Spidey: Cymbalta burnout

[spidey]

I'm willing to travel for this one (hopefully within Washington state)....Can anyone recommend someone that can serve as an alternative to psychiatrists and mainstream doctors for help with withdrawal from an SSNRI? I've become frustrated with these people. They do not listen, assume what I am experiencing is simply the return of depression, and offer only to throw more dangerous meds my way. I need someone that has extensive knowledge of this subject along with compassion for the individuals afflicted.

[lexicon]

Hi Spidey,

The person introduced to me who understands what we are going through, is Dr. Shipko from Pasadena CA..

I am sorry you are having a taught time.

But you are in a good place here ..:-

Wishing you well, Lexicon

[Jemima]

Here's the list of sympathetic doctors that we have so far, although I'm not sure there are any convenient to you:

 

Recommended Doctors, Therapists, or Clinics

 

As you can see, they are few and far between.

 

Welcome to the forum, Spidey. When you have a chance, please post more about yourself in this thread and put your drug history in the signature area of your profile, like so:

 

http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

Perhaps we can be of help whether or not there is a suitable doctor available to you.

[Rhiannon]

I just did a quick Google on Seattle Alternative Psychiatrists and quite a few came up...that might be a place to start.

 

Hearing Voices and Rethinking Psychiatry, both based in Portland, might be places to look for connections. They just had a workshop on getting off psych drugs recently. I was working so I couldn't go, unfortunately (I live out in the Columbia Gorge a couple hours from Portland).

 

Good luck with your search. I think you're in a good part of the country to find someone, but you'll probably need to do some shopping.

[flower]

I wish we had workshops here.That would be so helpful.I know so many trying to come off these drugs but yet, no help other than here.This is my workshop I guess.

[Altostrata]

If you contact those folks and can recommend them, please add them to our list!

[spidey]

About 2 or 3 months ago my dosage of Cymbalta was increased from 30mg to 60mg. I stayed on that dose for only 4 days due to an adverse reaction that I (compounded by the fact that was drinking my usual 3-5 cups of coffee a day) am certain was serotonin toxicity. Ever since this, however, I have been unable to continue to take this drug. If I take even 1/16 of Cymbalta (and yes, I have tried this and even less) I feel the symptoms returning (albeit on a much smaller scale). I should also mention that my tolerance for other substances that act as stimulants or depressants ( ex. ibuprofen, ginseng, valerian root, caffeine) has become incredibly low. What has happened to my body and why can I not continue with this drug?

[Meimeiquest]

Someone more knowledgeable will have to help, but I will share my experience. I "tolerated" Prozac for years, starting it up again after successful short-term therapy in my late 20's. so restarted near age 40. The longer/more I took it, the worse I got with "fibromyalgia" symptoms...never once dreamed Prozac could be the cause. Became depressed and switched to high dose of Cymbalta and eventually became hypomania or manic. Got Cocktailed" with several drugs. Now in withdrawal I seem to be exquisitly sensitive to serotonin enhancement, even the indirect effects from Wellbutrin. Good luck in sorting it out!

[Altostrata]

Spidey, I merged your new topic with your Intro topic as it seems to describe your specific situation. Your Intro topic is like a journal for your recovery.

 

It sounds like you are one of the select group of people who are genetically sensitive to serotonergics. These people have severe adverse reactions to antidepressants after only a few doses and have symptoms that match withdrawal syndrome for quite a while after they quit.

 

Like withdrawal, the Cymbalta knocked your nervous system for a loop. It needs to fix itself; it has a natural tendency to go back to factory settings.

 

Like withdrawal, this probably has made you hyper-sensitive to all neuroactive substances, including caffeine, and it's probably best for you to minimize their ingestion.

 

Most likely, you will never be able to take antidepressants again.

[spidey]

I believe I'm starting to have withdrawal symptoms....only I can't taper down on something that my body is "rejecting." I have to do this cold turkey and I'm scared. Withdrawal itself will be rough on my already compromised nervous system. Does anyone have any suggestions for me on how to deal with withdrawal when I am so sensitive to all drugs and herbs?

