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My 2 cents on cymbalta withdrawal(aka-advice)


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Okay- I know how pdocs like to think they know everything, like how it feels to withdraw from cymbalta, but they don't. so I wanted to share my withdrawal experience for someone who may have trouble(hell) coming off cymbalta. My pdoc, btw, told me I should have no trouble and she has never heard of anyone having trouble coming off cymbalta. WEll,, there's always ME!!

At first, she told me to go from 60 to 30 -take 30 for a week- then stop. That is when I got aquainted with brain zaps. I used to think they were just your head feeling tingly. NOT! They are just about the suckiest thing I have ever experienced. And to those who don't like hearing about other's minor side efffects, I appologize and I respect that you have it much, much worse. I am not one to complain about the side effects of a med that is working and that is not what I'm doing. I'm talking about witdrawing from a complex med , being a "fast metabolizer".

Anyway, The 60 to 30 didn'twork. Then I was instructed to go at my own pace and use my best judgement so I could withdraw more comfortably. I have been wd'ing for over 2 months and that's ok. I am now finally down to 20 mg every 36hours. ANd I only have brain zaaps for a couple of hours every two days.

My advice is to withdraw as slowly as you can. If you can. They make itin 40, 30 and 20 mg. Doctors have samples of all of these. TAKE IT SLOW! I hope this helps someone. mel

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mel1,

I would like to think that as many people that are on this site, that no one would "not want to hear" about your withdrawal problems.....I know I want to hear them!!!!  I just got off Cymbalta too.  My pdoc had me go from 120 mg to 60 mg overnight.  Then she had me take 60 mg ONCE EVERY OTHER DAY for a week, and then completely off, and straight on REMERON.

It has been going on 2 wks now, and I have the brain zaps/shivers almost every waking moment.  Plus I had a "vitreous detachment" in my right eye.  Unknown if Cymbalta had anything to do with that.  Although "RETINA DETACHMENT" is listed as an "infrequent" side effect of Cymbalta.

I have called my doc several times, but she is really gonna get an earful about Cymbalta when I see her next.  Also, I've been very weak, feel like a zombie, headaches, nausea, and just plain feel like crap!

Beth

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Beth- that-imho-is way way too fast. What is wrong with these doctors. Everyone is different and noone can predict who will or will not have trouble coming off cymbalta. The schedule I put up may help you. YOU are the boss here. Nobody can make you come off of a drug that fast if it is making you feel like hell.

Peter- cymbalta is a multi-reup-inhib. That means your body, organs, and brain are coming off of norep. , ser., and their metabolites. A SSRI isn't going to make the withdrawal go away. I am on seroquel, which has some serotonin benefits and strattera, which is a nor. re-up. and I still am having brain shivers.

Once again, my advice would be to GO SLOW with this med. No need to go through hell if you don't have to. Unless you have to go off of it in a big hurry. mel

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Peter- cymbalta is a multi-reup-inhib. That means your body, organs, and brain are coming off of norep. , ser., and their metabolites. A SSRI isn't going to make the withdrawal go away. I am on seroquel, which has some serotonin benefits and strattera, which is a nor. re-up. and I still am having brain shivers.

<{POST_SNAPBACK}>

yeah but on the crazymeds site it suggests getting on prozac right after the last effexor dose to minimize or do away with symptoms. and effexor is the same type of med as cymbalta, which essentially inhibits serotonin reuptake.

I was just saying that remeron does not inhibit reuptake the same way cymbalta or an SSRI does, so it wouldnt help with withdrawal. Id like to hear from someone who quit effexor or cymbalta and went right on an SSRI.

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Switching to another med can help.

If you're doing a slow taper you can often start on the replacement med before you're totaly done tapering off the old one.  This is a particularly good idea if your doc wants you to slowly taper up on the new med.  The safty of this is going to depend on the halflife of the old med and average time to reach a steady state of the new one.

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mel1,

I would like to think that as many people that are on this site, that no one would "not want to hear" about your withdrawal problems.....I know I want to hear them!!!!

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There was an interesting aside in the Medscape article I linked about a "warning to drivers while coming off Effexor" not long ago.  Check this out:

...during withdrawal of venlafaxine (Effexor), both serotonin and noradrenaline levels decrease instead of increase, ruling out toxic levels of serotonin and noradrenaline as a probable cause of the withdrawal symptoms, that can be hypothesized to result from a (too) rapid deprivation of neurotransmitter levels. Which neurotransmitters apart from 5-HT (2A) antagonists are involved may be deduced from some of the less often-reported withdrawal symptoms, such as the "electrical discharges in the head." These symptoms are similar to preseizure symptoms in epilepsy, and there is now evidence of the relevant role of the noradrenergic system in modulating seizures, providing further evidence that noradrenergic and/or serotonergic deficits may contribute to epilepsy and depression.  Although this does not necessarily establish a link between epileptiform manifestations and venlafaxine withdrawal, it does suggest that some of the venlafaxine-withdrawal symptoms are more likely to be caused by a lack of noradrenergic than of serotonergic action, contrary to the commonly accepted theory.
http://www.medscape.com/viewarticle/506427 (requires free registration)

I weaned off Effexor while tapering onto Wellbutrin three years ago, and while it sucked rocks and I did have brain zaps, I don't remember it being quite as bad as often described here.  Of course that could be attributed to good old YMMV.  Beth, I wonder how you would have done with a saner taper schedule.  And Mel ... damn, you've had a rough haul!  Good thing you're smart enough to speak up and challenge your pdoc (and she listened).  Thanks for sharing.

