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gardenlady   
gardenlady

Moderator's note: Link to gardenlady's benzo thread

 

I would like to taper off of 60 mg Cymbalta.  However, I am in the middle of a taper off of Valium and am now at 11 mg/day.  The horror stories I have heard about Cymbalta withdrawal terrify me.  Should I cross over from Cymbalta to another AD and then taper off?  And, should I wait until I finish my Valium taper?  I cross tapered from 1.75 mg Ativan to 13 mg Valium and am now down to 11 mg.  It's going to be a long time until I'm off of it.  I am horribly depressed since switching to Valium, but the anxiety from interdose withdrawals on the Ativan were unbearable.  I want off of ALL of these psychotropic drugs but realize I have to go slowly.  I just want my life back.  Any advice would be much appreciated.  

Edited by Shep
added link to benzo thread

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mammaP   
mammaP

Hi Gardenlady, welcome to SA.  Can you tell us how long you have been tapering valium, and how you are doing it? ( How often are you dropping doses and by how much, and how are you making up the dose )  

 

We usually recommend tapering the AD first, as the valium can help to buffer some of the withdrawal. We find that it is usually better to taper from the original drug because switching can cause more problems. If it is done very slowly the withdrawals can be kept to a minimum. We don't recommend tapering more than one drug at a time because it would be impossible to tell which one was causing any problems that may arise. Some people do successfully do multiple tapers but it takes a lot of time and patience, cutting by miniscule amounts and need very careful records to keep them on track.  If you've been tapering the benzo for a while you would be best to hold and stabilise then think about tapering cymbalta. 

 

Here are some links to topics for you to read through. 

 

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

 

Tapering more than one drug..

 

 

.http://survivingantidepressants.org/index.php?/topic/2207-taking-multiple-psych-drugs-taper-the-antidepressant-first/

 

http://survivingantidepressants.org/index.php?/topic/1070-taper-more-than-one-drug-at-a-time/

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gardenlady   
gardenlady

Hi Gardenlady, welcome to SA.  Can you tell us how long you have been tapering valium, and how you are doing it? ( How often are you dropping doses and by how much, and how are you making up the dose )  

 

We usually recommend tapering the AD first, as the valium can help to buffer some of the withdrawal. We find that it is usually better to taper from the original drug because switching can cause more problems. If it is done very slowly the withdrawals can be kept to a minimum. We don't recommend tapering more than one drug at a time because it would be impossible to tell which one was causing any problems that may arise. Some people do successfully do multiple tapers but it takes a lot of time and patience, cutting by miniscule amounts and need very careful records to keep them on track.  If you've been tapering the benzo for a while you would be best to hold and stabilise then think about tapering cymbalta. 

 

Here are some links to topics for you to read through. 

 

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

 

Tapering more than one drug..

 

 

.http://survivingantidepressants.org/index.php?/topic/2207-taking-multiple-psych-drugs-taper-the-antidepressant-first/

 

http://survivingantidepressants.org/index.php?/topic/1070-taper-more-than-one-drug-at-a-time/

 

Here is my benzo history:

May 2014-Tapered off of 2 mgs K via 6 wk fast taper

Protracted acute withdrawal for 7 months. 
10 month window
Protracted withdrawal reappeared as PTSD with akathisia after personal trauma in March 2016. 
Aug/29/16 - Reinstated 2 mg Ativan & 10 mg Ambien 
Oct/16-Tapered Ativan down to 1.75 mg & crossed from 20 mg Lexapro to 60 mg duloxetine 
Nov-Dec 2016-Tapered off of 10 mg Ambien
Jan-Feb 2017-c/o from 1.75 mg Ativan to 13 mg Valium
Feb/26/17-12 mg V
Mar/6/17-11 mg V (4 mg morning, 2 mg afternoon, 5 mg night)
 
I am using 5 mg and 2 mg Valium tablets and splitting as needed.  The taper plan for Valium is 1 mg cut every 1 - 2 wks or more (depending on wd sx) until I get to 10 mg and then I'll slow to .5 mg cut every 2 - 4 weeks or as symptoms allow, then decrease to .25 mg cut depending on symptoms.  If necessary, I'll go to a daily liquid micro taper. 
 
