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CymbaltaDrone

CymbaltaDrone - Choosing A Life Without Drugs

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CymbaltaDrone   
CymbaltaDrone

Case History

 

1990s (high-school) diagnosed with at least 2 bouts of depressions and prescribed Zoloft

late 1990s crisis in 2nd yr of university, ended up dropping out and spending a few years traveling

2000 married, ready to resume my studies, worked really hard, did really well.

mid 2000s graduated university, took job with multinational energy company, all going well

2008 All is not well, most noticeably at work, slowly losing my grip on my ability to get my job done, to relate to and influence people. Visit Centre for Sleep and Human Performance in Sundance, Calgary, start taking things like Novotrazodone, Seroquel and Zopiclone to help me sleep. Everything works great the first week but it ineffective, even at higher doses after a couple of weeks. The sleep CBT doctor was more helpful, including referring me to a book called "Say Good Night to Insomnia: The Six-Week, Drug-Free Program Developed At Harvard Medical School". I never did do everything it said but jsut reading the earlier chapters was enough to completely change the way I thought about sleep and thereby most of my insomnia.

mid 2008 almost ground to a halt, lost almost all ability to concetrate, retain memories, make decisions, get out of bed etc. I wrote a letter to my GP who FINALLY "gets" that something really is up and this is not just regular "stress". He refers me to a psychiatrist.

September 2008 Psychiatrist immediately issues a sick note and I commenced a medical leave from work. Start on 60mg Cymbalta. Start to improve within a few weeks. Continue to improve for next few months.

January 2009 return to work slowly, seems to be ok, but not good, exacerbated by transfer to new department and an unsupportive manager. Feel Cymbalta is not helping any more. Start on 150mg Wellbutrin XL.

May 2009 Fall pregnant - unexpectedly. Decide to stay on Cymbalta (which has never been tested in pregnancy) and Wellbutrin (has been in use for a longtime and seems to be safe). Very nauseous which further complicates workplace.

December 2009 Commence parental leave.

January 2010 Give birth, at home with midwives, to healthy baby girl. No indication so far of side effects from exposure to antidepressants inutero - advanced for age all through.

February 2011 Still on extended parental leave. Dissatisfied with lack of progress regarding medications. I ask to try something different, or perhaps even stop them. Doctor is not supportive at all. Asks me to double my dose of Cymbalta to 120mg. Dosage increaseis just before a 5 week trip to visit family overseas. Side effects are debilitating - intense hostility and anxiety were the worst. I managed to still have a fantastic vacation (I was very determined) but had the dose reduced the day after I returned home in March.

March 2011 Reduce dose back down to 60mg of Cymbalta.

 

____________________________________________________

Will have to finish later -gotta go put my babe to bed!

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Altostrata   
Altostrata

Hello, Cymb. Welcome to our community.

 

So you are still on leave now?

 

And at 60mg of Cymbalta, it isn't "helping"? What kind of symptoms do you have?

 

Are you thinking you want to quit Cymbalta at this point?

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CymbaltaDrone   
CymbaltaDrone

Case History Continued...

 

March 2011 The symptoms from the high (over)dose took about 6 weeks to ease off completely. Meanwhile my sister, who has been diagnsoed with T2 BPD 2.5 years before had been slowly coming up to speed on the underworld of psychiatry and showed me a movie on youtube. Watching that 10 aprt documentary (will post the link when I find it) really pushed me over the edge from not wholly confident in my conventional to determined to educate myself and work out what I considered to be the best treatment for me.

Spring 2011 My parental leave had given me a golden opportunity to really focus in on what I needed to do to be well and stay well - I think the formal term would be wellness determinants / factors / tools - and gradually build these new habits into my life. Some of the most important determinants for me are intense exercise (Curves circuit) at least twice per week, good nutrition especially eating breakfast early in the morning, interacting with my friends, contributing to enriching the lives of others, gardening, cooking and a positive outlook. I was still foundering, however, when in Spring a mother's bookclub I was attending began to study a book called "Sacred Rhythms". Getting up at 5am each morning - or earlier - and incorporating into my life the discipline of solitude and silence has been the ultimate key to unlocking wellbeing in my life. Somehow, that quiet time allows me to get my ducks in a row before the day begins and move confidently through each day, able to choose what matters most. When I miss my quiet time for whatever reason, my productivity drops to near zero and my mood is very deflated. During this time of gradually increasing wellbeing and confidence, I missed a couple of doses in a row of Wellbutrin when I fortuitously forgot to put them in my pill box for the week. When I realised, I decided to just wait and see a few more days. I experience withdrawal side effects (mostly anxiety, hostility, vertigo, dizziness, cognitive deficits) for a cuople of weeks and they eventually faded. I then stopped the Seroquel the same way, with no noticeable side effects (I hadn't been taking it for long and was not taking it every day, unlike the Wellbutrin and Cymbalta). This left me on Cymbalta 60 mg alone.