[FeelingAlone]

Hi Spidey, I went off my AD cause my body couldn't tolerate serotonin drugs any longer. Cold turkey really sucks. The first 6-8 weeks were the worse, but in the last few weeks I'm feeling better and better. What helped me was taking it easy and knowing that when the emotional rollercoaster started it was WD and NOT a return of my original issues. I journaled everyday so I could track my symptoms and started seeing a psychologist to help me cope. Hang in there, I promise it will get better! :-)

[Altostrata]

You could try a couple of beads of Cymbalta, that would be less than 1/16, to ease withdrawal symptoms. But given your sensitivity, this might cause a reaction.

 

You might start phoning the alternative psychiatrists to find one who will work with you. Low-dose lamotrigine might muffle those symptoms, see http://survivingantidepressants.org/index.php?/topic/392-one-theory-of-antidepressant-withdrawal-syndrome/

[spidey]

Thanks for the replies, everyone I am still looking for a doctor (or whatever else) that will listen to me and care enough to try and help, but in the meantime I'm going to prepare for the horrors to come in others ways. Keeping a journal is a good idea, as FeelingAlone mentioned. I am also experimenting with tweaking my diet a little (eliminating gluten and dairy, as I have always been intolerant/sensitive to both)so that my body has all the power it needs to heal. It's going to be hard and horrible, but I have no choice except to follow through. I have to fight for my brain and hope I come out reasonably intact.

[spidey]

So 3 days ago I was able to take my previous 30 mg dose of Cymbalta without my body freaking out. Three days back on this drug is a huge deal for me. I thought that my nervous system would never be able to handle this or any drug again. Progress to reverse the effects of withdrawal are slow going, however. I'm impatient and tired of dealing with the exhaustion, confusion, and persistent tingling and "fizzing" sensation throughout my entire body (mostly feet), but I know that my body must be given ample time to heal and readjust. I worry of course that these symptoms will be a permanent addition to my life.....

[Altostrata]

I hope this goes well for you.

 

If you start having adverse symptoms, I would immediately reduce the dose to a fraction of what you're taking.

[spidey]

Since starting back up I've been SUPER dizzy all day, my body feels numb (more so than when I was in full blown withdrawal), and my skin feels sticky. Is this something to worry about, or is it just my body readjusting to the drug?

[Jemima]

I would try reducing the Cymbalta dose to half or a third of the 30 mg. you're taking. Serotonin Syndrome is too serious to risk, and it doesn't sound like you're doing very well. At the very least, reduce the Cymbalta by a few beads and see if that helps.

 

Scary stuff. I'm sorry this has been such a rough road for you.

[spidey]

I am confused as to where to go from here. For the last week or so I have been taking half of my previous 30 mg dose of Cymbalta after a shifty on-off 2 months (the med was doubled by my dr., I had a BAD reaction and had to stop taking it for awhile as even a little bit was an uncomfortable experience). I am having problems with this dose. It always feels good at first, like my body is sighing in relief after getting what it wants. Then after a few hours I start to feel anxious, dizzy, my head starts throbbing along with some wave like ringing in my ears, and my skin feels itchy and on fire. The reason behind the increased dose was that I was complaining to my dr. that I felt fatigued, confused and detached, and lights were suddenly becoming too bright and painful for my eyes. She thought it was merely depression and upped my dose. Big mistake; it was NOT depression.

Bottom line, I guess, is that I don't know if I should continue on with the decreased dose until my body "gets used to it" again, or if I should switch drugs. My body is incredibly sensitive due initially to a swift withdrawal from a very high dose of Effexor XR and Depakote ER (I had been on these for 12 years). Now I have assaulted my body once again and don't know how to determine what exactly it needs. *Doctors have not been of much help with this.....most say they don't know how to help me, others say "wait and see." But if I am hurting my body more by continuing on with this, then it would be unwise to wait(?)*

[tezza]

Hi spidery,

 

I'm not sure what you should do at this point. Someone will be along with more knowledge than I.

 

I merged your new topic with your existing. Please locate your thread and add to it. This way all your info is together in one place. It's one topic per member in "intro".