The problem is that I am SO very depressed on the Valium that I'm concerned that stopping that taper and then tapering the Cymbalta (which could take months or a year) will only add to the depression.   
 
Other issues:
1. I can't open the 60 mg duloxetine capsules. I've tried several and they won't come apart.   
2. They are generic made by Citron in India.  I've investigated online and found that the beads in Citron duloxetine are irregular and in pieces, so I cannot use the bead counting method.
3. My 2 Gemini scales are inaccurate, weigh differently each time and won't calibrate.  I used them when tapering off of Ambien where the accuracy wasn't that important.  However, with duloxetine, it's crucial. 
 
Thanks for your help.

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scallywag   
scallywag

gardenlady -- Welcome to Surviving Antidepressants (SA)

 

No need to be terrified about tapering Cymbalta. I've been reducing Cymbalta dose for over a year now. After having followed some bad information from my doctor, I have settled into a very manageable rhythm of tapering.

 

I've been counting the beads from brand-name Cymbalta capsules to create taper doses -- I haven't needed to use a scale.

 

Are you taking brand-name Cymbalta or generic duloxetine?

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gardenlady   
gardenlady

gardenlady -- Welcome to Surviving Antidepressants (SA)

 

No need to be terrified about tapering Cymbalta. I've been reducing Cymbalta dose for over a year now. After having followed some bad information from my doctor, I have settled into a very manageable rhythm of tapering.

 

I've been counting the beads from brand-name Cymbalta capsules to create taper doses -- I haven't needed to use a scale.

 

Are you taking brand-name Cymbalta or generic duloxetine?

 

I'm taking the generic duloxetine made by Citron in India.  I've investigated online and found that the beads in Citron duloxetine are irregular and in pieces, so I cannot use the bead counting method.  So, If I can't bead count or use my scales, what other options are there?  Thanks for your help!

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nz11   
nz11

Have you thought about buying a more accurate scale?

It could be well worth the investment.

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scallywag   
scallywag

Well if the beads are irregular and inconsistent, then a scale it is! Sorry I missed that information in one of your previous posts. Several people here have used a Gemini Scale with success. YOu can find more information about that in this topic:

Using a digital scale to measure doses.

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gardenlady   
gardenlady

 

Hi Gardenlady, welcome to SA.  Can you tell us how long you have been tapering valium, and how you are doing it? ( How often are you dropping doses and by how much, and how are you making up the dose )  

 

We usually recommend tapering the AD first, as the valium can help to buffer some of the withdrawal. We find that it is usually better to taper from the original drug because switching can cause more problems. If it is done very slowly the withdrawals can be kept to a minimum. We don't recommend tapering more than one drug at a time because it would be impossible to tell which one was causing any problems that may arise. Some people do successfully do multiple tapers but it takes a lot of time and patience, cutting by miniscule amounts and need very careful records to keep them on track.  If you've been tapering the benzo for a while you would be best to hold and stabilise then think about tapering cymbalta. 

 

Here are some links to topics for you to read through. 

 

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

 

Tapering more than one drug..

 

 

.http://survivingantidepressants.org/index.php?/topic/2207-taking-multiple-psych-drugs-taper-the-antidepressant-first/

 

http://survivingantidepressants.org/index.php?/topic/1070-taper-more-than-one-drug-at-a-time/

 

Here is my benzo history:

May 2014-Tapered off of 2 mgs K via 6 wk fast taper

Protracted acute withdrawal for 7 months. 
10 month window
Protracted withdrawal reappeared as PTSD with akathisia after personal trauma in March 2016. 
Aug/29/16 - Reinstated 2 mg Ativan & 10 mg Ambien 
Oct/16-Tapered Ativan down to 1.75 mg & crossed from 20 mg Lexapro to 60 mg duloxetine 
Nov-Dec 2016-Tapered off of 10 mg Ambien
Jan-Feb 2017-c/o from 1.75 mg Ativan to 13 mg Valium
Feb/26/17-12 mg V
Mar/6/17-11 mg V (4 mg morning, 2 mg afternoon, 5 mg night)
 
I am using 5 mg and 2 mg Valium tablets and splitting as needed.  The taper plan for Valium is 1 mg cut every 1 - 2 wks or more (depending on wd sx) until I get to 10 mg and then I'll slow to .5 mg cut every 2 - 4 weeks or as symptoms allow, then decrease to .25 mg cut depending on symptoms.  If necessary, I'll go to a daily liquid micro taper. 
 
