Weaning off Cymbalta

[newwmn3]

Has anyone had success weaning off of Cymblata by, first, reducing the dosage to 20mg every day then taking 20mg every other day and then eventually just stopping? I have only been on it for about 8 months and want off of it. My doc said it was safe to do it this way and my pharmacist seconded that. I have read horror stories so I'd love to hear if this type of weaning has been successful for anyone else. Thank you!

[Bananas5]

Duloxetine can take 2.5 days to get 99% of your body and 12 hours to get 50% of your body. Symptoms of discontinuation typically begin when 90% or more of the drug has left your system. Doctors generally recommend staying on medication for six to nine months before considering leaving it.

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[newwmn3 in reply to Bananas5]

This is precisely how my pharmacist explained it to me. It sounds like, if my understanding is correct, that it would be okay to take it every other day simply because it is still in my body. Does that sound right to you? I wonder if taking it every 36 hours would be of any benefit rather than every 48?

[PFKAAde]

Although I haven’t weaned off duloxetine I have weaned off plenty of other difficult to wean off meds and I can tell you now that a) doctors have not got a clue about the reality of getting off drugs like this and b) skipping days is not a good way of getting off any medication.

When you miss a day you are effectively going cold-turkey for a day, followed by restarting it and repeat...

This is not a good approach. You are far, far better to reduce by the smallest amount possible, hold at that dose until any effects have stabilised and then repeat until you are off.

With antidepressants (which duloxetine is being an SNRI), the fluctuating dose will cause you all sorts of problems if you are susceptible to these effects. Duloxetine is known to be difficult to get off. I never understand why doctors think this is a good way of doing it.

I had a similar ordeal getting off sertraline and it was one of, if not the hardest drug I have ever come off. It took me over 6 months of reducing it as slowly as I could. I did this by breaking g the tablets into ever smaller pieces. You might find that even when you are almost off it, any reduction still causes you problems. With sertraline I was taking the smallest crumb I possibly could for the last month or two and wven then it was a nightmare when I eventually stopped.

Try reading up on line from groups that are familiar with the drug you are taking, and take their advice! I realise that lots of people might think that I’m saying not to listen to your doctor, and I’m sorry but if they think taking it on alternating days is a good idea, then that is exactly what I’m saying.

I would recommend this site:

survivingantidepressants.org

Good luck.

[newwmn3 in reply to PFKAAde]

Thank you! I had heard that the "every other day" plan wasn't the best one so I asked my pharmacist to explain why my doc felt that would be okay to do. She actually explained it to me in the exact same way as Bananas5 did in her/his reply to me. I weaned myself down from 30mg to 20mg/ day already and had some withdrawal symptoms but they were bearable. They have since subsided and I am ready to drop down again but am more than a little scared to do so. Unfortunately, 20mg is the lowest dose they make and they aren't tablets that you can break up. You're so correct in that doctors often don't seem to "get it" and us patients wind up paying the price. I will definitely also check out that website. Thank you so much!

[PFKAAde in reply to newwmn3]

The speed with which the body metabolises the active ingredient in a medication is not the only factor that determines how quickly or what method is ‘best’ when withdrawing from that drug. There are plenty of drugs that are totally eliminated from your body well before you will feel ‘normal’ again.

I urge you to explore that link above, although it’s been a while I think there is a link on there that explains why even a tiny dose of certain drugs still has a disproportionately large effect on the brain.

A lot of clued up people, both medically trained or otherwise, will say that you should try not to reduce a dose of something like an SNRI / SSRI / anticonvulsant etc etc by more than 10% in one drop. Obviously this becomes impossible once you get down to the last bit, otherwise you’d never actually stop taking it, but it helps explain why reducing the final bit and eventually stopping is so difficult. At some point you have to go from whatever dose you are on to nothing. The generally accepted trick is to make that drop as small as possible.

You say that the tablets are 20mg and not ones you can break, but there is almost always a way of dividing tablets. I have been criticised on here before for suggesting that capsules (for example) can be emptied into a measured quantity of water and measured out by the ml (water titration) so I won’t go into detail again, but suffice to say if you read up on withdrawal from antidepressants (or lots of other drugs) you will find lots of information about ways of splitting / crushing / dissolving etc tablets to enable smaller doses to be accurately measured out. Some drugs are even available in liquid form (though rarely prescribed) to enable precise doses to be measured.

Generally speaking the slower you can reduce the dose the fewer side-effects you should have. Unless there is a medical reason that means you have to stop quickly (like being pregnant with some drugs).

But please don’t take my word for it, I can only speak from my own experiences (many of which were extremely unpleasant) - but there are many more people and many more knowledgeable people with answers to any questions you might have on sites like survivingantidepressants.org

🙏🏻

[newwmn3 in reply to PFKAAde]

Thank you so much. I truly appreciate your taking the time to help me sort this out. I am headed to view that website right now.