Summer 2011 In mid-July I returned to work on a Monday-Wednesday-Friday schedule. It all went pretty well, although I could tell there was more stress than was healthful because I came down with a cold after the first evening of work that I still have not shifted 5 weeks later.

End of July 2011 I was finally able to convince my psychiatrist to allow me to drop my dose to 30mg of Cymbalta. I realise all this "allow me to" talk with respect to my doctor may seem odd, but since I have been taking medical leaves and working restricted hours for medical reasons, I have to be very careful to leverage the support of both my psychiatrist and my employers' medical centre staff while at the same pushing my own agenda of wellness without drugs. Appearing not to cooperate with treatment would leave me open to dismissal from my job, and when I leave them I want to do it my terms, not theirs. Anyway...The discontinuation symptoms kicked in on the third day and were severe. I had a major deliverable due at work mid August and was falling really behind. They were able to shift the deadline a bit for me and I though I could do it.

Mid August 2011 I was unable to deliver on the big project at work and the crap really hit the fan. I knew it was the cognitive deficit from the discontinuation, combined with the insomnia, that had prevented me yet I couldn't talk about that with my manager. That week, after accidentally missing two doses in a row of Cymbalta 30 mg, without my psychiatrist's knowledge, I decided to see if I could stop it altogether. Again, severe discontinuation symptoms. cold had progressed to a chest infection by this time and was so bad I didn't work at all the next week. I made sure that I sought out an extra appointment with my psychiatrist to submit a new medical form to my employer ensuring that the cognitive deficits were emphasised. Apparently he had submitted these the previous time, but the medical centre at work elected not to pass these concerns on to my management. This time I ensured that they were. Nothing too specific - they will never have concrete evidence of my condition although they'd have to be supremely retarded not to have it figured out by now - but I need them to know that for a little while longer I cannot really be relied on to meet critical deadlines, so give me grunt work instead. I haven't been back to wor since this form was submitted.

On Day 4 of no drugs, I called Eli Lily and they counseled that even after taking the drug for two years, study participants were able to drop to 30 mg for a week, then stop cold turkey. Eventually they looked into the details of that particular study for me over the phone, and discovered that this was not quite correct. That method apparently worked for people who had been taking Cymbalta for shorter lengths of time, but the 2 year participants had to drop to 30 mg for a week (or two? I forget) then take doses on alternate days for a week, then a dose every third day for a week, then every fourth day etc until they were off. They said I should go ahead and do this and update my doctor when I go to see him at the end of this month. They were very surprised that he had not given me any information at all on discontinuing the drug. To maintain my privacy, somewhat, I elected not to provide them his name (through him I've been participating in an anonymous study throughout my pregnancy and postpartum on the health of my child who was exposed inutero to Cymbalta and I don't want them to be able to identify her - who knows what consequences this could have for her later on in life). My symptoms were really bad by this day when I spoke with Eli Lily and I decided to take a 60mg capsule and measure out about 10-15 mg Cymbalta. My symptoms almost completely cleared up after taking this small amount and I finally got a good night's rest.

Day 7 of (almost) no drugs I repeat the small 10-15 mg Cymbalta dose. This was yesterday. I suppose I will continue to take nothing for as many days as I can, and then take a small amount of Cymbalta if the symptoms become too debilitating. I'll keep you posted on how it all goes.