The problem is that I am SO very depressed on the Valium that I'm concerned that stopping that taper and then tapering the Cymbalta (which could take months or a year) will only add to the depression.   
 
Other issues:
1. I can't open the 60 mg duloxetine capsules. I've tried several and they won't come apart.   
2. They are generic made by Citron in India.  I've investigated online and found that the beads in Citron duloxetine are irregular and in pieces, so I cannot use the bead counting method.
3. My 2 Gemini scales are inaccurate, weigh differently each time and won't calibrate.  I used them when tapering off of Ambien where the accuracy wasn't that important.  However, with duloxetine, it's crucial. 
 
Thanks for your help.

 

 

Please see this part of my post from yesterday.  I've bought 2 Gemini scales and neither one is accurate nor will calibrate accurately.  I don't know of another kind of scale to buy...I've investigated and found that to get a really reliable one costs hundreds of dollars.   The reasonable solution is to cross taper from Cymbalta to a drug that is more feasible to taper off of.  Do you have any suggestions?  I'm really stuck and need help.  Thanks!

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nz11   
nz11

You havent said what scales you have so anyway in case you have the one from the cornies packet there is this one

http://www.americanweigh.com/product_info.php?products_id=580

 

or this one

http://www.americanweigh.com/product_info.php?products_id=2116

 

Accuracy is required when tapering off all of these drugs and especially more so when one has a 'long history of ads'

I think that cross tapering your cymbalta is a very risky move. ...all these drugs require care when tapering.

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gardenlady   
gardenlady

Thanks for your response! I have 2 of the Gemini 20 scales from American Weigh. They are both inaccurate. This is one of the two you recommended. I'll look into the Gemini Pro version, but wonder if it would be any better since it's also an American Weigh product.

I have cross tapered from and to numerous ADs successfully since 1990, so wonder why crossing from Cymbalta to something else would be any different. Honestly, I've never been able to tell any difference in any of them. I just want off completely.

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scallywag   
scallywag

Others have talked about how they work around Gemini scale's deficiencies in the topic I linked. The scale seems to be less precise at low measurements so they weigh their medications with the 10mg tare weight on it. Have you tried that?

 

To get a scale with greater accuracy and precision, you'll need to spend at least $1,500 US.

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ChessieCat   
ChessieCat

From Post #87 in the Using a digital scale:

 

"One trick for getting more accurate readings is to keep the calibration weight in the pan while weighing our dose.  Put the weight in the pan and press the "TARE" button.  This will zero the scale but put the electronics in the middle of their range where they are the most accurate.  Now weigh your dose as usual."

 

(Scally just beat me to it)

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gardenlady   
gardenlady

Yes, I have tried using the 10 mg weight that comes with the scales and they are still inaccurate.

 

I simply want to cross taper from Cymbalta onto something else.  I'm stunned that there is no solution to this....really hard to believe.  I did read somewhere on a link on this site about crossing from 20 mg Cymbalta to 10 mg of Prozac, but I'm on 60 mg of Cymbalta.   

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ChessieCat   
ChessieCat

Have you spoken to the pharmacist about what other generic versions of Cymbalta are available?  You may need to try different pharmacies to find out what they supply. See at the bottom of Post #1 under the heading Switch to Prozac in this topic:  Tips for tapering off Cymbalta (duloxetine)

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ChessieCat   
ChessieCat

The big issue with change your drug is that you may end up getting withdrawal symptoms from the duloxetine and get start up and or side effects from the new drug.  You won't know what is causing any issues.

