1191 replies to this topic

[Mxpro32]

Hi.  I started tapering from 60mg cymbalta about 6 months ago.  I had been on it for years (can't remember how many).  my psychiatrist recommended going from 60mg to 40mg for a month, then 40 to 20 for a month, and then cold turkey.  he said I could take the 20mg every other day if I needed to.  what a joke.  trying to go from 20mg to nothing was impossible.  I took my 20mg capsules apart and found 4 tiny tablets.  I started with 3 and kept at it until the brain zaps stopped, then went to 2, then 1.  going from 1 5mg tab to nothing was by far the hardest jump.  I would take one and then not take another till I started having brain zaps.  eventually it would be 4-5 days, and eventually the brain zaps stopped.  

 

other meds:  lamotrigine, and concerta (extended release ritalin)

 

my withdrawal symptoms while tapering were:

 

-crying a lot, but not for no reason.  mostly happy ones,   I almost ran out of my sons kindergarten graduation because I didn't want to cry in front of everyone.  any touching story would have me crying.  crying was an option before, now theres no stopping it and I've never been like that even before antidepressants.  some of the crying is for appropriate sad moments (I was never really able to feel the pain and process the sadness of losing my mom and brother 10 years ago 2 weeks apart).   I don't really mind the crying, as numbness is the main reason I quit, but I'm hoping I adjust to having emotions and not cry so often.

 

-brain zaps

 

-completely losing my train of thought to the point of stopping mid sentence with a blank brain.  

 

-dizziness/ head feeling funny

 

 

I've been completely off the cymbalta for 2 months now, and things are getting way worse.  My business went through a scary time that really stressed me out and I almost fell apart.  turns out a lot of the business stress was caused by my foggy brain.  I forgot to process $16,000 in sales that came in through customer financing, and I forgot about some orders that were P.O.s that payment hadn't come in for yet.  doing the math, I thought I was screwed and that my money wasn't profitable (been in business 13 years so this should have been an indication I wasnt being rational).  turns out I'm not in that bad of shape, but I can't shake the crazy anxiety and depression and its been several weeks.  in my head, Its inevitable that I am completely screwed and the prospect of losing my business and having to get my first career job as an engineer while dealing with all these emotions and anxiety is completely overwhelming. 

 

symptoms 2 months of no cymbalta:

 

-insomnia.  I've been waking up at 4 am every morning feeling like I drank a pot of coffee.  the lack of sleep and anxiety had me at my breaking point.  I'm now taking .5mg xanax at night, and again at 4 am when I wake up so I can get a little more sleep.  

 

-depersonalization.  feeling like I can't trust my thoughts or feelings.  like I have no idea who I am or what makes me tick.  can't even imagine what would make me feel fulfilled.  not sure whats left of me.  

 

-mood that is all over the place, hour to hour, sometimes minute to minute.  I'll actually be pretty happy, then a moment later I can be completely depressed and miserable.  anxiety happens any time I am unable to stop the constant negative thoughts that are creatively coming up with all the ways I am screwed.  lately, I am mostly depressed.  

 

-constipation.  I have never really been constipated in my life.  actually the opposite, my wife makes fun of me for how often I go, especially on the ritalin.  now even on the ritalin I have a hard time going.  

 

-dizziness has returned this week.  

 

I went to my psychiatrist when I was pretty sure I was having a nervous breakdown and couldn't take it any more.  he said I would most likely need to be on antidepressants for the rest of my life.  he prescribed latuda, an antipsychotic.  I was desperate for relief, but the side effects of increased blood sugar and cholesteral and others, I decided I wanted to commit to getting off all of them, so I never started the latuda.  now my main question I'm struggling with is:  am I really just a depressed anxious person when i'm not on antidepressants, or are these symptoms of withdrawal?  I'm leaning toward withdrawal because my depression was no where near this bad before I started messing with antidepressants almost 20 years ago.   I was just a little numb and out of it then and probably should never have started AD.  now I'm in deep despair and pain, way worse.  its hard for me to picture a future, and any future I can imagine is one where I am miserable and its anxiety inducing.  my kids are the only thing that actually bring me joy lately (they are 4 and 6).  I am glad I still have the patience for them.  

