33 replies to this topic

[Linco]

Hello,

 

I was put on Duloxetine in August of 2018 for neuropathy in my feet.  The dosage was 30mg.  Looking back, I guess I was experiencing side-effects but they were fairly mild and I attributed them to other causes. (Weight gain, night-sweats, insomnia, very warm during the day).  I saw the specialist in December of 2019 and he prescribed an upped dosage to 60mg.  By early January, I knew there was a problem as all the old problems increased tremendously. I tried to get in to see the doctor but his first available appointment was the end of March.  On January 27th, I had become so sleep deprived that I would just "zone out" at times.  That night I stuck my hand in a running blender and took off a large chunk of a finger.  The following day I went back to my old dose of 30mg.  The first few days were easy; a little dizziness or nausea in the mornings but that was it. By the end of that first week, I started having diarrhea.  

 

3 weeks later and I still have diarrhea.  It is almost constant - I eat something and within an hour, I have diarrhea.  I saw my GP and his suggestion was to wait another week and make sure I stayed hydrated. 

 

Eventually, I want to wean of the Duloxetine completely.  But 30mg is the lowest dosage here in Canada.  My Doctor said to skip it every other day but from what I have read here, that's not great advice.

 

I will probably try bead counting but not sure when to start.  Should I wait out the diarrhea?  Everything else seems to have returned to normal except that, which shows no sign of getting better.

 

Does anyone have any experience with the Canadian brand Sandoz-Duloxetine?

 

Thanks for any help or suggestions!

[frog]

Hi Linco!

Welcome to the forum. It's so wonderful that you found this forum before following your doctor's very incorrect advice on how to get off this drug. Take it from me, I Frankenstein'd my entire "taper" process because I didn't know any better and by the time I got to 18 or 20mg I started getting some unpleasant symptoms and decided to just quit cold turkey. Major no no, but I didn't understand that the symptoms were actually my body trying to tell me to slow down because it needed to adjust. 

 

The reason skipping days doesn't work is because Cymbalta has a very short half life. 12 hours after your dose, it's about half metabolized, by 24 hours it's 3/4 gone so by waiting until it's practically all gone out of your system and then hitting it with the full dose again you're just putting your body through a constant rollercoaster of withdrawal. A slow, gradual taper will give your brain and body much smaller increments to adjust to and should make things more bearable overall, and that means bead counting. Here in the US, the lowest dose is still a whopping 20mg so still no good. 

 

There are some long standing members on the forum that will be along throughout the day and can offer better advice on how slowly you should taper, but if the diarrhea is your only symptom I would probably say you can start the taper as soon as you feel ready. I quit Cymbalta mid-last October, and I started getting horrible diarrhea, nausea, anxiety, adrenaline, you name it, about 3 weeks after that. Everyone's different but for me the worst of the diarrhea hung on for 3 months. It's still not 100% back to normal but it's a lot better. I also kind of use it as a gauge on my progress. I think the gastro issues will fade away at the same time as all the emotional stuff does. 

[fishinghat]

frog pretty well covered it. For now just stay at the 30 mg until things stabilize which can take several weeks (sorry). In the meantime try  Imodium ad for the diarrhea. It really helped me.

[invalidusername]

Hi Linco...

 

Can I be brave enough to ask about the blender incident? That sounds quite frightful. Was this a result of the zoning out that was cause by the meds? This is very worrying...

 

Yes, skipping every other day is the wrong way to go due to the short half life of the drug. Bead counting is your best bet as you already have read. As the others have said, you will need to stabalise on the 30mg again and start the bead count from a position of as much strength as possible. 

 

If you haven't done already, download a copy of our eBook and make it your bedtime reading

 

IUN

[Linco]

Hello!  I have downloaded the eBook and read through several sections already. 

 

As for the blender incident -- a few weeks after the dosage was upped to 60mg, I started having a lot of problems sleeping.  By the time this occurred, I was waking up at least once per hour (often more), absolutely drenched in sweat.  I was so tired each day that I ran out of steam by about lunchtime.  I would often find myself just staring at a wall or spending my afternoons on the couch staring at the TV,  not remembering what I had watched.  On that day, I had decided to make home-made soup.  I used the immersion blender on it and then put it under the tap to rinse.  I was so zoned out that I stuck my hand in the blender to clean it while it was still running.   The finger is healing well; just some strange feelings in the end where I cut it.

 

But, it did propel me to try to do something about it.  I've never had any issues with medications so it just never occurred to me that this could happen.

[invalidusername]

Oh my goodness! That is quite an issue with the blender - you poor thing. Horrible what these drugs can do...

 

Glad you located the eBook and it has been of some use.

[Linco]

Checking in.  The diarrhea is getting better so I am thinking about the next step.  

 

Once you open the capsule and take out 10% of the beads, how do you take it?  can't put the capsule back together because they are too brittle.  So, do you just eat the beads?  

 

Sorry if this sounds silly!

