80 replies to this topic

[mforster]

Hi everyone,

 

I was prescribed 20mg of cymbalta after having bad experiences with both zoloft and wellbutrin. I didn't like the emotional flattening, the fatigue, and the lack of motivation--turned my anxiety into depression!

 

Anyway, I asked my doc about going off and she said because I'm on the lowest possible dose, just to go cold turkey. And well, you know how that goes:

 

Last night was night three and I was up all night vomiting and having diarrhea. I have strange muscle aches and headaches that feel like the flu. My doctor (who OF COURSE has never heard of this before!) reluctantly prescribed 20mg again and I told her of my intention to count beads, like I read about here during my insomnia.

 

I see several threads about weaning from 20mg. My question is--can I decrease my beads more quickly because I've only been on it for 2 months? What would a proper weaning look like, in terms of percentage of beads weekly?

 

Thanks for any help you can provide!

 

M

[fishinghat]

Welcome mforster.

Unluckily 2 months is enough to have a strong withdrawal. Normally we suggest starting at around 1% drop a day at the most. You can adjust from there once you see how you are doing.

[invalidusername]

Hi mforster,

 

As Hat said, 2 months is plenty of time to kick off a withdrawal. I was only on 10 weeks and had to go slow. With regards to the speed, everyone is different, and logically, 2 months should be easier to come off than 2 years. Your initial reaction is not surprising since you have cold turkey'd, and I would suggest you reinstate the 20mg today and bead count as you say. 

 

Count the amount of beads in a capsule, and go 1% for a few days and see how you fair - bear in mind you will need to level out from the last couple of days which in itself will take around 3 days. You can then adjust the drop from there, but do slow very slowly. If in doubt, please ask!

 

IUN

[gail]

Welcome Mforster,

Just two months and to have to bead count sucks. But, it's the way it goes with Cymbalta.

We're here for you anytime you need. You need to buy capsules that are not gelatine. You need enteric coated. Guys, help me with the right word. Enteric coated? You got a French gal here. Words Are tough at times.

[invalidusername]

You are spot on Gailage. Enteric coated is correct - or "acid resistant".

 

This is important as the capsule needs to survive the stomach acid for correct metabolism in the liver, otherwise blood levels will be reduced significantly. And courtesy of Hat's research, we also know the bead coating is hazardous to the stomach lining.

[mforster]

Thanks, guys. Ordered the capsules. My wife is going to pick up the Rx now. I'd normally take it around 8pm. Can I take it as soon as she gets back? How soon will I feel un-flu like, in your experience.

 

I am so grateful for the info and attentiveness of this forum where my doctor's medical degree seems to have failed her. 

[invalidusername]

Not knowing what time it is where you are I cannot say!

 

As you have already been 3 days off, then the blood levels will already be messed up, so yes, take it as soon as she gets back, but just make sure you stick to the same time after this. If 8pm worked for you as a reminder, then start that tomorrow.

 

Keep us posted!

[lady2882Nancy]

Hi M

I was on 30mg for 5 weeks then 60mg for 1 week. So even with a total of only 6 weeks it was a long tough battle to get off. In hindsight I know I tapered too fast but my depression on Cymbalta was so bad that I was suicidal. I had to make some drastic cuts along the way and it was really rough. The stupid thing about that is I was on it for pain and not depression. 

The point being here is to go slow and don't push it if you do not have to. 

It may see crazy to take longer to taper off then you were on them but trust me the long term side effects from going too fast are to be avoided at all cost.

 

Take care

Nancy

[invalidusername]

How soon will I feel un-flu like, in your experience.

 

Sorry - we missed this part. Levels should settle again within 3 days or thereabouts. Expect to feel a bit ropey until then. You should start to feel a bit more like yourself with each passing day thereafter.

[fishinghat]

Good catch IUN. I missed that too.

[invalidusername]

We try our best - but some slip the net!

 

Keep us posted on how you get on mforster...

[mforster]

You guys are so amazing! The flu symptoms continued through the day (body aches, head ache, lethargy, nausea, although vomiting/diarrhea went away). I took some xanax to sleep and woke up feeling 100% better. I am going to drop my first beads tonight (2). Crossing my fingers! Thank you, again, for all of your help.

[invalidusername]

Glad to hear you are feeling better. Did you count the amount of beads in your capsules?

 

Just remember not to rush ahead, but if you feel you are ready then go for it.

[mforster]

Yes, I think I got ~ 110 in a 20mg of generic, so 6 beads = 1mg (approx). I'm going to see how it goes for 3 days and try and weather forward. If it's bad, I'll add beads back in and go slower.

 

I don't know how long I'll have this Rx. It feels silly to have to go get another psychiatrist and pay for that appointment just so I can be in charge of my own weaning. It's really a shame doctors don't seem to know the risks beyond what they read in the drug company's info packet. She told me that I am "exquisitely sensitive" and that most people don't have any problem coming off Cymbalta. 

[invalidusername]

"I'll add beads back in and go slower"

 

This is what you want to avoid, which is why I say go steady. Better to go slowly forward than get ahead of yourself and have to go back up. If you do hit a bad patch, it is better to stay on the dose - stabalise - and carry on. Going down, up and down again will only make things more difficult for you.