[PFKAAde in reply to newwmn3]

I hope you find it useful.

[Jtal19305 in reply to newwmn3]

Hello

I take this Cymbalta and I am currently in the long process of weaning off. Using a capsule is easier to adjust imo. Cymbalta is coated beads so you can easily open the capsule, empty the beads into a weigh boat or something similar to hold the beads, and use a small scale (you can buy one on Amazon for less than $20, I did and it works great) which is accurate to 1 mg and weigh out what is inside your 20 mg capsule. From there you can easily calculate how much you have to remove in terms of weight, and then you can adjust by removing beads to get to your desired dosage.

I hope this helps. If you have any questions, feel free to ask.

Btw, I tried to quit Cymbalta cold when I was on about 20 mg, and after being off one day, the withdrawal symptoms kicked in bigtime, and I had to take the 20 mg again to feel better. The symptoms were a combination of so many bad things I do not even want to mention it again for fear of triggering bad memories. This stuff is nasty, and lately, I wake up in the morning with what sounds like salt shaking in my head. These antidepressants medications cause more problems than help in chronic pain patients such as myself, imo. I just want to take my one medication for pain, and only deal with that.

Good luck!

Jerry

[Classicslaw]

My husband has weaned off Cymbalta this way. His Dr provided low dose Valium (2mg) just to get him through the “rough” days, and this seemed to work. The “off” days were rough, but not unbearable, he said. He was coming off the same dosage as you.

I wish you luck, and I know it’s not easy ( having had to wean off similar drugs myself). Stick with it, and I hope you feel better!

[Bananas5 in reply to Classicslaw]

Much better to substitute another drug than start cutting up tablets.

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[PFKAAde in reply to Bananas5]

Why?

Benzodiazepines are one of the hardest ones to get off and the easiest ones to get hooked on.

I am totally aware of how it feels to be withdrawing from various drugs and how long it can last (months). I’m not sure how adding yet another addictive drug to the situation will help. It might help you feel better for the day, but what about the next day and the day after?

[Bananas5 in reply to PFKAAde]

When taken as directed, Valium is usually more helpful than harmful.

x

[PFKAAde in reply to Bananas5]

And what is ‘as directed’ if you are going through a withdrawal that potentially lasts months?

I took pregabalin as directed (2 years of hell to get off).

I took sertraline as directed (3 attempts and well over 6 months of hell to get off).

I took morphine as directed (and am still stuck on a low dose of dihydrocodeine).

If I’m ever offered benzos I will politely decline.

I know when trying to get off various drugs that we are desperate for anything that will make us feel better, believe me I know. Everything I read about benzos tells me to stay well away from them, because they are one of the worst ones in terms of addiction and withdrawal problems.

So I personally would not suggest taking one addictive drug to temporarily mask the negative effects of another.

So far following the advice of folks with specific experience of withdrawal from various meds has got me off everything apart from 4 x 30mg dihydrocodeine a day (I’m working on those). Compared to what I was on a couple of years ago that is nothing.

There is nothing inherently wrong with dividing tablets, you can even buy pill crushers / splitters in every pharmacy.

🙏🏻

[Bananas5 in reply to PFKAAde]

How did you come off pregabalin?

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[PFKAAde in reply to Bananas5]

Very, very slowly. In the end I had to use water titration because dropping from 25mg to nothing in one go would have been an absolute nightmare. It took me about 4 months to get off that final 25mg. Any quicker and I had the full list of withdrawal effects. Even at that speed I felt awful for months after I stopped taking it and had effects that most people probably wouldn’t believe could have been caused by pregabalin - but I know they were and they eventually went away.

Maybe not everyone has such dramatic effects from withdrawing g from pregabalin (or sertraline or duloxetine or whatever) but for those of us that do reducing at the rate suggested my most doctors is madness.

Anyone reading this that has been having problems withdrawing from anything, please read up on it and do it slowly.

[newwmn3 in reply to PFKAAde]

Wow, that had to be such an incredibly difficult challenge to come off of all those medications. I am on Gabapentin as well and plan to tackle that one next. I believe that medication is similar to the one you took. At least, with that one, it comes in doses that can be tapered down slowly. You sure would think that , with Duloxetine/Cymbalta along with other meds I'm sure, if it were dangerous or extremely unpleasant to stop taking it without tapering that there would be dosages small enough to make a taper relatively simple to do. Grrr.

[newwmn3 in reply to Classicslaw]

Thank you so much! My doc offered to put me on Zoloft to help me get through any withdrawals if I need it. The idea of adding yet another medication scares me a bit. I am so glad the Valium helped your hubby! I may mention this to my doc if I find I'm having a rough time. Did he experience any withdrawal symptoms while he was taking the 20mg every other day or was it just once he completely stopped that the withdrawal symptoms started? Once he had totally stopped the medication entirely did the withdrawal symptoms last for much longer? Thank you so much for your help.