[invalidusername]

You should be able to put the capsule back together... if they are that bad, they I'd suggest getting some enteric replacements for the ones that come with your prescription. But no - definately do not chow down on the beads by themselves!! They will release too early and not have the desired effect, thus leading to more nasty withdrawal.

 

Nothing to sound silly about - it is far better you ask and not endure worse...

[fishinghat]

IUN is right. You are the second person to mention the capsules braking , interesting. You might try holding the capsules in your hand for a few seconds to soften them (they are heat sensitive).Do you store your Cymbalta in the refrigerator my any chance? This would make them brittle as well.

[Linco]

No, I dont store them in the fridge. I was able to open one up without it breaking - it's a little crushed though. Now I am trying to figure out how to refill them. Then we'll see if I can get them back together!

[invalidusername]

We're here if you need anything... like you say about refilling. If you need pointing in the right direction, just ask.

 

There are no stupid questions... someone said that once... can't remember if it was quoted, but very true.

[Linco]

OMG!  How do you get it back in the capsule?  So far, all I have succeeded doing is spreading it all around the room!  I have found a super tiny funnel online but it won't be here for 10 days.   I can't make one small enough.  And they fly around!  How do you do this?

[frog]

You could try folding a piece of paper in half and making a really sharp crease and then lining up the beads in the crease and using as a little funnel into the capsule. 

[Linco]

I will give that a try.  Have been looking at capsules.  I think it would help if I put it into a larger capsule.  Does it sound reasonable to buy size 00 or size 1 for going down from 30mg?

[frog]

I'm pretty sure mine are 00. 

[fishinghat]

I think mine was also 00.

[invalidusername]

I just used to push my finger down on the beads so they would stick to my skin, and then drop them in from my finger. Might also help if you moistened your finger beforehand/during.

 

Wow - everyone remembers their days of bead counting. Its enough to drive you mad...

[fishinghat]

That is also what I did although I did not moisten my fingers.

[invalidusername]

Try moistening your fingers, it won't affect the beads doing so...

[Linco]

I thought I would send an update. After 5 weeks back at the 30mg dose, things had calmed down so I decided it was time to start bread counting. Week 1 - I removed 30 beads from each capsule. The diarrhea cam back with a vengeance and mild dizziness in the morning. Once that calmed down, I removed another 30 beads per capsule. I am almost a week into that and there have been virtually no effects so tomorrow I will remove an additional 30 beads. That will mean just over half of the capsules content gone.

So far,really encouraging. I feel better and I am sleeping better. I still wake up about 3-4 hours after taking the pill with intense night sweats but I can then go back to sleep for several more hours.

[fishinghat]

That is very good Linco. Just remember the last few beads are the tough ones.  When you get down to 0 beads I would drop 10 at a time though.

[invalidusername]

Ok, ok... but how many beads are in each capsule?

 

Remember you need to reduce by PERCENTILE not AMOUNT. Reducing by percent keeps the drop even and the effects manageable. So if you have 100 beads in a 30mg capsule, you need to start reducing by 10%. The first drop will be to 90, then 10% of 90 is 9 which gives you 81 beads and so on. You can speed this up if you need to, but it gives you a balance to reduce by...

 

Any questions just shout...

[Linco]

Ok. So, there are 225 beads per capsule. That means in week 1, I removed 13.5% and in week 2, I removed 15.5%. If I remove 15.5% again this week, it would mean removing 26 beads. So would that be a more reasonable way to do it? I want to get off this stuff but in the current climate, I don't want to get sick and need a doctor!

[invalidusername]

Absolutely - you don't want to rely on an already screwed health service.

 

You taper should always include a slow exit, so plan for a one bead drop when you get to the last 10%, so you should be dropping one bead at a time when you hit 23 beads. I'd say drop 3 beads between 23 beads and the 50 bead mark, 10 beads from 50-100 - and do what you feel is comfortable to reach that 100 beads being the mid-point as most don't feel anything too bad at this point, but make sure you put the brakes on after this point in a plan similar to the above.

 

IUN

[Linco]

Oops!  My beginning count was WAY off! There are 160 beads per capsule so I have been weaning off at a pretty rapid rate.  A little over 3 weeks to drop 108 of those beads.  So far, I'm doing pretty good but I am going to slow it down a lot.

[invalidusername]

Woh! Yes - put the brakes on! The first 50% or so drop isn't necessarily that bad, but had you continued there would for sure have been a problem!!

[Linco]

UPDATE:  I slowed to 10% each drop.  Today I am going down to 28 grains.  So, what is a good time period for each drop?  Currently, I am dropping every 3 days.  I haven't experienced any issues since the first month.  How fast should problems arise?  After 1 day? more?  Could I go faster?

[fishinghat]

I am a little confused here. 28 grains is about 1 lb or are you saying 28 beads? (Grains are a unit of weight)

[Linco]

LOL!  Oops! Yes, I meant 28 beads! 

[invalidusername]

LOL!  Oops! Yes, I meant 28 beads! 

 

Blame the Cymbalta - Hat always does...