 

Citron duloxetine is available in 20mg, 30mg & 60mg.  You could take 20 + 50 + capsules (then 20 + 20 + capsules) compounded by a pharmacy.  This is similar to what I have done to taper Pristiq which is only available in 50mg & 100mg.  I got small amounts compounded and was taking them with my 50mg.  After I got lower than 50mg I have been taking only compounded Pristiq.

 

From the tips-for-tapering-off-cymbalta-duloxetine:

 

Have a compounding pharmacy make up capsules of smaller dosages
For precise dosing, a compounding pharmacy will accurately weigh the doses and put the right number of beads into capsules for you. See http://survivinganti...ndpost__p__3001

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nz11   
nz11

I have cross tapered from and to numerous ADs successfully since 1990, so wonder why crossing from Cymbalta to something else would be any different. Honestly, I've never been able to tell any difference in any of them. I just want off completely.

Do you think, as you reflect back, that your cross overs have always resulted not in going drug free but in moving sideways to a higher equiv dose? and the introduction of a benzo?

 

What does your doctor have in mind this time?

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gardenlady   
gardenlady

Thanks so much for the advice.

 

 

I have cross tapered from and to numerous ADs successfully since 1990, so wonder why crossing from Cymbalta to something else would be any different. Honestly, I've never been able to tell any difference in any of them. I just want off completely.

Do you think, as you reflect back, that your cross overs have always resulted not in going drug free but in moving sideways to a higher equiv dose? and the introduction of a benzo?

 

What does your doctor have in mind this time?

 

I haven't moved to a higher equivalent dose AD when crossing.  The benzo was first used for insomnia.  The second time around I was in protracted acute withdrawal (didn't know at the time that's what it was....looked like PTSD) 2 years after tapering off clonazepam so my psychiatrist put me on Ativan when she switched me from Lexapro to Cymbalta.  I no longer go to psychiatrists since they are the ones who put me on these poisons.  My current doctor & psychologist want to get me off the benzo and AD permanently, as I do.  They are making me sick.  Thank you for your interest. 

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gardenlady   
gardenlady

The big issue with change your drug is that you may end up getting withdrawal symptoms from the duloxetine and get start up and or side effects from the new drug.  You won't know what is causing any issues.

 

Citron duloxetine is available in 20mg, 30mg & 60mg.  You could take 20 + 50 + capsules (then 20 + 20 + capsules) compounded by a pharmacy.  This is similar to what I have done to taper Pristiq which is only available in 50mg & 100mg.  I got small amounts compounded and was taking them with my 50mg.  After I got lower than 50mg I have been taking only compounded Pristiq.

 

From the tips-for-tapering-off-cymbalta-duloxetine:

 

Have a compounding pharmacy make up capsules of smaller dosages

For precise dosing, a compounding pharmacy will accurately weigh the doses and put the right number of beads into capsules for you. See http://survivinganti...ndpost__p__3001

Thanks so much for your help and advice!  Combining various doses to get wean down probably is a good solution.  Am still hoping that my doctor will come up with a way to cross me from Cymbalta over to something I've been on before and then taper off of that. 

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scallywag   
scallywag

What do you mean when you say the scale is inaccurate? When you put the 10 mg calibration weight on the scale what happens?

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nz11   
nz11

 Am still hoping that my doctor will come up with a way to cross me from Cymbalta over to something I've been on before and then taper off of that.

Sounds a little like the 'roll the dice and see what happens' plan.

 

Im sorry you were given a benzo for insomnia.

 

nz11

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gardenlady   
gardenlady

What do you mean when you say the scale is inaccurate? When you put the 10 mg calibration weight on the scale what happens?

 

Both fluctuate significantly in weight when weighing the same thing repeatedly whether using the 10 mg weight or not.  When I calibrate them, they don't reach an exact 10.000....always over or under.  And after that, the weights are all over the place again even right after calibrating.  These scales are pieces of junk.  

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gardenlady   
gardenlady

A couple of new developments have taken place so I thought I'd share here and get your thoughts.  

 

1.  My doctor said that since Valium is a controlled substance, he insists that I keep tapering to get off of it as fast as my body tolerance allows.  He is opposed to my stopping that taper to start the Cymbalta taper. Cymbalta isn't a controlled substance so he said that one can wait. 