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I'm wondering if noradrenergic is thesame as norepenephrine(pleeaseforgive any sp.boo sboo's!) I am ok on every other day of 20 mg. I'm wondering if I can ever get off this drug woithout feeling like shit or do I have to just stop taking it and feel like shit for a while ,because it is really really reeaaaalllly hard to work full time as a teacher and come home and take care of 2 little ones by myself when I feel like shit.

Here's a question. Is the very low amount of cymbalta I'm taking not enough to have much of an effect on me? UHOH- I have one more:I just started taking Strattera- I'm on 40 mg /day right now. My pdoc told me it would probably eliminate my wd from cymbalta-NOPE! I also take a daily pain pill-low dose for my pinched nerve in my neck- it's just enough to keep my pain down to bearable. It is ultracet(tramadol and tylenol) and it does a mild re-up of nor. and ser. Shouldn't that be enough between seroquel, ultracet, and strattera to make me not have wd.

end rant, whining, complaining , asking unanswerable questions-mostly venting- I'm getting pissed at this med! mel

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Beth1954:

(Mel, this will be just a quick hijack!)

Posterior vitreous detachment is common with people ages 40-70.  I don't know how old you are, but in that age group, it's considered almost as common as wrinkles.  For the young folks here, PVD is when the vitreous sac that makes up your eyeball begins to shrink and pulls away from the back of the eye--the retina.

Retinal detachment is when it totally detaches from the retina and can cause blindness if not treated immediately.

Beth, I had PVD, too (while on Cymbalta) but I'm investigating the study re: Cymbalta and retinal detachment.  As soon as I get my hands on it, I'll bring it here.  My two eye doctors did not think that there was any cause for concern with cymbalta.  My retina specialist thought that it was a coincidence that someone on the drug also had a detachment.

Please PM me if I can explain anything better than this.

olga

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does this vitreous detachment thing ever go away? like do the flashes disappear after 6 months? that's what I heard.

ok back on topic, my doctor seems to think the only thing that helps with tapering cymbalta...is cymbalta. that is how he feels with any medicine. but hopefully I can convince him to put me on some other SSRI right after my last dose, whenever I have to quit.

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I used to get the zapping coming off of Zoloft. They didn't believe I had that symptom, so I suffered for 8 weeks with that.

Then I was on Lexapro for a year, and got those zappings when I forgot a dose. They wanted to put me on Cymbalta this May, so they tapered me down for a few weeks, then I took both for a week, and then just the Cym. It was virtually zap-free and it was a nice switch.

I also take Remeron once or twice a week for sleep. When I took it years ago continuously, I never had zapping...but the weight gain/appetite was out-of-control! It's interesting that both the Remeron and Cymbalta are both SNRI's, but only the Cym causes the zapping. Hmmmmmm...???

Now I'm on Cymbalta 60 and if I forget one...zapping within a few hours. So I have a small stash in my workbag for the days I forget to take it.

I just started Lamictal as well.

HTH!

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It's interesting that both the Remeron and Cymbalta are both SNRI's, but only the Cym causes the zapping. Hmmmmmm...???

<{POST_SNAPBACK}>

Cymbalta is an SNRI, but more so an SSRI.

I read its like 10:1 serotonin to norepinephrine.

its the SSRI part that causes most of the withdrawal.

which is why it makes sense that taking a different SSRI would ease the withdrawal symptoms when you try to get off it.

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Mel,

I wonder if a small dose of a benzo would help? I got brain zaps titrating up on it. Either they went away after a few months or adding Xanax even things out. I know coming off benzos can be rough on its own, but I think that's only if you are on higher doses for a long period of time. I'm on about the lowest dose of Xanax you can get.

I haven't tried coming off Cymbalta yet (I've been on it since December), but I've jumped around with the dosaging (30 to 60 to 90 to 60 and now steadily at 30) and didn't notice withdrawal effects when switching doses. I'm getting a little worried about coming off it (though I have no plans to in the near future).

Hope things get better for you!

Sunshine

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Sunshine, I take .5 mg klonopin - 3 times a day. I am just going to keep steady for a while at 20mg every other day. Hey- that's progress, right? Iwill be discussing this w/ pdoc on THurs, however. I am a "fast metabolizer" according to my pdoc and that is why I' m having so much trouble. So, I don't want to scare people who stop taking cymbalta. mel

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It's interesting that both the Remeron and Cymbalta are both SNRI's, but only the Cym causes the zapping. Hmmmmmm...???

Cymbalta is an SNRI, but more so an SSRI.

I read its like 10:1 serotonin to norepenephrine.

its the SSRI part that causes most of the withdrawal.

which is why it makes sense that taking a different SSRI would ease the withdrawal symptoms when you try to get off it.

It's my understanding that Cymbalta is about 50/50 with 5HTP and NA.  Perhaps you are thinking of effexor?  It's definitely a more potent SSRI than SNRI. 

Remeron is neither an SSRI nor SNRI. It works via receptor antagonism, not reuptake inhibition. 

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  • 2 weeks later...

I am now taking cymbalta comfortably(only mini-brain zaps) every 3 days. I think I'l be done with it soon. I took it Mon. morn. That was the first time I  started getting the zaps. Then I took itThurs. morn. and that was the next time I had little zaps. Nothing bad, just annoying. If I wasn't such a baby, I could probably just stop altogether! But, I'm in no hurry. mel P.S. MY advice to stopping cymbalta- if you can, take it slow.

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