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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by partlycloudy on February 14, 2005, at 6:56:20
I am on day 6 of a doctor-ordered cessation of Cymbalta. At 60mg my blood pressure would not come down to normal levels. I have been taking xanax as needed, but the headaches, the crying, the bleak and abrupt depression has me desperate.
I've never felt so utterly melancholy in my life. My husband is out of town this week for business and I am afraid of being by myself with this misery. I came in to work this morning. I had the presence of mind to forgo the mascara as the tears have already accompanied my commute to work.
What can I do for this depression when I can't take an antidepressant? No anger or rage this morning. Just a wish that this will stop somehow.
Posted by SLS on February 14, 2005, at 7:26:55
In reply to Cymbalta misery, posted by partlycloudy on February 14, 2005, at 6:56:20
> I am on day 6 of a doctor-ordered cessation of Cymbalta. At 60mg my blood pressure would not come down to normal levels. I have been taking xanax as needed, but the headaches, the crying, the bleak and abrupt depression has me desperate.
>
> I've never felt so utterly melancholy in my life. My husband is out of town this week for business and I am afraid of being by myself with this misery. I came in to work this morning. I had the presence of mind to forgo the mascara as the tears have already accompanied my commute to work.
>
> What can I do for this depression when I can't take an antidepressant? No anger or rage this morning. Just a wish that this will stop somehow.
>
Did you stop taking Cymbalta abruptly or did you taper? If you stopped taking it abruptly, I guess you expected a withdrawal syndrome to develop. Did your doctor tell you any of this?
- Scott
Posted by saw on February 14, 2005, at 7:28:24
In reply to Cymbalta misery, posted by partlycloudy on February 14, 2005, at 6:56:20
I know that you have just had some long term sick leave. If there is no way you can start on another AD, is it at all possible that you could have another week or 2 sick leave? I imagine you would need to withdraw yourself from all outside stressers and just crawl into the comfort and safety of your bed with a good book (if you can manage to read) and your cat to cuddle with.
Also, why can't you take another AD now? Are they waiting for your blood pressure to stabilize?
I know how this feels. I went through the same thing last year after my counting accident with Topomax and the 2 week wait before I started Cymbalta.
(((PC)))
Sending you HUGE smile and hug.
Sabrina
Posted by partlycloudy on February 14, 2005, at 7:46:28
In reply to Re: Cymbalta misery, posted by SLS on February 14, 2005, at 7:26:55
My doctor's instructions were to stop the Cymbalta abruptly as my blood pressure was refusing to come down from the 145/100 range. She (and I) were concerned about the risk of stroke. My blood pressure is to stabilize for a week before she will put me back on *any* AD.
The headaches add to the misery as nothing touches the pain. They are not migraines but as I try the OTC options my stomach is protesting.
The tingling in my face and lips is not a problem, nor are the tremors in my hands.
The utter sadness and longing for release from it is the most frightening thing for me. I am not bearing up at all.
Posted by partlycloudy on February 14, 2005, at 8:53:35
In reply to Re: Cymbalta misery » SLS, posted by partlycloudy on February 14, 2005, at 7:46:28
They have me absolutely frantic. What would help them?
Posted by SLS on February 14, 2005, at 8:55:22
In reply to Re: Cymbalta misery » SLS, posted by partlycloudy on February 14, 2005, at 7:46:28
> My doctor's instructions were to stop the Cymbalta abruptly as my blood pressure was refusing to come down from the 145/100 range. She (and I) were concerned about the risk of stroke. My blood pressure is to stabilize for a week before she will put me back on *any* AD.
> The headaches add to the misery as nothing touches the pain. They are not migraines but as I try the OTC options my stomach is protesting.
> The tingling in my face and lips is not a problem, nor are the tremors in my hands.
> The utter sadness and longing for release from it is the most frightening thing for me. I am not bearing up at all.
You are in a very frustrating position. The way you describe things, your depression is probably more painful and with more anxiety now than it was before you started Cymbalta. This phenomenon is known as "depressive rebound", and comes when one discontinues an antidepressant quickly that had been helping. I wish I had a magic recipe for you to get through the withdrawal period. Personally, I don't think your blood-pressure measurements indicated such an urgent need to discontinue Cymbalta without a taper. Some people say that Benadryl (diphenhydramine) helps with withdrawal.I would like to see compiled a list of strategies that people have used successfully to treat SRI discontinuation syndrome. Hopefully, this new board will help accomplish that. Because I have always been allowed to taper, I never had any real problem coming off these drugs.