 

2.  I was finally able to pry open my 60 mg Citron duloxetine capsule and found that the beads are the same size!  There are approximately 363 beads in a 60 mg capsule.  I had read elsewhere that Citron duloxetine beads were irregularly shaped and in pieces so were not candidates for counting.

 

So, I have to either do what my doctor says, or start the Cymbalta taper while I'm also tapering the Valium.  That's risky since I wouldn't know which drug would be causing which sxs.  But, people have done it.  Any thoughts?  Also, I'm reading about people doing micro bead cuts by cutting very small numbers each day vs cutting 10% all at once once a month.  How does one know which method to use?  And, does the 10% refer to the number of beads or number of milligrams of drug?? 

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Shep   
Shep

Hi, Gardenlady.

 

So that we are all on the same page, I'm going to link to your newly created benzo thread:

 

gardenlady: On Cymbalta & Tapering Valium

 

My post there also contains some information for your questions raised in your latest post here, too, such as information for a micro taper. 

 

I hope you're feeling better soon. 

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gardenlady   
gardenlady

I have trouble swallowing large pills, so I need to stick with the smaller size...hoping that the 00 size won't be too big. 

 

My 60 mg Citron duloxetine capsules have between 363 and 372 beads....I've counted only 2 since they are so hard to get pull/twist apart and I haven't yet ordered the empty gelatin capsules.  Would my first cut be 10% or about 36 beads?  And, should I hold there for two weeks until cutting another 10%? I read about people removing 1 bead at a time, so I'm a bit confused.  Thanks. 

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ChessieCat   
ChessieCat

I've moved your post here because it is about your own situation and will keep your questions, answers and history in one place.

 

"should I hold there for two weeks until cutting another 10%?"

 

SA recommends tapering by no more than 10% of the previous dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.

 

Before you begin tapering what you need to know

 

Why taper by 10% of my dosage?

 

These helped me to understand SA's recommendations:

 

Brain Remodelling

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

This topic discusses how to weigh beads:

 

Using a digital scale to measure doses

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gardenlady   
gardenlady

I am taking a break in my benzo taper (holding at 5 mg diazepam) because I am moving.  I signed a contract on a condo and am prepping my house for sale.  This whole process could take 3 months or so and I need to be functional enough to withstand the rigors and stress of moving.

 

I've decided to start my Cymbalta taper during this time and am on day 8 of a 10% cut from 60 mg to 54 mg.  I am weighing beads using my American Weigh Gemini 20 scale from Amazon.  It does fluctuate, but I will deal with it.  (You get what you pay for.....this thing cost $20).  The plan is to cut every 2 weeks assuming the withdrawal effects aren't too bad.  What is anyone else's experience with cutting 10% every 2 weeks?  Is it risker to shorten the time to every 10 days if I'm not having bad symptoms?  Right now, I'm having late afternoon & evening nausea, but it's manageable. I'd sure like to cut as quickly as possible while avoiding severe withdrawal symptoms, especially while I'm moving.  

Edited by scallywag
moved post about individual situation from "Tips about Tapering Cymbalta"

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Findingmyidentity   
Findingmyidentity

Hang in there. The fear came over me just thinking about tapering too. But please challenge every anxious or negative thought. See them as not true and no proof you cannot do well without AD. I have been taking vitamin D3, B12, Omega-3 fish oil. As well as magnesium and potassium for withdrawal symptoms. Also take the reduction as slow as you need to. There is no rush, as well as no pressure. I am holding my taper until i feel stable. I also try and accept these symptoms. Good luck to you!

Edited by scallywag
moved response about gardenlady's individual situation from "Tips about Tapering Cymbalta"

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gardenlady   
gardenlady

I have found that magnesium makes me more anxious which is exactly opposite from others' experiences.  Perhaps it's because I'm also in benzo withdrawal despite still being on 5 mg of it.  I'm avoiding fish oil as it is not recommended during benzo withdrawal.  I did a rapid taper from 13 mg to 5 mg valium in 6 weeks and hit the wall.  So, I'm holding there now and starting the Cymbalta taper.  On day 11 of my first 10% cut, I started having high anxiety and am still having it, so I guess I need to stabilize a bit before cutting another 10%.  I'm kindled from so it's making all of this more difficult.  I need to remain functional since I'm moving.