 

Thanks

 

Sorry, spidey, I just noticed the autocorrect changed your name above.

Edited May 25, 2013 by tezza
Added 'Sorry...'

[Altostrata]

It sounds to me like 15mg is too much for you, you're getting adverse reactions as the drug loads for a few hours. I would reduce it, perhaps to 13mg to see if that helps.

 

See http://survivingantidepressants.org/index.php?/topic/283-tips-for-tapering-off-cymbalta-duloxetine/

[spidey]

Another follow up question:

 

When I have anxious reactions to the doses that I try should I hold off taking the pill for a day or so, or immediately follow with a lower dose? I am wondering which is going to put less stress on my body.

 

*Also, I was curious as to why (exactly) this med feels good only during the first couple of hours. What does "load time" have to do with my adverse reactions?*

[spidey]

Alto : Would switching to another drug at this time (like Celexa) be a better course of action if my body has become uber sensitized to Cymbalta? Please excuse my confusion and seemingly redundandant questioning.....I'm trying to solve this issue as best I can before I make matters worse. I'm a bit on edge and feel very lost at times.

[Altostrata]

Load time means it's going into your bloodstream and reaches a peak after a certain time.

 

It sounds like you feel better when the amount in your bloodstream is less, then you feel worse when it reaches peak.

 

I don't know if switching to another drug would help or hurt. It's a gamble and your decision.

[spidey]

So a bit of an update:

 

 Found out from my new dr. ( a naturopath) that my iron, estrogen, and T3 numbers are all very low. She suspects that this has been going on for months. It sounds like this was my original problem 4 months or so ago when I stepped into that inexperienced dr. of conventional medicine's office and was prescribed an updose surge of Cymbalta. They couldn't have checked these things then??? Why is the answer always a pill for most dr.s? The fault also lies with me, though.....I knew it didn't sound right to just increase my dose, but I thought "they are the dr., I am the sick patient; they know, I don't."  That's why I was fatigued. That's why my period was absent (it's now been 5 months since my last menstration~no chance of pregnancy). I'm a little angry at the moment. Angry at myself mostly for being so passive and always looking to be lead through life. The upside to this: I know now that professionals and authority figures do not own your body or your mind. They do not always "know best." YOU do.

[spidey]

So I messed up.....again. I thought 13mg of Cymbalta after 2 days without would be okay. It was not. I've not slept in 5 days. I'm pretty sure it's drug induced mania. My family wants me to see a dr. (regular) for this, but I know what he will say...and what he will think. He won't be able to help and I'm afraid he'll just suggest more pills (obviously it's my choice whether or not to take them; I realize this). I was hopeful there for awhile as things seemed to be fairly under control. Now I don't know if my system has been permanently screwed over. Whatever pain I am experiencing now, cold turkey will be 1000x worse. I am trying to be strong, but not sleeping is causing me to stress more. Why is this happening? Is there no way out for me??......

[spidey]

I realize no one here can "help" me......I'm just frustrated I guess.

[Jemima]

Please tell us more about what happened.  Why were you off the Cymbalta for two days?  How much were you taking per day up to that time?  When did you start on 13 mg.?

[spidey]

I was off the drug for 2 days because every time I get the dose "wrong" (which has been happening more often than not) I either get intense side effects that were never present prior to my being double dosed, or else my body completely freaks out and goes into an hours/days long panic attack. It sounds like it doesn't appreciate sudden jumps in dosages, but again: I have no idea what I am doing. Too little, and I can't function, too much (which can even be 5 beads or less sometimes) and I'm in fight or flight mode for days. I've not been on a consistent taper (which is a huge part of this problem) with this drug because I don't know how much my body wants or can handle. Some dosages felt fine until I reached the fourth or fifth day.....then suddenly they weren't as I would get weird side effects. So I would pull back.....sometimes with no dose, sometimes with very little. My system has destabilized. I don't know if I can help it heal at this point. Alto warned me this would happen, but again: I've had NO IDEA from the start what I'm doing. Ever since the doubled dose 5 months ago my body's reactions have been unpredictable.