[frog]

Hi Mxpro,

The more knowledgeable members will be along soon to offer more insight and advice and help get things stable. To me this all sounds like withdrawal/your brain trying to relearn how to function properly without the crutch of Cymbalta. The good news is there are supplements and things you can take to get some of your symptoms under control! The other good news is that brains are pretty handy at healing and fixing things. The bad news is that the healing and fixing takes a while and the progress can be jagged and so gradual that sometimes it can be hard to see it. 

 

I'm also dealing with acute withdrawal right now. And similar to you I had an initial round of withdrawal symptoms and thought that was that! I had some brain zaps (nothing too bad), very irritable and easy to anger/annoy, and a little stomach issues. Everything was improving and then 3 weeks in BAM got completely blindsided by intense non-stop anxiety, nausea, a variety of extra stomach issues along with lightheadedness/dizziness. That was 4 weeks ago. Things are still tough to be sure, but I'm seeing some slight improvements and gaining more of an ability to do regular things again without completely dissolving into a pile of anxious mush and crying when my husband asks if he can leave for an hour to go to the store (true story).  

 

Did these new bad symptoms you're having start very recently or have you been dealing with them for a bit already? Are they getting worse or just kinda staying the same? 

[Mxpro32]

the really bad anxiety and hopeless depression started about a month ago (1 month off of cymbalta completely).  I started jolting awake at 4 am with anxiety.  my depression has been crushing.  we just had game night with friends and I'm exhausted from trying not to cry and collapse on the floor.  I wish I knew for certain if this was the depression returning or cymbalta withdrawal.  it would be easier knowing it was withdrawal because there would be a light at the end of the tunnel.  otherwise, I don't know how much of this I could take. 

[TmanB]

Hi Mxpro

 

so sorry for hearing your issues, but on the other hand also proud that you managed to get off the Cymbalta for already 2 months !!!

 

Your symptoms sound very familiar to me. Especially these anxiety stories. I am (next week) 5 months off of Cymbalta and my anxiety/insomnia started a bit later than yours ... after 3 months. I started a company of my own and all went quite well (and objectively, everything is still going quite well) but I wake up every morning at 6 AM (could be worse, like your 4 AM) with anxiety and thoughts of doom ... Will this company work? Will I be able to keep on doing this? If not, will I ever find a job? What is my future gonna be like? etc etc. All this is the typical morning anxiety (related to cortisol) and when I get up and going, it goes a bit better ... not gone completely, but better and manageable. Do you see that as well? Some people take a bit longer to shake it and start feeling better in the afternoon ... I have also noticed that eating something sweet in the morning helps ... Maybe that is only my case, but it helps bringing down the anxiety ... probably has to do with the sugar-serotonin link.

 

Recently, I cut out caffeine from my diet and that was really a tough moment. It took me roughly 2 weeks to kick it. While caffeine gives (most) people anxiety, I actually had a worse time coming off of caffeine (only drank 60 mg/day or 2 cokes) than while drinking it. My anxiety shot through the roof and was 10x worse than before. Now, after 2 weeks, I have to admit that my anxiety is better and even lower than before kicking the caffeine. So, if you drink caffeine, it is worth considering ... But I recommend to taper (especially when you take it in the form of coffee) and to have some ibuprofen (or similar) on hand as it gives some nasty head aches. Cutting it from your diet will definitely lower that anxiety ... If you don't drink caffeine, that is one thing less to worry about.

 

The anxiety overrules our normal thinking completely. Like yourself, your company is doing good and you have been in business for 13 years ... that should give one some confidence that you are doing something right. But then, anxiety is there and it takes away the reality of the situation. This is really hard to deal with but I have found some help in breathing exercises and trying to take 1 step back from the situation when anxiety takes over.