Edited by scallywag
moved post about individual situation from "Tips about Tapering Cymbalta"

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gardenlady   
gardenlady

I am holding my valium taper because I hit the wall at 5 mg.  Also, I am moving, so didn't think I could keep up the benzo taper during such a stressful time.  I decided to start tapering the Cymbalta since I thought it would easier, especially the first several cuts.  However, I was wrong about that.  Perhaps it's because I'm kindled from the benzo taper.  I cut 10% of the Cymbalta down to 54 mg for 12 days and then cut another 10% (approximately...I'm doing this by gram scale weight so the conversion to mg isn't exact) down to 48 mg.  I am having extreme anxiety and akathisia.  All this while my house is on the market & I'm having to clean out closets, etc.  I guess I'll need to give up all tapering until I'm moved and settled.  I just hated to waste the time and not taper at all.  It looks like it might take years for me to get off of the Cymbalta.  I think it may be worse than the benzo taper & withdrawal.  The problem is that I'm 64 and single with no spouse, children or family for support.  Has anyone else had this much trouble with Cymbalta?  It's a wicked drug.  If I'm having this much trouble at the beginning and at higher doses, I can't imagine what it will be like as I get lower.  

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mammaP   
mammaP

It isn't a good idea to taper when you are moving, it is better to be as stress-free as possible. You have made a second cut before your brain has had a chance to adjust. There are no short cuts it is actually faster to wait the 4 weeks that we recommend. This is because we go too fast then have to hold to stabilise and that can sometimes take months. It is terrible when you realise that it will take years to taper but as the dose lowers the side effects often lessen. I have been tapering for 5 years and am 65. I have about 2 years to go before I am finally free! I just get along with life while tapering, it is much better than staying on the drugs, I was housebound for years when I was taking them all. Hold the doses for a while to stabilise, it will be much better for you than trying to push ahead. 

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gardenlady   
gardenlady

It isn't a good idea to taper when you are moving, it is better to be as stress-free as possible. You have made a second cut before your brain has had a chance to adjust. There are no short cuts it is actually faster to wait the 4 weeks that we recommend. This is because we go too fast then have to hold to stabilise and that can sometimes take months. It is terrible when you realise that it will take years to taper but as the dose lowers the side effects often lessen. I have been tapering for 5 years and am 65. I have about 2 years to go before I am finally free! I just get along with life while tapering, it is much better than staying on the drugs, I was housebound for years when I was taking them all. Hold the doses for a while to stabilise, it will be much better for you than trying to push ahead. 

 

Thanks, mammaP.  What you wrote is a hard truth to accept, but I know you are right.  I am greatly discouraged to realize how long the Cymbalta taper might be.  I am anxious to be drug free mostly for spiritual reasons.  Faith and trust in God are difficult enough when at one's best, much less while tapering & withdrawing.  The longer it takes, the more alienated I feel from Him.  That's the worst part.  

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mammaP   
mammaP

I know what you mean, I felt the same too but my feelings came back as the dose lowered. This is a side effect of the drug and side effects tend to lessen as the dose lowers. I remember when I started to feel again. It seemed unreal because I hadn't felt anything much for years. I started to cry at something on TV, then cried tears of relief because I was crying!  Stopping too soon causes havoc, the brain struggles to cope after such a long time working around the drugs. 

It isn't about getting them out of the blood it is about regrowing the brain. Our Rhi wrote an excellent piece that makes sense of it. Tapering slowly means you get those feelings back as you go, all the side effects will lessen and then you can jump off when there is no lower dose to go to and barely even notice it. Go too fast and your brain will be in chaos trying to regain homoeostasis. We all want to be off as quickly as possible but suffer the consequences if we go too fast.  Holding to stabilise and then a slow taper will mean you gradually get back the feeling. I tapered too fast and had to reinstate and start again. Honestly, it just isn't worth it!  Rhi wrote a great post explaining this. 