 

What you were told was EXACTLY what the p-doc told me. I tried to reason with the idiot, but he just didn't want to know. The meeting concluded with my beads being taken away to force me to cold turkey from 10mg. It was harsh - believe me.

[KathyInFL]

She told me that I am "exquisitely sensitive" and that most people don't have any problem coming off Cymbalta. 

 

Doctors don't know or don't want to know how problematic this drug is. I'm on a facebook group with over 10k members in it, and I'm sure there is more than 1 group.

[fishinghat]

I am glad you are feeling better. I would normally recommend dropping no more than 1% a day which would be around 1 bead but you can try the 2 bead drop and see how it goes.

Also, could you let me know the brand of Cymbalta. I keep a data base of how many beads in each dose of each brand. Thank you.

[mforster]

It's Duloxitine, 20mg.

 

I know. I'm hoping because I had the three days off and only took it for 2 months, I'll be able to go a little quicker. Maybe this is foolish thinking on my part. 1 bead every three days would take me almost a year to wean and I just can't fathom that!

 

When people say the last 10 are the hardest, do they mean the last 10 beads or the last 10%?

[invalidusername]

Do you have the pharma name for the Duloxetine (such as Teva, etc)?

 

You may indeed be just fine with the 2 beads - 1 bead every 3 days is for extreme cases! As Hat says, see how it goes...

 

It is the last 10mg, as the level of 10 beads depends on the bead count. The last 10% can get tougher still though. But where people have casually dropped and dropped, it is usually the 10mg point that is the proverbial "wall". If you haven't hit it before, you are guaranteed to do so at this point! We prefer to prevent that by bead counting before you get to that point as once you have hit, it is the repair work that really sucks!

[mforster]

Can't find the actual pharma name. Would that be on the bottle somewhere?

[fishinghat]

It should be but if you can't find it then it is Ok.

[mforster]

A group I just joined on facebook recommends dropping 5-10% every 10-14 days in order to let the brain stabilize. They have me second guessing my original plan of every three days. Have you heard of this longer adjustment period? Do you think it's overkill? 

[fishinghat]

It is my opinion and experience with others here that a 5-10% drop can be very devastating and take months to recover from. Just my opinion. There are those that come off Cymbalta with little to no issues but that is uncommon.

[invalidusername]

Are we still talking bead counting here, or one-drop at the 10/14 days mark?

 

If the case of the former, it would be comparable to what you are doing - in the latter, certainly not... in my opinion... (oh, and Hat's by the looks!)

[mforster]

Best I can tell, they are talking about the "cut and hold" method of bead dropping (been doing some additional research). They advocate 5-10% drop of the new amount every 2-3 weeks. (i.e. weeks one - three, I'd drop 5 beads from my 110 bead capsule; if that was ok, I'd take 5% of the new 105 bead capsule for 1-2 more weeks and so on a so forth). They are saying this will help me avoid "protracted withdrawal" because I reinstated use of the drug within a week of discontinuation. At that rate, I'd be weaning off for like, a year.

 

I want to optimize my chances of success here, but I also don't want to be obsessing about bead counting for a year for a drug I was on for 2 months. It seems like a cruel joke that one of the conditions Cymbalta is prescribed for is OCD and then the only way to come off of it is by obsessing and compulsing (not a word, but you know what I mean). 

 

If I follow the loose-ish plan I made based on your recommendations, I will drop 9mg the first month and then 3 -4 mg a month thereafter to get me off of the drug by mid-August. Feels like a 4 month taper should be good. But I guess only time will tell! I am pretty sensitive to medications. I feel like I can withstand some milder withdrawal symptoms as long as I'm not experiencing the kind that make me bed and bathroom-ridden. 

[invalidusername]

That is a bloody long withdrawal. I don't think that would be necessary. 

 

A slow and steady incline is fine if done slowly and I think the 4 month route will serve you well. Potentially, you might have to go a little slower towards the end - last 20 beads or so - but let your body tell you what it wants.

[fishinghat]

I have been on this site for 6 years know and while I don't have any hard statistics I am more and more convinced that a slow withdrawal for a year or more would be wise for most. If I had to do it again (God forbid) I would shoot for a 2 year withdrawal. Just an opinion, no proof. In your case I would not take that long however considering the short time you were on it.

[DebbieC61]

From Cymbalta Hurts Worse support group--do not use enteric coated capsules--people in that group use regular gelatin or vegetable capsules.

 

Quote from the moderator of that group:

 

"Do not use enteric coated capsules. The capsules that come from the pharmacy with your prescription are not enteric coated. The tiny beads inside are enteric coated. If you do this as we suggest that capsules will dissolve in your intestine as intended by the manufacturer. We want this."

[invalidusername]

Hi Debbie - thanks for posting this.

 

We have been through this in some detail here on the forum and can confirm that the capsules ARE enteric coated, and that the beads when exposed to the stomach are considered toxic. I forget where the post is, but there are links to back up all the claims.

 

Lovely avatar btw

[invalidusername]

Found it

 

https://www.cymbalta...st-2mg/?p=81374