Psycho-Babble Medication Thread 1062501

Shown: posts 1 to 20 of 20. This is the beginning of the thread.

 

cold turkey cymbalta-not working

Posted by joe f on March 14, 2014, at 17:04:24

2 months on 30 mg Cymbalta...dr told me to quit cold turkey...horrible..last 5 days..emotional..crying anxious...should I just go back to 30 for now? Too many crying jags and dizziness..or ride it out?

 

Re: cold turkey cymbalta-not working » joe f

Posted by Phillipa on March 14, 2014, at 18:18:30

In reply to cold turkey cymbalta-not working, posted by joe f on March 14, 2014, at 17:04:24

Did you call the doc? Weekend is here. If can't get ahold of him I would go back on till can reach him unless in some way this could harm your health. Phillipa

 

Re: cold turkey cymbalta-not working

Posted by joe f on March 14, 2014, at 18:41:09

In reply to Re: cold turkey cymbalta-not working » joe f, posted by Phillipa on March 14, 2014, at 18:18:30

going back on tomorrow

 

Re: cold turkey cymbalta-not working » joe f

Posted by Ronnjee on March 14, 2014, at 18:41:25

In reply to cold turkey cymbalta-not working, posted by joe f on March 14, 2014, at 17:04:24

I can't speak to Cymbalta withdrawal, but I doubt it's as bad as Klonopin withdrawal (my wife wanted me to go to a hospital, it was so bad). During my cold turkey withdrawal, I got to a similar spot as you after a few days, and had the same decision to make. I figured if I was this far into it, I might as well finish, as opposed to facing it again (I had failed tapering too many times already). I sweated it out, but it was several weeks until I felt like something even approaching OK.

Good luck!!!

 

Re: cold turkey cymbalta-not working » joe f

Posted by phidippus on March 14, 2014, at 18:43:44

In reply to cold turkey cymbalta-not working, posted by joe f on March 14, 2014, at 17:04:24

Well, the crying and such may be your symptoms returning, so you may not be able to 'ride' it out.

Otherwise, try a slow taper-one pill every other day for a week, one pill every two days for a week, etc.

Eric

 

Re: cold turkey cymbalta-not working

Posted by Ronnjee on March 14, 2014, at 18:52:17

In reply to Re: cold turkey cymbalta-not working » joe f, posted by phidippus on March 14, 2014, at 18:43:44

> Well, the crying and such may be your symptoms returning, so you may not be able to 'ride' it out.
>
> Otherwise, try a slow taper-one pill every other day for a week, one pill every two days for a week, etc.
>
> Eric

Or it may be withdrawal. I though it was the returning-symptom thing on several occasions. Only after I was completely drug-free for a long enough time (months) did I realize that it was most certainly withdrawal symptoms.

Remember - Joe's doc told him to go cold turkey, and you seem to be big on compliance and protocol.

 

Re: cold turkey cymbalta-not working

Posted by joe f on March 14, 2014, at 20:05:03

In reply to Re: cold turkey cymbalta-not working, posted by Ronnjee on March 14, 2014, at 18:52:17

honestly think it might be the horrible depression returning

 

Re: cold turkey cymbalta-not working » joe f

Posted by SLS on March 15, 2014, at 1:55:24

In reply to Re: cold turkey cymbalta-not working, posted by joe f on March 14, 2014, at 20:05:03

> honestly think it might be the horrible depression returning

For me, I found that a depressive rebound (withdrawal) for discontinuing Parnate lasts for 7 - 10 days. It manifests as mostly fatigue, though. The relapse into severe depression occurs 1 - 2 weeks afterwards and persists until treatment is reinstated.

If your depression persists or gets worse beyond 2 weeks, it is very possible that it is a relapse rather than withdrawal.

If your depression does return, what are your plans to deal with it?


- Scott

 

Re: cold turkey cymbalta-not working » joe f

Posted by SLS on March 15, 2014, at 2:01:08

In reply to Re: cold turkey cymbalta-not working, posted by joe f on March 14, 2014, at 20:05:03

Your dosage of Cymbalta was only 30 mg/day? This is subtherapeutic and gives you little chance of getting the full antidepressant/anti-anxiety effects. I think that 60 mg/day should be the target dosage. Some people go to 120 mg/day.

Have you already tried Effexor or Pristiq?


- Scott

 

Re: cold turkey cymbalta-not working

Posted by joe f on March 15, 2014, at 6:48:03

In reply to Re: cold turkey cymbalta-not working » joe f, posted by SLS on March 15, 2014, at 2:01:08

yes it was subtheraupetic and I think I need to re start and talk to my dr.

 

Re: cold turkey cymbalta-not working » joe f

Posted by SLS on March 15, 2014, at 7:51:28

In reply to Re: cold turkey cymbalta-not working, posted by joe f on March 15, 2014, at 6:48:03

> yes it was subtheraupetic and I think I need to re start and talk to my dr.

