Kris: Cymbalta reinstatement?

[Kris]

I had been on cymbalta 60mg for a few months. My doctor took me down to 30mg for two weeks and stopped me. I have been in and out of the hospitals for 4 weeks now. I can not function . Am I past the point of reinstating

Edited December 5, 2016 by scallywag
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[LexAnger]

hi Kris,

 

Before one of the mods provides you with comprehensive information, would you put all your meds history in your signature with start and stop dates fro each? This will help with a faster guidance/ advice.

 

Also, can you provide more about symptoms you experienced from each dosage and experiencing now?

 

If you just stopped 4 weeks ago, you are in a great chance to reinstate, usually it is recommended a small dose to start.

 

Lex

[Kris]

I started cymbalta in may of this year for anxiety and depression. I started out on 20mg a day. I did start to feel better however sometimes had a little fogginess. The anxiety attacks stopped. I increased to 30mg after a month and felt ok. Then after another month went to 60mg. I felt a little spacy and had a bit of a headache. I felt tired alot.

 

I spoke to my psychiatrist and she said well then go down to 30mg for 2 weeks then stop. I had a surgery the next day.

 

I was home for two days and I lost it started shaking and having the worst panic attack I have ever had. I ended up in a mental institution. They gave me a low dose of lexapro and Ativan I still had no relief. I came home 4 days later and kept having uncontrollable anxiety went back in. They gave me atarax and higher dose of lexapro which did nothing and they sent me home.

 

I went to a different facility I kept shaking. Vomiting. Diarrhea. Anxiety. No energy . I felt like I was loosing my mind. When I went to the other facility they gave me Zoloft and clonazepam which did not work. The clonazepam did calm me down for a bit. I had been off of cymbalta since October 28. I still do not feel good. I am taking  atarax  and clonazepam right now.  

 

I am still vomiting shaking diarrhea unable to eat no energy I rock back and fourth can't think nightmares can't sleep heart palpitations lightheaded headache I'm scared.

Edited December 5, 2016 by scallywag
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[scallywag]

Kris -- Welcome to Surviving Antidepressants (SA)
 
I'm sorry that you are suffering the results of your doctor's "misundereducation" about these medications. Your symptoms sound very much like symptoms from discontinuing an SSRI/SNRI like Cymbalta. You can read more about withdrawal symptoms at this discussion topic:
What is withdrawal syndrome

You are still within the window where reinstatement of Cymbalta is most likely to be effective. Many but not all people get relief from withdrawal symptoms. Easing of symptoms does not occur overnight, it takes about a week or so for most people to notice an improvement.  Please do not reinstate Cymbalta just yet -- take some time to get more information. Read the first post in the discussion at this link
About reinstating and stabilizing to reduce withdrawal symptoms

A request: Would you summarize your history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-18 months particularly?

• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Any drugs prior to 18 months ago can just be listed with start and stop years.
• You don't need to include symptoms or diagnoses other than the initial condition that led to prescribing the first drug.
• We ask for this information in your signature so that we can see it at a glance. A list is easier to understand than one or multiple paragraphs.
• You can find instructions in this topic: Please put your withdrawal history in signature
• If you are using a phone or mobile device, you need to switch to the "full" or desktop version of the site. Instructions are in Post 8 and Post 9

I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but am glad that you found us.

[Kris]

Can there be effects from reinstating?

[scallywag]

The first post in the topic on reinstatement (linked above) discusses that.

[Kris]

So here is what happened .. after I stopped the 30mg I went nuts. Went to er with severe anxiety and they put me in mental institution. Started lexapro and Ativan for 4 days.

 

I got home and felt just awful and went back to the er put me in mental institution again where they continued lexapro for 3 days and atarax. Then I came out and my husband took me to a good place and they stopped lexapro and put me on Zoloft for 3 days sent me home.

 

I still wasn't doing good went to doc again and they kept up with Zoloft for 3 days did heart Cath etc. And sent me home I have been home for over a week now and have not been taking anything but atarax and clonazepam I didn't know anything about cymbalta withdrawal before now.

 

I went to my Psyc doc and she refused to help me. Went to my family doc and she said to start low dose cymbalta and do not take anymore Zoloft

Edited December 6, 2016 by scallywag
paragraph breaks for readability

[scallywag]

Thanks for the update about your latest visits to see the pDoc and your family doc.  Low dose Cymbalta is a good idea.

 

Do you have Cymbalta capsules on hand? Are they the brand name Cymbalta by Lilly or generic duloxetine?