I hope this period becomes more tolerable for you. Other posters here will help you through it.
Good luck.
- Scott
Posted by partlycloudy on February 14, 2005, at 9:43:03
In reply to Re: Cymbalta misery, posted by SLS on February 14, 2005, at 8:55:22
Posted by Minnie-Haha on February 14, 2005, at 17:37:06
In reply to Re: Cymbalta misery, posted by SLS on February 14, 2005, at 7:26:55
If you stopped abruptly, try to get the doc to let you discontinue gradually. Say you were at 60mg. See if you can take 30mg for a few days, then 20mg, which is the smallest capsule. After that, you could break the capsules open and take only about half.
Posted by partlycloudy on February 14, 2005, at 18:54:50
In reply to Re: Cymbalta misery, posted by Minnie-Haha on February 14, 2005, at 17:37:06
Thanks - I was halted a week ago from 60mg to zero. I had come in for a followup visit and told the p-doc that I kept hearing whooshing in my ears, and my BP was consistently high. This prompted her to check it (and her nurse, and her administrator in her office to check it, with their eyes increasingly widening as they wondered when my head was going to pop off my neck). When my pressure wouldn't come down from 145/100 she told me to stop taking the Cymbalta cold-turkey until the pressure was normalized. I have been treating my anxiety with Xanax during this past week, but the depression really walloped me these last 2 days. Saturday and Sunday I experienced serious wishes of permanent release.
Much to my relief, I am being put back on to the minimum 30mg dose of Cymbalta tonight. personally, I think that the high blood pressure needs to be treated as a seperate issue as it goes from 97/60 to 140/97 all day long - is that normal? I dunno.
I have a wrist cuff that I check myself with periodically, and I do have very good command over bringing my pressure down with meditation and deep breathing. This ability fled while I was on the 60mg dose of Cymbalta.
I actually felt a huge relief when the p-doc told me this afternoon to restart the med. Perhaps tomorrow won't be so bad.
Posted by Spriggy on February 14, 2005, at 22:05:40
In reply to Re: Cymbalta misery » Minnie-Haha, posted by partlycloudy on February 14, 2005, at 18:54:50
I am experiencing a very similar situation (the utter and complete depression/suicidal thoughts) from stopping Lexapro.
I had to stop because it was wigging me out so badly but I had no clue going off would mess me up the way it has.
I just wanted you to know you aren't alone and I am praying for you!
Posted by saw on February 15, 2005, at 5:53:31
In reply to Re: Cymbalta misery, posted by Spriggy on February 14, 2005, at 22:05:40
Posted by partlycloudy on February 15, 2005, at 7:55:42
In reply to How are you feeling today PC? (nm), posted by saw on February 15, 2005, at 5:53:31
Took a minimum dose of 30mg last night per my doctor's instructions, and I feel like a shiny new penny today.
I don't care if it's a placebo effect or not - I'll take it!And I would not wish this experience on anyone, not anyone on earth. It completely unhinged me.
Thanks so much for asking, Sabrina.
Posted by chris777 on February 16, 2005, at 0:11:05
In reply to Immensely relieved! ? saw, posted by partlycloudy on February 15, 2005, at 7:55:42
how long do you have to be on this stuff to cause whithdrawal?
I have been taking it for pain (fibromyalgia), and have recently lost my job, do I may have to quit, (plus I can't tell any benefits anyway)
and to Spriggy and partly (if you still need it)
on the depression, I had a severe depression after ceasing methadone, and going on a new pain med. It was the worst depression, of my life, and I was in excruciating pain to boot, but I made it. (at least the depression lol)It probably sounds corny, but IT WILL PASS. It's one of the hadrest things I ever had to do, but I had to be rational about it. I had been in pain for around 5 years, and even though the pain had been greatly amplified, from the whithdrawal/reaction I knew that the depression, had to also stem from it, as it came on me just as suddenly. I honestly didn't care if I lived or died, and honestly felt that this is probably the closest a person can come to being in hell on earth, literally. But I knew it would pass as it wasn't normal, It was just too intense, Like a bad flu, or an intense fever. I have had a few high fevers as a child, where i was so dizzy and nauseated, I couldn't , get up off of the floor, because for some reason even elevating myself to the couch, much less the bed , just made me feel worse., but I didn't die. and I had a flu so bad that I couldnt even hold down water, I couldn't see, and I had to call my parent's to take care of the kids, cause my ex wife was sick as well, but I didnt die , and it passed. Just keep it in mind that whatever garbage you are going through is temporary, and relatively short, seriously how long is a hundred years in the grand scheme of things? I have been in pain for 5 years now, and If it stopped tomorrow, it would be like a cold, or a flu that I had in the past, that just passed, like a storm, and then it was over. Just be patient, I am better than I was during the whithdrawal, but worse, than I was before it. but the depression passed after about 3 or 4 weeks. But If you can't make it on you own , by all means get some sort of help, I have been through alot before this happened, and so I could be rational, but I can't think of a time, that I wanted to go to the hospital more, but I knew their wasn't anything they could do for me, other than put me back on methadone, and by that time, I had already gone through the worst of it, and I thought I would rather be miserable at home , than at a hospital.