 

I think you are on the right track and if you can, please keep going without any medication. I know it is tough, I am in the same boat, but every day is an extra day you are free of Cymbalta and allows your brain to heal ... My first target is January 2020 ... which puts me at 6 months clean and has been more or less a benchmark for starting to see noticable improvement ... Until then, I know it will be struggle (and probably some time after that as well) ... but having a target helps in your mind.  

 

I am sure some "senior members" will help you on the road as there are some supplements that help with anxiety, but that is not really my expertise unfortunately.

 

T

[fishinghat]

"he said I would most likely need to be on antidepressants for the rest of my life. "

 

 

Mxpro - What an idiot. It is just withdrawal. Don't worry Mxpro. It is just withdrawal b ut having said that it can last for months before it starts to turn around. Just jabg in there and try not to get too stressed. Give your body a chance to heal.

 

 

"it would be easier knowing it was withdrawal because there would be a light at the end of the tunnel. otherwise, I don't know how much of this I could take."

 

 

Good news, there is a light at the end of the tunnel. It may be only a 5 watt bulb but it does get brighter with time.

 

 

Last but not least I would strongly recommend to all of you to scan through our ebook. It contains a lot of information on what makes the withdrawal worse and/or better. Different over the counter meds that have been tried and the results, medical research and much more. It even covers issues with diet.
 

[Mxpro32]

thanks for the replies.  I'm trying my best to keep my thoughts under control.  when I start thinking about the future, and how hard its going to be, and how there is no way I could get or keep a job in this condition, etc. my anxiety keeps amped up all day.  I've noticed my emotions are very fluid, and if I get my thoughts straight and work on cbt my mood turns up just as fast usually, at least if I can keep the anxiety down.  this is another reason I'm thinking this is just withdrawals and not relapse.  

[invalidusername]

Hi mxpro and welcome...

 

I can see you have already been off to a good start with some relies already, and I'm with Hat on the notion of being on AD's for the rest of your life being ridiculous. The brain adapts all day, every day, conscious or unconscious. It is therefore possible for it to get to a state whereby such drugs are no longer needed. 

 

What you are going through is for sure a protracted withdrawal. Some feel it right away, and others it takes a while to rear its ugly head. Everything you have described is consistent with withdrawal and you can see from what the other members have said that you are not alone.

 

What you need now is some management strategies to keep these symptoms under wraps as best you can. If things are that bad you have the option of goin bak on a few beads of Cymbalta to stabalise and then go slower - or some opt to use Prozac as it is a gentler drug to get you past this nasty transition. The down side being that it could take a good 6-8 weeks to see improvement. I would therefore suggest you get a copy of the eBook, and have a read;

 

https://www.cymbalta...tion-the-ebook/

 

You will find exactly what you need to help with your specific symptoms and we are here to help guide you through any part you do not understand...

 

IUN

[Mxpro32]

I considered trying a 5mg tab and tapering from there if things keep being so rough. Would that be beneficial or is it too late? Mine don't have beads, just the 5mg tiny tablets so I would have to cut them up. It's amazing how hard it was to come off of 5mg. Actually, I still have some of my 60mg and im pretty sure those have beads.

[fishinghat]

You shouldn't cut the tablets as that will ruin the enteric coating and release the Cymbalta into the stomach forming naphthol. Not a good thing. Stick with the beads.

At 2 months off I would be a little hesitant to go back on a few beads. You might consider taking a bead every few days to try and get some breaks but there are some medications that can be beneficial if you have a good pdoc to talk too. Let me know if you want some suggestions.

[invalidusername]

Hat - what did we find out about the "big bead" capsules? Were the big beads coated? Or is it just the capsule that is coated? I seem to recall a difference, although I may be wrong. Either way... breaking the big beads down is also not recommended as they are unlikely to be correctly balanced. Unless a pill is scored, it is not suitable for breaking down to get equal amounts. So whilst you might have 4 big beads in a 20mg capsule... breaking one of those big beads in half might you would expect to get 2.5mg, but the result could be anything from nothing to 5mg!

 

The best bet is to find a beaded alternative from another pharma if you were to go that route.