If you don't know which they are you can ask the pharmacist where you picked up the prescription or use this Pill Identifier at drugs.com

 

Did your doctor suggest an actual dose? If not, you might want to try 5 mg.  If an adverse reaction is going to occur, it will happen within the first few days; if that happens, please stop taking it. Otherwise it will take at least 7-10 days for you to notice an improvment, possibly longer.

 

For tips on how to get 5 mg of Cymbalta, please read:

Tips for tapering off Cymbalta (duloxetine)

I have been tapering Cymbalta since May by counting the beads contained in the capsule, more than 20,000 beads so far. My 30 mg brand-name Cymbalta capsules have on average 280 beads, for about 9.25 beads per 1 mg of medication. You'll want to check that your capsules have about the same # of beads. If your brand-name capsules have about the same number of beads, 5 mg would be 46 beads.

 

Generic manufacturers make "mini-pills" instead of tiny beads, usually putting 6 or 12 min-pills in a capsule. If you have any questions, please post them here in your introduction.

 

What doses are you taking of atarax & clonazepam?  What time of day do you take them?

 

Please keep notes on paper of your symptoms and the times of your dose(s). Please post notes from few days here in your intro topic. This post has a useful format for a daily log:

Take notes of doses and symptoms

[Kris]

The doctor prescribed me 20mg which is the lowest dose I am on 50mg of atarax three times a day and .5mg of clonazepam three times a day and the cymbalta is generic

[Kris]

I took apart my generic cymbalta 20mg. Which is a green pill. I counted 125beads is that accurate. So would I take 37 beads for a 5mg dose?

[scallywag]

5 mg is ¼ of 20 mg, ¼ of 125 beads is 31 beads. Start with that, allow 7-10 days; it takes 4-5 days for the medication to reach a steady daily pattern in your body and then at least another 3-7 days for your CNS (central nervous system) to start to make noticeable changes.

 

Take it at the same time every day. Please keep notes on paper of your symptoms and the times of your dose(s). This post has a useful format for a daily log:

Take notes of doses and symptoms.

[Kris]

Is there a reinstatement window. I was told that if I started back it could be life threatening after the 4 week mark

[scallywag]

Where did you read or were you told that reinstatement after 4 weeks could be life-threatening?

 

There is no hard-and-fast reinstatement window. There is little scientific research into this issue because most research into these medications is funded by pharma manufacturers and they have strong incentives NOT to research negative aspects of their products such as difficult symptoms after stopping.

The experience of members and moderators here is that reinstatement is more predictable when it is done sooner after the last dose than later. What seems to be optimal is up to 3 months. Some people, however, haven't been helped by a reinstatement within a few weeks of their last dose and other people have found relief from symptoms with a reinstatement as long as 9 months or a year after last regular dose. The unpredictability of it is why we suggest a low dose.

Would you please edit your signature to clarify between which medications you

• have taken previously
• have taken recently, the last dose(s) in mg and the date(s) of your last dose,
  -- and --
• are currently taking and the doses?

[Kris]

I seen on Facebook cymbalta hurts I was scared to go back on it. Said I could have seizures etc. I was on 60mg cymbalta for 5 months then was switched to 10mg lexapro for two weeks then was switched to 50mg Zoloft for a few weeks I didn't know I was in cymbalta withdrawal . Can I still reinstate on cymbalta

[Kris]

I am not taking anything for a week now when I was on the Zoloft it didn't help or the lexapro because I believe now I was having cymbalta withdrawal

[scallywag]

Yes you can reinstate Cymbalta.  Because it's difficult to know where your CNS (central nervous system) is in its restoration work returning to a drug-free state, it's best to reinstate at a low dose, which is why we've suggested 5 mg as a reinstatement dose for you to consider.

 

I don't know where the facebook group got its information about seizures from reinstatement. Nothing shows up on a web search I ran.

[Kris]

So it is safe to restart cymbalta even tho I had been subjected to other medicines that's my concern

[scallywag]

What other medical concerns?

[Kris]

Serotonin syndrome and or adverse side effects or anything

[scallywag]

Please post a medication and withdrawal history in your signature so that we don't have to read all your posts to get the big picture of your situation.

 

Did you experience serotonin syndrome when you were taking Cymbalta 30 mg or 60 mg?

Are you currently taking any other medications?

 

If no to both questions, then serotonin syndrome is unlikely to occur at a dose that is 1/6^th  of the therapeutic dosage. It's not impossible, but extremely unlikely.

 

Adverse side effects are a risk with any medication:

Did you experience adverse effects when you were taking Cymbalta 30 mg or 60 mg?

Are you currently taking any other medications?