 

Rhi with more reasons for a slow taper and treating our nervous system gently:

 

You can't get off the drug (without major instability) faster than your brain can re-adapt itself to the absence of the drug. This involves changes in gene expression everywhere in the system (not a fast process), adjustment of populations of different receptors and cell types, et cetera. These are concrete processes and are not fast.

More to the point, they're also not very reliable and not very efficient. Healing a bone or an organ is one thing; we've had five billion years of evolution to get pretty good at that. Our brains have never before in evolution encountered anything like what these chemicals do to them. The kinds of changes in neurotransmitters that our brains know how to deal with are subtle--things like response to changes in day length, changes due to varying hormones in puberty and pregnancy and with aging, changes due to stressors in the environment, et cetera. We have never encountered ANYTHING like these extremely potent and precisely targeted chemical perturbations.

Our brains do their best to re-establish homeostasis when the drugs are introduced; this requires concrete changes in gene expression, cell populations, etc as above, which continue and change over time, because neuroplastic processes are happening in the brain all the time.

Reversing what the drugs do to them is just as complicated. It's no accident that (according to the Harm Reduction Guide by Will Hall) the single factor that best predicts the success of getting off psych meds is how long a person was on them to begin with. And that's just with a single med. Polydrugging takes the whole thing up to another level.

And when you've been on and off various meds, and on combinations of meds, there's really no telling what's happened, what kind of changes have taken place. Like Alto says (only she says it better)--our nervous systems are not infinitely pliable. Sooner or later something's gotta give.

Hence the need for caution when you start yanking stuff out and shoving stuff around. Ouch. It's your brain. You only get one.

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gardenlady   
gardenlady

I know what you mean, I felt the same too but my feelings came back as the dose lowered. This is a side effect of the drug and side effects tend to lessen as the dose lowers. I remember when I started to feel again. It seemed unreal because I hadn't felt anything much for years. I started to cry at something on TV, then cried tears of relief because I was crying!  Stopping too soon causes havoc, the brain struggles to cope after such a long time working around the drugs. 

It isn't about getting them out of the blood it is about regrowing the brain. Our Rhi wrote an excellent piece that makes sense of it. Tapering slowly means you get those feelings back as you go, all the side effects will lessen and then you can jump off when there is no lower dose to go to and barely even notice it. Go too fast and your brain will be in chaos trying to regain homoeostasis. We all want to be off as quickly as possible but suffer the consequences if we go too fast.  Holding to stabilise and then a slow taper will mean you gradually get back the feeling. I tapered too fast and had to reinstate and start again. Honestly, it just isn't worth it!  Rhi wrote a great post explaining this. 

 

Rhi with more reasons for a slow taper and treating our nervous system gently:

 

You can't get off the drug (without major instability) faster than your brain can re-adapt itself to the absence of the drug. This involves changes in gene expression everywhere in the system (not a fast process), adjustment of populations of different receptors and cell types, et cetera. These are concrete processes and are not fast.

 

More to the point, they're also not very reliable and not very efficient. Healing a bone or an organ is one thing; we've had five billion years of evolution to get pretty good at that. Our brains have never before in evolution encountered anything like what these chemicals do to them. The kinds of changes in neurotransmitters that our brains know how to deal with are subtle--things like response to changes in day length, changes due to varying hormones in puberty and pregnancy and with aging, changes due to stressors in the environment, et cetera. We have never encountered ANYTHING like these extremely potent and precisely targeted chemical perturbations.

 

Our brains do their best to re-establish homeostasis when the drugs are introduced; this requires concrete changes in gene expression, cell populations, etc as above, which continue and change over time, because neuroplastic processes are happening in the brain all the time.

 

Reversing what the drugs do to them is just as complicated. It's no accident that (according to the Harm Reduction Guide by Will Hall) the single factor that best predicts the success of getting off psych meds is how long a person was on them to begin with. And that's just with a single med. Polydrugging takes the whole thing up to another level.

 

And when you've been on and off various meds, and on combinations of meds, there's really no telling what's happened, what kind of changes have taken place. Like Alto says (only she says it better)--our nervous systems are not infinitely pliable. Sooner or later something's gotta give.

