the meds out of the sun but I'm worried the heat will alter the effectiveness of the drug. Any thoughts?

[invalidusername]

Not in a short period of time, no. Weeks, not days, will cause non-liquid meds to loose efficacy in heat.

[fishinghat]

In a hot place in Toronto?  Who that Cymbalta did effect you a lot.  lol

 

Temperatures above 90F (32C) in general is not to be exceeded but some meds are different. If there is a specific med you are curious about let me know and I will find out.

[gail]

Not Toronto but Les Caraibes!

[ForLyla]

FH just in regard to Cymbalta.

[ForLyla]

I've definitely been feeling better since I've been here but I feel so anxious since eating lunch today. I realized I had some mustard that had wine vinegar in it. Alcohol does set me back hard but is there even any alcohol in a tiny amount of wine vinegar? Could this just be in my head? I have heard of people who suffered from benzo wd that got setback after mouthwash etc. I don't get why I'd feel so weird after lunch though when all I had was a bit of chicken and mustard.

Also, I'm wondering if the non drowsy anti-histamines might have a lagging effect in setting me back as well. FH what do you think?

[fishinghat]

Could be a routine swing in withdrawal but I would bet on the alcohol. Alcohol goes into the blood stream very fast so any set back from it would have a quick onset. Some wine vinegar mustard contain  as much as 50% wine by weight although I am sure a lot of that is lost in  processing.

 

Any negative effect from the antihistamine would show within a day or two and then fade. How long since your last dose?

[ForLyla]

The mustard was a cheap one so I doubt it would have anywhere close to that.

FH do you think it would fade quickly? My last non drowsy antihistamine was 4 days ago. They make me feel so much better though!

[fishinghat]

I still think it was more likely the alcohol. You took that antihistamine before, did it give you a set back then and how long did it last?

[ForLyla]

I'm not sure. I take an antihistamine and feel fine for 2 or 3 days and then get very anxious when it wears off.

[gail]

Lyla, what antihistamine are you taking? Still in the Caraibes? I'm coming. You should see the snow that fell across Quebec, you won't want to come back!

[fishinghat]

It just sounds like the antihistamine is helping you with the anxiety and then after a couple days the effects wear off and the anxiety returns.

[ForLyla]

Having a rough couple of days. My heart pounding is much better but now I'm in tired/brain fog/vision problems mode. I realize this typically follows and I'll likely feel like this for about 2 months. I also have weird numbness on the side of one of my feet which is freaking me out. I've heard of numbness with benzo wd but not cymbalta. I had a brain MRI a year ago and it was all clear.

[ForLyla]

So it turns out I have methane SIBO. The known treatments are going on an all liquid elemental diet and/or antibiotics. This sucks but at least I know what I have now. My methane levels blew astronomically high. Amazing what a little stomach flu can cause.

[gail]

At long last!

[fishinghat]

Methane SIBO

https://www.ncbi.nlm...les/PMC5418558/
Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus.
High methane levels relate to constipation causing SIBO.

https://www.ncbi.nlm...pubmed/23470880
The importance of methane breath testing: a review.
Good overview.


https://www.ncbi.nlm...m_medium=search
Functional 13C-urea and glucose hydrogen/methane breath tests reveal significant association of small intestinal bacterial overgrowth in individuals with active Helicobacter pylori infection.

https://www.ncbi.nlm...pubmed/26278025
Breath hydrogen and methane are associated with intestinal symptoms in patients with chronic pancreatitis.

https://www.ncbi.nlm...pubmed/19997657
Small intestine bacterial overgrowth is frequent in cystic fibrosis: combined hydrogen and methane measurements are required for its detection.

https://www.ncbi.nlm...pubmed/31689699
Association between increased breath hydrogen methane concentration and prevalence of glucose intolerance in acute pancreatitis.

Note - Sounds like a pancreatic wnzyme test may be in order or a urea breathing test for H. pylori.

[ForLyla]

It looks like I may have to take Rifaximin and Neomycin. Any reaction with Cymbalta? It would be hard to believe that any antiobiotics would react with Cymbalta. 

 

Does anyone know what I should be worried about in withdrawal by taking antibiotics?

[ForLyla]

I also might just try an elemental (all liquid) diet to start. Apparently methane sibo causes histamine intolerance which may very well explain why non-drowsy antihistamines make me feel so much better. 

[fishinghat]

Rifaximin
Mainly by CYP3A, not the same as Cymbalta. No listed interaction with Cymbalta.

Neomycin
Excreted through kidneys and feces and does not use a CYP system. No listed interaction with Cymbalta.

ALERT: U.S. Boxed Warning
Toxicity:
Systemic absorption of neomycin occurs following oral administration, and toxic reactions may occur. Patients treated with neomycin should be under close clinical observation because of the potential toxicity associated with the use of neomycin. Neurotoxicity (including ototoxicity) and nephrotoxicity following the oral use of neomycin sulfate have been reported, even when used in recommended doses. The potential for nephrotoxicity, permanent bilateral auditory ototoxicity, and sometimes vestibular toxicity, is present in patients with healthy renal function when treated with higher doses of neomycin or for longer periods than recommended. Serial, vestibular and audiometric tests, as well as tests of renal function, should be performed (especially in high-risk patients). The risk of nephrotoxicity and ototoxicity is greater in patients with impaired renal function. Ototoxicity is often delayed in onset, and patients developing cochlear damage will not have symptoms during therapy to warn them of developing eighth nerve destruction, and total or partial deafness may occur long after neomycin has been discontinued.
Other factors which increase the risk of toxicity are advanced age and dehydration.

Neuromuscular blockade:
Neuromuscular blockage and respiratory paralysis have been reported following the oral use of neomycin. The possibility of the occurrence of neuromuscular blockage and respiratory paralysis should be considered if neomycin is administered, especially to patients receiving anesthetics; neuromuscular-blocking agents such as tubocurarine, succinylcholine, decamethonium; or massive transfusions of citrate anticoagulated blood. If blockage occurs, calcium salts may reverse these phenomena, but mechanical respiratory assistance may be necessary.

Concurrent therapy:
Concurrent or sequential systemic, oral or topical use of other aminoglycosides, including paromomycin and other potentially nephrotoxic or neurotoxic drugs such as bacitracin, cisplatin, vancomycin, amphotericin B, polymyxin B, colistin and viomycin, should be avoided because the toxicity may be additive.
The concurrent use of neomycin with potent diuretics such as ethacrynic acid or furosemide should be avoided, since certain diuretics by themselves may cause ototoxicity. In addition, when administered intravenously (IV), diuretics may enhance neomycin toxicity by altering the antibiotic concentration in serum and tissue.