Posted by jessers11581 on May 23, 2005, at 10:09:43
In reply to Re: stopped Cymbalta-need advice, support » jessers11581, posted by SLS on May 23, 2005, at 8:54:44
> Hi.
>
> First of all, it sounds like you may have experienced a withdrawal "rebound-improvement". This is a phenomenon that occurs with some people where they actually feel transiently better for having reduced the dosage of an antidepressant or discontinue it abruptly. It usually doesn't last for very long. This is what those first 4 days were about. However, it often takes 3 days or so for the negative withdrawal symptoms to develop after stopping one of these drugs.
>
> So, the question now becomes, what are you willing to do about it?
>
> If you look back on the earlier threads on this board, you will find many that deal with discontinuing Effexor. I would use the same strategies to discontinue Cymbalta that others have found successful for Effexor.
>
> If it were me, I would restart the Cymbalta at 20-30mg per day. However, it now becomes important to split this daily dosage into at least 3 doses spaced apart by 6-8 hours. I have had great success using a "flexible-dosing" strategy. I simply wait for the beginnings of the withdrawal syndrome to appear and then take a small dose that will relieve it for about 6-8 hours. I do not take my next dose until symptoms re-appear. For you, perhaps you can use the appearance of brain-zaps as an alarm that it is time for you to take your next dose. This will take some experimentation in the beginning to find the right amounts to take at each dose. Of course, you must monitor your total intake of medication for the day and don't exceed your daily alottment. I would probably start by taking 5mg doses 4 times a day to start with. If this proves enough to prevent withdrawal symptoms from appearing, move to 5mg 3 times a day. After you go a few days without symptoms, begin to allow them to appear before taking your next dose. If you can split the doses into amounts smaller than 5mg, this would be ideal. You could continue to reduce the size of each dose while monitoring for withdrawal symptoms. You should find that you use less and less to last 6-8 hours. Alternatively, you will find that you can go longer and longer between 5mg doses.
>
> Perhaps the best way to divide capsules is to add them to a glass of juice and drink fractional amounts. This was suggested the other day by someone here. Just be sure to mix the combination well before drinking it. Since I have never done this with any of these drugs, I don't know if the contents of the capsules actually dissolve or if they settle to the bottom or remain in suspension. People often open a capsule and count pellets. I really don't think that you need to be too precise. A little more or a little less will simply change the amount of time you go between doses. Flexibility works as long as you allow your body determine dosing and not the clock.
>
> A completely different strategy involves taking Prozac for a few days as a substitute and allowing this long-lasting drug to leave your system gradually and naturally. Prozac and its active metabolites have a half-life of over a week.
>
>
> - Scott
>
>Wow, thank you so much for such a detailed response! About an hour and a half after posting my original message, I was feeling completely hopeless and had a fit of crying and uncontrollable rage (aaaggghhh!). This is truly unbearable. So what I did was empty out half of a 30 mg. Cymbalta cap and take the rest (approx. 15 mg.) all at once. I'm hoping that this will kick in at some point today. From now on, I am definitely going to try the divided doses and see if that makes a difference. I don't know much about the pharmacological makeup of Effoxor, Prozac, or other meds, but Cymbalta pellets are enterically coated and I don't think they're supposed to be mixed with anything (juice, etc.). So I will will probably just use empty capsules to break it up. Man, I feel horrible. I don't want to see or speak to anyone for fear of losing control over my emotions. How long should tapering last? Do you think that the 15 mg. I took earlier will help me today? Anyway, thanks again for your support. I appreciate the advice and will certainly give it a shot. :)
poster:jessers11581
thread:501604
URL: http://www.dr-bob.org/babble/wdrawl/20050519/msgs/501646.html