 

If no to both questions, then adverse effects are unlikely to occur. It's not impossible, but extremely unlikely.

[Kris]

What kind of adverse reactions since I've started to reinstate yesterday should I be looking for

[scallywag]

Potential adverse reactions are

- on the patient information pamphlet

- available from many pharmacies

- online at drugs.com if you search for Cymbalta on that site.

[Kris]

Day 3 of reinstatement at a 5mg dose headache went away. Still some anxiety. Able to focus longer. My strength is increasing slowly have to push myself to do anything. A little less shaking today

[scallywag]

I'm glad to hear that a few things are improving for you.

 

Please update your signature with the date you reinstated and the reinstatement dose so that we don't have to read all your posts to get the big picture of your situation.

[Kris]

Day 4 of 5mg cymbalta still sick in the mornings from panic attacks at night still light headed etc when would be a good time to increase medicine

[scallywag]

It takes 4-5 days for the drug to reach a steady cycle in your body then another 7-10 days for your CNS to respond. Give the 5 mg at least another week.

 

Please keep notes on paper of your symptoms and the times of your dose(s). This post has a useful format for a daily log:

Take notes of doses and symptoms

[Kris]

Ok so day 5 of 5mg cymbalta . I take it around 7 at night I start to feel better no shakes and can actually relax. However about ,7 am I am experiencing panic attacks and all the other symptoms again. Is this normal

[scallywag]

Please post your notes (symptoms and doses) from the last few days.  If you haven't been taking notes, please keep notes on paper of your symptoms and the times of your dose(s). This post has a useful format for a daily log:

Take notes of doses and symptoms

 

It's easiest and fastest for us to help you if you post your notes here in your thread in the format detailed in the link above.

[Kris]

My symptoms have still been the same I feel better towards night then in the am wake up in panic attack and vomiting. Should I continue medicine at this point

[scallywag]

When did nausea and vomiting start? Just on day 5?

[Kris]

Do I just put on my post what I have been experiencing the last five days and dosage this could end up to be a long post not sure where to post at. Felt bad with headache and nausea and sinus pressure today. Had to take clonazepam today for heart palpitations still dizzy took 5mg cymbalta at 8 tonight and had to take clonazepam .5 trying to get some sleep still heart palpitations

[scallywag]

What we need to see for every individual day over several days is:

 

- Time and dosage for drugs taken in morning

- Time and description of any symptoms in the morning

 

- Time and dosage for drugs taken in afternoon

- Time and description of any symptoms in the afternoon

 

- Time and dosage for drugs taken in evening

- Time and description of any symptoms in the evening

 

- Time and dosage for drugs taken in middle of the night

- Time and description of any symptoms in the middle of the night (such as waking)

 

And so forth. A diary, in chronological order, such as:

 

6 a.m. Woke and vomited

8 a.m. Took 2.5mg Lexapro

10 a.m. Had diarrhea

10:30 a.m. Ate breakfast

11:35 a.m. Got a headache, lasted one hour

12:35 p.m. Ate lunch

4 p.m. Stomachache

5 p.m. Took 2.5mg Lexapro

6 p.m. Ate dinner

9:20 p.m. Headache

10:00 p.m. Took 50mg Seroquel

10:20 p.m. Headache got worse

10:30 p.m. Fell asleep

2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")

2:45 a.m. Fell asleep

4:30 a.m. Woke with headache

 

 

Post here in your introduction thread. Just post a new reply the same way you post other messages.

[Altostrata]

Kris, do you get heart palpitations after you take Cymbalta or in the morning? Is this a new symptom?

 

At first, it seemed Cymbalta was helping after you took it, does it still help?

[Kris]

I have always been getting the heart palpitations at night and in the morning and sometimes through the day it doesn't change if I take a dose of cymbalta I thought it would have been alot better by now yesterday I was really sick and decided not to take the cymbalta this morning the bad migraine is gone (knock on wood) I am still nervous all the time and nauseated at times. I'm hoping today will be a better day without any cymbalta

[Kris]

I took a 5mg dose of cymbalta yesterday and had a good day. Day (7) I took it at 330 and noticed a difference within an hour . Heart palpitations have gotten better except I am really shaky and panicky in the mornings at this point should I increase.? Could it be possible the drug is wearing off too soon? I felt really bad the day before and didn't take any. Yesterday I had a horrible headache and it went away after I took the cymbalta advice anyone ?

[Kris]

This morning I took 50mg atarax and .5mg Klonopin because of the shakiness and heart racing. It's been an hour later and still shaky and now beginning to get a slight headache again. Not due for the 5mg dose of cymbalta until 330?