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CymbaltaDrone   
CymbaltaDrone

My Discontinuation Symptoms

 

  • Aggression
  • Agitation
  • Akathisia
  • Anxiety
  • Concentration difficulties
  • Confusion
  • Decisions making difficulties
  • Dizziness
  • Dysphoria
  • Emotional lability
  • Hostility
  • Hypomania
  • Insomnia
  • Irritability
  • Lethargy
  • Memory difficulties
  • Nausea
  • Planning difficulties
  • Slowed thinking including brain freezes/pauses
  • Sweating
  • Tremors

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CymbaltaDrone   
CymbaltaDrone

Some Sources of Help, Support and Information That Have Helped Me

 

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CymbaltaDrone   
CymbaltaDrone

Hi Alto,

 

Thanks for the welcome. I think my followup posts have answered your questions (no, no longer on medical leave but working with medical limitations; yes, want to quit Cymbalta).

 

Now, about my symptoms. I'm not talking discontinuation symptoms here, rather, I'm referring to the underlying symptoms of "depression", the exacerbated forms of which got me into this whole three ring circus in the first place. It has been the continued presence and lack of improvement in these symptoms that has ultimately frustrated me and undermined any faith I had in drugs as a treatment. While Cymbalta certainly helped me in those first few months in 2008, I remain unconvinced that they were the best option and certainly shouldn't have been offered as the first intervention option. But they were, and here we are.

 

So despite improvements, I have continued to have "bad" days or even weeks when I lack almost all motivation and my mood is deflated. This invites me to choose all kinds of self-defeating behaviours like not going to they gym, not eating well, not socialising with my friends, not looking after my home etc. Whether its an "up" day or a "down" day, however, I have been most concerned with an underlying sense of unease, agitation, hostility and even aggression which has gradually - very gradually - become worse and worse. I now experience almsot daily fits of (mostly) internal rage and frustration and have never been so suicidal and homicidal in my life as now. This is what has really scared me adn which my doctor doesn't seem to hear. Information my sister has shared with me makes me wonder if perhaps this is the drugs themselves causing these symptoms.

 

While these sensations have become more pronounced, so has an undercurrent of wellness and positivity which has finally given me the courage to try and get off Cymbalta while I'm still on medical limitations at work. For some reason my doctor wanted me to let everything at work settle down and then go off, which may sound good at first blush, but I prefer to get all the medical stuff at work out of the way in one go rather than revisit and draw it out. I suppose that ultimately the jury is still out on which strategy has the most chance of success.

 

So that is where I am now. Today has been a good day. I have contributed my history here. Probably not too far in the future it will be a bad day and I will turn here for hope. Thanks for running this forum.

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Roads   
Roads

Hi CymbaltaDrone,

 

I hope this place will bring you all the good it is capable of, and that your journey to definitive healing will be the shortest and smoothest possible.

 

Many people have recovered, so your healing is ineluctable. Plus, going through this kind of extreme ordeal will make you tougher, wiser, and more capable of happiness. It is not vain.

 

I send you my most supportive and affectuous thoughts.

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Altostrata   
Altostrata

CD, it seems to me you have gone about this in a very smart way, using the best information available to you. (I am also impressed with the systematic thinking and the links.)

 

You were right to reinstitute a small dosage of Cymbalta when you experienced withdrawal symptoms.

 

(The advice you got from Lilly about tapering was stupid, but what else do we expect from pharma regarding adverse effects? Alternating dosages is a terrible way to taper. Please don't do it.)

 

What I would do in your situation is stay consistently at this dosage for about a month. This is to allow your brain and nervous system to adjust to the roller-coaster ride they've had for the last several months. Since you've experienced withdrawal symptoms, your system has already had a big upset, think of it as fragile. Rocking back and forth in dosage puts stress on it. Don't push things -- be careful, consistent, and gradual from this point on.

 

(You might want to count the pellets in your capsules, see http://survivingantidepressants.org/index.php?/topic/283-tips-for-tapering-off-cymbalta-duloxetine/page__view__findpost__p__9954 -- looks like there may be about 250 pellets in a 30mg capsule.)

 

Then, reduce by, say, 10 pellets, hold for a few weeks to see if withdrawal symptoms arise. If no symptoms, reduce by another 10 pellets.

 

Slow and steady is the way to minimize risk of withdrawal symptoms and prolonged withdrawal syndrome after you quit.

 

As for your pre-existing depression, it would be hard to say what's going on with you while you're withdrawing. Withdrawal can cause mood effects, too, or exaggerate feelings (emotional lability).