[Mxpro32]

My psychiatrist doesn't acknowledge extended withdrawal. I asked him if it's possible my brain 8s still adjusting and he said no, the cymbalta is already out of my system. Not sure if I should try my general practitioner or another psychiatrist. What do you recommend?

[frog]

WOOF that is so frustrating. It's supposed to be a psychiatrist's job to understand the brain better and keep themselves informed. It seems obvious that the brain would need time to adjust to life without this MAJOR crutch? I feel like you should try finding someone else. I've never had a psychiatrist and am now looking for one just to have someone on hand while I deal with all this withdrawal and recovery and it's stories like this that have me so wary of the likelihood of landing on someone who actually understands and acknowledges. 

[Mxpro32]

Ya, it's like he just reads the manufacturers literature

[frog]

Lazy. Pompous. Any doctor that doesn't continue to educate themselves constantly is worthless to me. 

[fishinghat]

"Hat - what did we find out about the "big bead" capsules? Were the big beads coated?"

Yes coated but not as effective a coating as the enteric coated beads. Teva is usually the brand that uses these tablets and the FDA has had trouble with them meeting the enteric coating criteria.

My psychiatrist doesn't acknowledge extended withdrawal. I asked him if it's possible my brain 8s still adjusting and he said no, the Cymbalta is already out of my system. Not sure if I should try my general practitioner or another psychiatrist. What do you recommend?

You definitely need a new dr as even the manufacturer warns of the severity of the withdrawal on their drug inserts.

Lazy. Pompous. Any doctor that doesn't continue to educate themselves constantly is worthless to me.

I have to stand up for the drs here on this one. with over 300 medical research articles published each week it would be impossible for them to keep up. In addition the DSA does NOT require drs to be trained on any new medications AND the courts, when they rule against a drug manufacturer will require a warning to be added to the drug inserts but no requirements on informing the drs.

[Mxpro32]

What medicines would you recommend?

[invalidusername]

My psychiatrist doesn't acknowledge extended withdrawal. I asked him if it's possible my brain 8s still adjusting and he said no, the cymbalta is already out of my system. Not sure if I should try my general practitioner or another psychiatrist. What do you recommend?

 

Of course the damn drug is out of your system.. that is why they call it WITHDRAWAL!!!

 

 

I have to stand up for the drs here on this one. with over 300 medical research articles published each week it would be impossible for them to keep up. In addition the DSA does NOT require drs to be trained on any new medications AND the courts, when they rule against a drug manufacturer will require a warning to be added to the drug inserts but no requirements on informing the drs.

 

I'm with Hat on this one. Although I went through my relapse as a result of my doctor telling me the wrong way to withdrawal, he at least acknowledges his fault now and listens to me when I tell me stuff he needs to know. NHS doctors in the UK really do have it tough with what they have to do. Far too much red tape. Don't blame the players, blame the game...

[frog]

Ok maybe I was a little harsh. And if they're willing to listen and learn I do think that's different. But to just say that once a psychoactive drug is out of your system you bounce right back to normal and no way could there be any withdrawal following it, is just crazy to me. I know some people can go cold turkey and have 0 side effects but it's pretty well known at this point that at least some withdrawal is to be expected (or 'discontinuation syndrome' as Eli Lilly likes to spin it) for most people even if it only lasts for a few weeks or what have you.

 

In any case the real point is that Mxpro's doctor is the absolute wrong person to be guiding him during this time and he needs to find another doc that has some proven experience with helping patients manage AD withdrawal/recovery or at least is willing to figure things out together without being dismissive. 

 

I was feeling crappy during Thanksgiving as you know and my husband's uncle is a physician at a hospital affiliated with a very very very well known university. I talked to him for a bit about what I was dealing with and sadly I was kind of disappointed with his answers. Granted I'm not his patient and he doesn't know my history so it's likely he was just trying to give me some basic advice. But he basically said that maybe the Cymbalta had been doing something good for me I didn't realize and maybe that's why I was suddenly feeling so messed up and that perhaps I should just go right back on the full dose since I didn't really experience any bad side effects while I was on it. And then maybe work with a doctor in the future to get off if I decided to try again. I was pretty bummed because I don't think Cymbalta was doing anything special for me. It wasn't causing any major side effects fortunately but I started taking it for chronic pain which it actually worked quite well for but I felt like I had gotten the pain to a more manageable place through other means and so what was the point of taking this drug that made me sweaty and killed my sex drive? 