[Jemima]

Skipping days and frequently changing your dose is making matters worse.  There is NOTHING that will make you feel better immediately, so looking for instant relief is pointless, and in this case probably harmful.  Getting through this is going to take patience and putting up with discomfort.

 

The fourth or fifth day is exactly when the full effects of a different dose would take effect.  If taking 13 mg. for four to five days has proven too much and 5 mg. is too little, you might cutting back by a bead or two, but stick with it for four to five days so you know what effect it's having. Rinse and repeat.  When you start to feel somewhat better, you might want to stay wherever that may be for a month or more.  It's really difficult to tell what will work because of all the changes.  The effects of all that cloud the picture and you may still be feeling bad from previous increases or cuts rather than your current dose.  You may also simply be unable to take any sort of drug that effects serotonin levels.

 

I'm sorry that there is no sure cure for this.  Even for someone who isn't sensitive to serotonergic drugs,  tapering is something of an experiment.  Many people have had to back up and hold  for  a while on their tapers, although they eventually succeed.

 

As for switching to another drug, especially an SSRI like Celexa, I think that would likely cause even more problems as it is a different drug from the SNRIs.  All of them affect serotonin levels, so there's probably no point in changing to something else, although you might look into the lamotrigine, as Alto suggested.

 

Please don't expect to feel really wonderful or even normal when you hit on the right dose, just better.  I'm guessing that there's going to be discomfort for some time while getting off of Cymbalta.

[spidey]

At this point my options seem to be: 1). try yet again to reinstate Cymbalta 2). switch to Pristiq 3). go on Lamictal.

I have no guarantee on any of these, obviously. In your opinion, and from what you've seen others go though, which of these would pose the least risk for someone in my situation?

[Jemima]

I'm confused.  I thought you were taking 13 mg. of Cymbalta.  Now you're considering reinstating, which implies that you haven't been taking it.  Is that correct?

 

Beware of Pristiq.  It comes only in a  50 mg. and 100 mg. time-released form that cannot be cut or made into a liquid.  Many people have had to switch to Effexor to get off of Pristiq, and Effexor is one nasty drug to taper.

 

As for Lamictal,  I don't know.  I think you're asking for more trouble changing doses, changing meds, and stopping and starting Cymbalta.  You've been following this erratic pattern since late April and it doesn't seem to have helped, so why not try something different, like making a plan and sticking to it?  As I've said before, there is absolutely nothing that will make you feel better right away.  In fact it may be weeks before you feel even somewhat better even with steady dosing and taking good care of yourself.  You will have to learn to tolerate some misery and just get through it.

 

Believe me, if there were an easy way out of withdrawal, Alto and us other staff would be enjoying the millions we made from our best-selling book instead of offering advice online.

[spidey]

I would love pick a plan and stick to it----I would looove to reinstate Cymbalta, but I'm afraid of the nervous/manic surges that I keep getting. Are there ways I can help my body to not overreact to this med?

[Jemima]

Does this mean that you've stopped taking it again?

[spidey]

The last 2 days I've not taken it. Again, I don't know when to reinstate and I'm scared of the reaction I might have. I'm living day to day on borrowed time it seems. This feels like hell....or the introduction to hell. Sometimes I wonder about suicide if I can't resolve this. I don't want to be living out the rest of my life brain damaged and in an institution.

[Jemima]

Antidepressants do cause brain damage of a sort, but it's temporary. That will take some time to resolve (months to years) after the drug is tapered or discontinued, but there is very little chance that you'll end up drooling on yourself in a mental institution.

 

I don't know what to tell you to do at this point.  Perhaps just stay off the drug for a few days and see what happens.  There's a one month window for a fairly safe reinstatement, although with your sensitivity reinstatement may be a bad idea regardless of  the time lapse.

 

Meanwhile, here's a big collection of non-drug ways to feel better:

 

http://survivingantidepressants.org/index.php?/forum/8-symptoms-and-self-care/

[spidey]

You're very kind, Jemima. Thank you for listening to me. It's nice to have someone to talk to at least.