 

You have found some good ways to well-being. Perhaps when you are out of the tunnel, you will be able to say good-bye to the psychiatrist and find a therapist who will help you identify the root of your depression and address it with, for example, self-acceptance. This may be an ongoing project, but you've already transformed yourself, there's only growth ahead.

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CymbaltaDrone   
CymbaltaDrone

5 Days Ago (Day 7 of (almost) no drugs) I Took a small three ~15 mg doses when discontinuation symptoms became intolerable.

 

Last few days I experienced (as expected) progressively worse discontinuation symptoms

 

1 Day Ago (yesterday) The discontiantion symptoms were very bad yesterday afternoon but I was out and about with no access to meds so I had to push through it. By the time I got home in the evening the crisis had passed and I've felt progressively better since. I realise that this goes against the tapering recommendations on this site (and just about everywhere else), but since I have arrived where I am rather unintentionally (if a little neglectfully) I am thinking of continuing to wait and see what happens.

 

QUESTION: If I am going to develop chronic brain disturbance by stopping so abruptly (and so should continue on a more conventional, gradual taper as recommended on this site to prevent this damage), would I have phsyical and mental sensations which would indicate this? Will I continue to improve each day adn then one day start getting symptoms fo this kind of damage? Or is it experienced as a discontinuation symdrome that never eases up?

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CymbaltaDrone   
CymbaltaDrone

5 Days Ago (Day 7 of (almost) no drugs) I Took a small three ~15 mg doses when discontinuation symptoms became intolerable.

 

Last few days I experienced (as expected) progressively worse discontinuation symptoms

 

1 Day Ago (yesterday) The discontiantion symptoms were very bad yesterday afternoon but I was out and about with no access to meds so I had to push through it. By the time I got home in the evening the crisis had passed and I've felt progressively better since. I realise that this goes against the tapering recommendations on this site (and just about everywhere else), but since I have arrived where I am rather unintentionally (if a little neglectfully) I am thinking of continuing to wait and see what happens.

 

QUESTION: If I am going to develop chronic brain disturbance by stopping so abruptly (and so should continue on a more conventional, gradual taper as recommended on this site to prevent this damage), would I have phsyical and mental sensations which would indicate this? Will I continue to improve each day adn then one day start getting symptoms fo this kind of damage? Or is it experienced as a discontinuation symdrome that never eases up?

 

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Altostrata   
Altostrata

cd, I moved your post above here from Lor95's topic because I thought you wanted to ask a question about your own situation. I hope I guessed right.

 

....

QUESTION: If I am going to develop chronic brain disturbance by stopping so abruptly (and so should continue on a more conventional, gradual taper as recommended on this site to prevent this damage), would I have phsyical and mental sensations which would indicate this? Will I continue to improve each day adn then one day start getting symptoms fo this kind of damage? Or is it experienced as a discontinuation symdrome that never eases up?

 

Withdrawal symptoms can come and go. Some people don't develop full-blown withdrawal syndrome until maybe 6 weeks after quitting.

 

You can't tell if you'll develop chronic (more than 6 months) withdrawal syndrome until you actually do. We advocate slow, gradual tapering to protect your nervous system from potential harm. Even if your withdrawal symptoms are mild, your nervous system can be fragile for a very long time. You may have trouble later. This sends a lot of people back on medication.

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Rhiannon   
Rhiannon

Another thing to keep in mind is this: You cold turkeyed off Wellbutrin and Seroquel in spring of this year. Personally I think it would be very odd if you were NOT experiencing withdrawal from that experience, as part of what's going on with you. With these drugs, you can't always go by how you feel right after you quit taking them, to tell you how your CNS is dealing with the w/d.

 

In fact, as you probably already know, most people who take antidepressants and quit don't experience a "relapse" (which I think is a withdrawal response) for at least six months. That's when they're usually put on another antidepressant, and the chronic nature of depression-on-antidepressants begins.

 

I think it would be a good idea to try not to taper Cymbalta any further at this point, to change nothing, to give your CNS time to stabilize and achieve some kind of homeostasis again as it recovers from those already very drastic changes. Personally I'd give it another six months or so.