[fishinghat]

Good post frog. You must be your own advocate.

[frog]

Thanks FH. 

 

Mxpro sorry for hijacking the thread. 

 

I hope FH and IUN can help guide toward a few medicines or supplements to get you feeling better like they did for me while you find a new doc

[fishinghat]

MxPro32

On the prescription side I would start with clonidine. A 0.1 mg dose every 8 hours is where most drs start.
Second Hydroxyzine. 25 mg 2 or 3 times during the day and 50 mg at night to help you sleep.

The reason I always start with these two is that they are not addictive and no withdrawal.
Third, benzos (Xanax, valium, lorazepam, etc). very effective but very addictive. Not to be used for more than 4 weeks on a regular basis. Bad withdrawal unless you go very slow.

Those are the ones to start talking to your dr about. Most drs say "Oh, just start with the benzos and we will deal with the withdrawal later.". Why bother if the clonidine or hydroxyzine work why worry about a withdrawal later?

He should respect your opinion if he is a good dr.

[Mxpro32]

Man, I had a pretty good day today. I told myself last night I was going to watch my thoughts and see if I could keep my mood up by avoiding rumination and stressful thoughts. It mostly worked and I pulled out of a few nose dives, but it was also exhausting. Now my anxiety is spiralling out of control before bed. I just keep trying to tell myself one day at a time, but it scares the crap out of me that I can't count on my ability to function without losing it.

[gail]

Withdrawal=wax and sane for a time. You'll need to find patience within yourself.

[fishinghat]

Man, I had a pretty good day today. I told myself last night I was going to watch my thoughts and see if I could keep my mood up by avoiding rumination and stressful thoughts. It mostly worked and I pulled out of a few nose dives, but it was also exhausting. Now my anxiety is spiralling out of control before bed. I just keep trying to tell myself one day at a time, but it scares the crap out of me that I can't on my ability to function without losing it.

Many members have said not to resist the emotions but to embrace them. To fight them is to make it worse. I can not attest to how effective this is because I am a fighter by nature.

[Mxpro32]

What about exercise? I know it's supposed to be good for depression but I tried jogging 30 minutes one day and felt like crying on my way back and felt emotionally drained. So the next several days I took brisk walks for 30 minutes and that drained me too. Should I keep trying?

[fishinghat]

This is common during withdrawal. You need to get your exposure to the sun in so you can make enough vitamin D3 made BUT too much exercise can really set you back. The challenge is to find a balance. Start small. A 5 minute walk each day and see how that goes and then adjust from there.

[frog]

Is it ok to just take a supplement for D3? I've also been trying to walk a little bit here and there but SF is going through a rainy season right now so sun is... not present. 

[fishinghat]

You can take a supplement for D3 but D3 can build up to toxic amounts in the body. I would recommend that your dr do a blood test for D3 first but on the other hand if it were me I would try a low dose say 400 mg per day for just 4 or 5 days and see if there is any effect. Be sure to get one with added calcium as D3 can lower calcium in the body. If a few days does not help then I would not consider any more.

[frog]

I was taking D3 earlier in the withdrawal and then I read about the potential toxicity and stopped. I don't feel like I had any adverse effects but I don't know that it was doing anything either. 

[frog]

Mxpro I think going outdoors is great to clear the head. You don't even have to do much exercising. When it wasn't raining my husband and I would drive to the beach and hang out there for a couple hours and it was very therapeutic. Some days my head feels better and I can do a longer walk, some days my head feels heavy and I feel more dizzy and I can only walk for maybe 10 minutes. I think the idea is just to get moving a little every day. Even if it's 5 or 10 minutes you're still getting the benefit of more blood flowing to the brain and your brain producing those BDNFs that help recovery. On the flip side I think doing more than you can handle right now is just going to add more stress at the moment.