[PFKAAde in reply to newwmn3]

Zoloft (sertraline) was one of the worst ones for me. Took me 3 attempts and months to get off. Why anyone would suggest that as a way of getting off another drug defies belief.

[newwmn3 in reply to PFKAAde]

Oh, wow, I am really glad you were able to get off that one, too. I didn't realize that sertraline was Zoloft! I told my Doctor's PA "thanks but no thanks - I am trying to get OFF of all medications, not add new ones." She told me to call back if I changed my mind.

[Classicslaw in reply to newwmn3]

He did experience the withdrawal symptoms as soon as he started cutting down/alternating days. As others have said, the problem is there is no small enough doses to make weaning off easier. Of course, the Valium does not mask the withdrawal entirely, but it certainly helped “take the edge off”.

For those commenting on taking “another dependence- causing drug”, the Valium was only used for a short time, and in small doses- having a mother who has been benzo-dependent for 30 years makes me very wary of these drugs. But if used for short periods, they can be useful.

Once he had entirely stopped the medication, the withdrawal symptoms stopped fairly quickly (I know that everyone reacts to drugs differently, and so no-ones experience will be the same).

Hang in there, things will get better! I wish you all the luck in the world 🤗

[newwmn3 in reply to Classicslaw]

Thank you so much! I am really glad that your husband's withdrawal symptoms were bearable and that he stuck with it. It helps me so much to hear positive things about getting off of this darn drug. I started tapering down from 20mg last night. I am taking it slowly and removing beads every week. I am determined to get off of this stuff. I will definitely keep in mind that there are other things that may help if I need them. Hopefully I won't but it's nice to know that I am not alone or without other options.

[Kimmiejo]

My youngest daughter was on it years ago for fibromyalgia and she is off the med. she did it like the doctor said to wean your self slowly and she did with no problem

[newwmn3 in reply to Kimmiejo]

Thank you so much for telling me this. I have been so very fearful of coming off of this medication. There are so many horror stories online and it's so helpful to hear that there are people who have had no issues coming off of the med. I am really glad your daughter was one of those people.

[LaurieLee]

Hi, sorry for taking so long to reply. I am currently reducing my duloxetine (Cymbalta). Have done this before and it does work. Pull the capsule apart on a table (do it slowly) and pour out a QUARTER at a time, or even less if you want and put excess into small pot or something and put that aside. Then just slip the 2 parts of capsule together. Do this until you get no side effects.

THEN, start again by increasing to half the capsule or less if you want, until you have no side effects again.

Do again leaving only a QUARTER left in capsule, for few weeks or no side effects.

Warning it is difficult to judge how much is half or quarter, but if you put in a small pot then it’s easier to estimate. You can literally go down to just a few of the tiny beadlets that are inside the capsule, if you want.

Take as long as you need to reduce. If it takes 3 or even 6 months, or more, then so be it. Hope this helps,

Good luck.

[PFKAAde in reply to LaurieLee]

Totally agree - for more precision you can dissolve the contents of said capsule in a measured amount of water, stir well and draw off the amount needed with a marked syringe.

You can also buy empty gel caps if you prefer to do it that way but don’t like the idea of throwing away the excess or taking it as powder. Fiddly though.

🙏🏻

[newwmn3 in reply to PFKAAde]

My capsules actually contain tiny beads and I am removing 15 at a time and making new gel caps with the remaining beads. It'll be a slow process but I will be patient and go slowly. Everyone seems to give the advice that slow and steady is the way to go. Now I just need to figure out what to do with the beads that I remove. I wonder if my pharmacy would take them and dispose of them safely?

[PFKAAde in reply to newwmn3]

Oh yes, good point. In the case of beads just count them out and you can work out an accurate dose.

If you have your own gel caps why would you have spare beads? Aren’t you just filling up new gel caps with the beads you remove from an original?

Any leftover medication should be taken by your pharmacy I think (depending where you live).

[newwmn3 in reply to LaurieLee]

Thank you so much! This is exactly what I just started doing over the weekend. I am starting out by removing 15 beads which is about 1/6 of the number of beads in the capsule. I then dumped the rest of the beads into a new gel capsule. I made enough for 2 weeks and, if I am doing ok after that, I will remove 15 more. I will be as patient as I need to be. The way I look at it is that I have enough problems as it is right now and I don't need to add awful withdrawal symptoms to the mix just because I am inpatient.

[Livedaybyday in reply to newwmn3]

Hi just wondering if it worked out for you doing that ? With side effects or no ?