Posted by Patient on February 27, 2005, at 10:54:32
In reply to Immensely relieved! » saw, posted by partlycloudy on February 15, 2005, at 7:55:42
> Took a minimum dose of 30mg last night per my doctor's instructions, and I feel like a shiny new penny today.
> I don't care if it's a placebo effect or not - I'll take it!
>
> And I would not wish this experience on anyone, not anyone on earth. It completely unhinged me.
>
> Thanks so much for asking, Sabrina.It would be helpful to know your prescription history-like, how long you have you been taking Cymbalta (duloxetine) SSNRI AD? Have you taken any other med. and how did you do on it? Has your doctor diagnosed you with any disorder, e.g. anxiety, depression, mixed, bi polar, etc.?
High blood pressure can be a problem with this serotonin and norepinephrine reuptake inhibitor drug, as well as Effexor (vanlafaxine), which has some of the same actions. Make sure your doctor doesn't switch you to Effexor or Wellbutrin (bubropion) for you may get high blood pressure reaction from these as well.
If you hadn't gone back on Cymbalta, I would have suggested you take Percogesic, a combination of acetominophen and antihistamine anelgesic. Or a single antihistamine like diphenhydramine which can help when discontinuing from an AD. Your doctor should wean you off of Cym over a period of weeks, or switch you to a non-NE action AD.
No, I don't think that was a placebo reaction. I've gone off of ADs in the past and when the irritability and mood swings got so bad (a couple weeks after discontinuing), that I would go back on the med. and within a few hours I would be relieved of these extreme mood swings. Currently I have been off of 10mg Lexapro (acitalopram) for 16 days now-doing much better with discontinuation effects than when I went off of Zoloft and Celexa.
Cymbalta is a heavy duty wide-effecting AD that I'd only use it as a last resort AD-Effexor is also in this class. I'd never use it as a first choice med. You said you were or are taking Xanax? This might be adding to the depression problem when you discontinued from Cym. But this is just a guess. I'm no doctor, just my opinion.
Hopefully things will work out for you!
Posted by SLS on February 27, 2005, at 13:31:14
In reply to Re: Immensely relieved!, posted by Patient on February 27, 2005, at 10:54:32
Hi.
> Cymbalta is a heavy duty wide-effecting AD that I'd only use it as a last resort AD-Effexor is also in this class. I'd never use it as a first choice med.
Is it the potential to experience withdrawal effects upon discontinuation of these drugs the only reason why you feel this way?
- Scott
Posted by Patient on March 2, 2005, at 15:30:01
In reply to Re: Immensely relieved! » Patient, posted by SLS on February 27, 2005, at 13:31:14
> Hi.
>
> > Cymbalta is a heavy duty wide-effecting AD that I'd only use it as a last resort AD-Effexor is also in this class. I'd never use it as a first choice med.
>
> Is it the potential to experience withdrawal effects upon discontinuation of these drugs the only reason why you feel this way?
>
>
> - ScottHello,
No, for they all can cause withdrawal effects. From reading other's experiences with Effexor, this particular medicine seems to be a very difficult drug to discontinue-it just seems to get more complaints.
My feelings and thoughts tell me it is safer to start a patient on an SSRI that mainly targets SR inhibition, then an AD that has a high affinity for NE reuptake as well, or even dopamine DA, besides Ser. The "let's hit one neurotransmitter instead of the whole kit and kaboodle neurotrasmitors" approach seems sensical. For me, multi-selective ADs are like taking more than one type of drug-better to start out simpler and see how the patient does on it before tinkering with the other neurotransmitters. I also think NE reuptake drugs in general, cause more severe side effects. It's not just severe withdrawal-Paxil can be placed right up there with Effexor in that contest, with the others coming in behind.
Thanks for asking.
This is the end of the thread.
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