 

I don't have time to re-compose my usual treatise on brain changes in response to psychiatric medications, but I think I already have some posts here that cover that subject, if you can maybe take a look at them. Having an idea of what's going on in my body helps me both to cope with the changes and to figure out what might be going on and how best to work with that. I think that's a lot of why I've been so successful at my taper so far. It's definitely why I am so emphatic about the need to go slowly. Brains don't grow and change fast.

 

Also--the actual drug companies, and most doctors for that matter (who only know what the drug companies have told them), are usually the WORST possible sources for information on how to safely get off psych drugs. Just FYI.

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CymbaltaDrone   
CymbaltaDrone

Case History Continued...

 

February 18, 2012 - ~6 mths drug free

I've been drug free now for about 6 mths. I don't think I’ve had any readily identifiable discontinuation symptoms since about 4 mths post last dose. I still don't feel that I'm back to 100% of my cognitive and general life management abilities, though; I’m not sure if this is due to a kind of long-term “hangover” or if it is due to the underlying health / lifestyle issues that contributed to going on ADs in the first place. I’ve addressed many of these in the last couple of years (or I probably wouldn’t have recognised that the drugs were holding me back in the first place) but there are definitely still areas to improve in. Probably there are elements of both at play - whichever it is, my approach remains the same: focus on my wellness supports, particularly sleep, diet and geed relations with my husband and our now 2 year old.

 

I've noticed huge improvement over the last 2 months,though. I’ve been able to resume full-time work as an engineer (9 weeks now – Iwent back part time in July and gradually increased my hours), and have managedparenting our 2 yr old much better, too.

 

My gut feeling on getting off cymbalta is that you just haveto basically write off a year of your life to getting off it, to finding a wayto survive the tapering down – I think mine was actually fairly aggressive inthe end but when I was down to taking a small amount every few days I didn’tmess around: when the symptoms were unbearable, I took another small dose.Eventually, I didn’t need another one and I was off it. It’s not going to beeasy but it’s worth it once the discontinuation wears off and your “self”begins to re-emerge and live again. I am so alive and engaged with life now compared to any time while I was on cymbalta (~3 yrs total).

 

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autimom4ever   
autimom4ever

I am so happy about your recovery/success..

 

Me, on the other hand, have failed.

Why? I cannot write off a year of my life for withdraw. I am the primary provider of a family with 2 individuals with disabilities. I HAVE to work. I have NO choice.

 

I tried... I weaned (probably too fast) from 5 years of taking 60 mg/day of cymbalta. Went from 60 to 40 mg for 2 weeks then to 20 mg for 2 weeks then to 0.

 

I was at 0 by Nov. 1, 2011. After that, life was hell. For me AND my family.... I had a hard time functioning at work. All of the symptoms you listed were basically my symptoms.

But I developed another pretty debilitating symptoms - pain. Pain in my back that I NEVER had prior to or during Cymbalta.

A pain that not 1 but 3 specialists could not find a cause for after numerous tests (radiological and blood work). I also went through PT and Chiro.

A pain that all 3 specialists agree that was probably masked while taking cymbalta that, if I knew was there, would have taken care of many years ago.

 

So, I hit bottom this month... Almost losing my job and my family.

So I had to make a choice.... Go back on and see what happens or possibly go insane or even submit my life.

I chose life.... I have to live.... my family needs me.....

 

The only specialist that seemed to not throw his hands up in the air with me was the neurologist, he gave me options (while I sat in his office crying my eyes out). One of them was to titrate back up and see what happens and maybe eventually go back down again, but slower...

He promised he would keep an eye on me and make sure I never go through such a withdraw... Will it help my pain? I hope..

 

So here I am, on day 3 of titrating back up... I'm nervous, angry, upset, feel like a failure.... but what else was I supposed to do?

I, too, have called Eli Lilly multiple times over the months...to no avail... no answers there either...

 

Just please... Pray for me and my family and that one day, I will be free from this horrid chemical that has taken complete control of me one day too...

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Altostrata   
Altostrata

Good to hear from you, CymbaltaDrone.

 

Your taper method of taking Cymbalta irregularly may have contributed to your long recovery time. However, that's water under the bridge and it's great you're almost 100%.

 

When you feel you can say you're completely recovered from withdrawal, please post in our new forum Recovery stories

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