 

Hence the need for caution when you start yanking stuff out and shoving stuff around. Ouch. It's your brain. You only get one.

 

Thanks, again, mammaP!  How will I know when I'm stable enough to cut again?  And, any suggestions as to what % the next cut should be whenever that is?  And, I know you're not a crystal ball & that we're all different, but how low do you think one has to get before starting to feel again?  Sorry to pepper you with so many questions!

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mammaP   
mammaP

 It could be some time but your brain is adjusting while you wait patiently. When you feel no more withdrawal symptoms and have been stable for 6 weeks you could start to think about another cut.  Personally, based on my own tapering experience I would make a 5% cut and see how it goes.  I wish I could tell you what you want to know but I can't, it depends on a lot of things but the biggest factor is the slow taper. I am experienced with ADs but not with benzos, I don't know if you have seen it but we have a benzo forum if you would like to take a look, someone there might be able to share their experiences.

 

  http://survivingantidepressants.org/index.php?/forum/29-members-only-benzo-forum/ 

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gardenlady   
gardenlady

 It could be some time but your brain is adjusting while you wait patiently. When you feel no more withdrawal symptoms and have been stable for 6 weeks you could start to think about another cut.  Personally, based on my own tapering experience I would make a 5% cut and see how it goes.  I wish I could tell you what you want to know but I can't, it depends on a lot of things but the biggest factor is the slow taper. I am experienced with ADs but not with benzos, I don't know if you have seen it but we have a benzo forum if you would like to take a look, someone there might be able to share their experiences.

 

  http://survivingantidepressants.org/index.php?/forum/29-members-only-benzo-forum/ 

 

Yes, I've posted on the benzo forum and Shep has been a wonderful help there.  Just wish I could find someone who could coach me on both.  Is there anyone you know of among the moderators who fits that bill?

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JanCarol   
JanCarol

Hi Gardenlady!

 

We're all on at different times around the world, and are all volunteers - so - different moderators respond at different times. While each of us has a slightly different experience, we try to keep the protocols consistent.

 

So - Mamma told you it's not a good time to taper (moving), and she took the words right out of my mouth!

 

If you are having bad symptoms from the Cymbalta, you could increase to your last taper (54 mg) and hold there.  Or, if you feel the worst has passed, you can hold at the 48 mg Cymbalta.  We do recommend 4 weeks (sometimes more) in between tapers.  Holding is your best option now.

 

We have a debate here as to which is harder to withdraw from - benzos or antidepressants.  There is no conclusive answer, as everybody is different - but - I would give them equal weight, and suggest that there is no walk in the park with either of them.  Please respect these drugs and your body, you are at a good time to "catch" yourself from falling, and hold.

 

 I think that holding still will help you.  I haven't read the benzo side yet, but I'll bet Shep is telling you to hold over there, too.  If it had been me knowing what I know now, when I  "hit the wall" at 5 mg of diazepam, I would have stayed there for 3-6 months or more, until I felt better.  Then, I might have switched over to tapering the Cymbalta.

 

We've found that people who are destabilised from another taper - need to really slow down and be careful.  Our moderator Scallywag said it best when she said:

 

Changing dose, up OR down, can be destabilizing. Most often the lowest risk action is no action -- staying at the same dose.

 

Stable is the most important part.

 

It is important to hold, and not taper, when we have symptoms.  Symptoms are a sign that you are tapering too fast.

 

 

 

 I am anxious to be drug free mostly for spiritual reasons.  Faith and trust in God are difficult enough when at one's best, much less while tapering & withdrawing.  The longer it takes, the more alienated I feel from Him.  That's the worst part.  

 

This sounds like you might be experiencing anhedonia, or loss of feeling.  It's not the tapering and withdrawing which have cut you off from your faith and trust - but the drugs themselves.

 

As your doses get lower, your feeling and sense of connection will return.

 

So instead of rushing your taper and getting into trouble - "Be Still" - and hold.

 

What have you decided to do? 

 

I hope you see the Sun today.

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