Just a thought for further down the line:

If you respond only partially to Cymbalta, I would consider adding Wellbutrin to it. If you find Cymbalta to be unacceptably fatiguing despite a partial response, you can switch over to Effexor or Pristiq. If cost is not an issue, I would go with Pristiq.


- Scott

 

Re: cold turkey cymbalta-not working

Posted by joe f on March 15, 2014, at 10:20:09

In reply to Re: cold turkey cymbalta-not working » joe f, posted by SLS on March 15, 2014, at 7:51:28

or maybe go back to 60 Cymbalta...or perhaps try paxil at night

 

Re: cold turkey cymbalta-not working

Posted by ed_uk2010 on March 20, 2014, at 5:17:35

In reply to cold turkey cymbalta-not working, posted by joe f on March 14, 2014, at 17:04:24

> 2 months on 30 mg Cymbalta...dr told me to quit cold turkey...horrible..last 5 days..emotional..crying anxious...should I just go back to 30 for now? Too many crying jags and dizziness..or ride it out?

These sudden symptoms, including the classic withdrawal sign of dizziness, sound very much like withdrawal symptoms, not a return of your depression. Withdrawal symptoms occur very quickly after stopping Cymbalta. You may feel very emotional and cry at the slightest thing. A depressive relapse tends to occur later after stopping Cymbalta, and does not include dizziness.

Fortunately, withdrawal symptoms can be dealt with by restarting Cymbalta and reducing the dose gradually. You can do this by opening the capsule and reducing the number of granules taken, over a few weeks. The granules are coated and should not be crushed or chewed, just swallow whole with a drink of water. The capsule shell itself does not need to be taken, it's basically just a piece of gelatin. The key is to reduce gradually over a few weeks, the rate of reduction depending on whether you experience any symptoms. The manufacturer's leaflet may advise not opening the capsules. This is because the granules are coated and may be damaged if you chew them. So long as you don't crush the contents you'll be fine.

If you plan to start a new antidepressant, some antidepressants will reduce the withdrawal symptoms and allow you to cross over to the new drugs without reducing Cymbalta so gradually. Starting an SSRI, for example, should reverse the dizziness and intense emotions/crying.

Hope you feel better soon. I think you will.

 

Re: cold turkey cymbalta-not working » joe f » ed_uk2010

Posted by SLS on March 20, 2014, at 7:33:21

In reply to Re: cold turkey cymbalta-not working, posted by ed_uk2010 on March 20, 2014, at 5:17:35

Joe, did Cymbalta produce any improvement at all? I am unclear on this.

> > 2 months on 30 mg Cymbalta...dr told me to quit cold turkey...horrible..last 5 days..emotional..crying anxious...should I just go back to 30 for now? Too many crying jags and dizziness..or ride it out?

I agree with Ed.

It would be better if you were not to ride it out. It is an uncomfortable and unecessary experience. In addition, it is my belief that allowing the system to be shocked by withdrawal can make future withdrawals more severe and protracted. It might even produce and untoward sensitivity to drugs of the same type.

> These sudden symptoms, including the classic withdrawal sign of dizziness, sound very much like withdrawal symptoms, not a return of your depression. Withdrawal symptoms occur very quickly after stopping Cymbalta. You may feel very emotional and cry at the slightest thing. A depressive relapse tends to occur later after stopping Cymbalta,

I agree with you, Ed. The constellation of symptoms and timing would indicate withdrawal rather than relapse.

> and does not include dizziness.

I would just add that dizziness can also be a symptom of untreated depression (autonomic instability), but I doubt that it is of the same magnitude as that seen in SRI withdrawal. Although dizziness has been a part of my presentation, I have never been affected to the point of falling faint. I have also experienced the dizziness produced by SRI withdrawal. It feels very different. It was robust, came in waves, and almost felt like vertigo.

Is there any reason why you would not have someone who responds partially to Cymbalta 30 mg/day increase the dosage to 60 mg/day?


- Scott

 

Re: cold turkey cymbalta-not working

Posted by joe f on March 20, 2014, at 10:55:05

In reply to Re: cold turkey cymbalta-not working » joe f » ed_uk2010, posted by SLS on March 20, 2014, at 7:33:21

well back on the 30 for now...feeling so much better...was not willing to ride out the 2 weeks for know whether it was withdrawal or symptoms..just know the ocd etc was coming back with a vengeance....may switch later but not now too many other stress factors going on now...question why a dr would just stop 30 mg. cold turkey

 

Re: cold turkey cymbalta-not working

Posted by ed_uk2010 on March 20, 2014, at 12:10:10

In reply to Re: cold turkey cymbalta-not working, posted by joe f on March 20, 2014, at 10:55:05

> well back on the 30 for now...feeling so much better...was not willing to ride out the 2 weeks for know whether it was withdrawal or symptoms..just know the ocd etc was coming back with a vengeance....may switch later but not now too many other stress factors going on now...question why a dr would just stop 30 mg. cold turkey

I assume your doctor thought it would be OK because 30mg is a fairly low dose. It's no placebo though, and Cymbalta is frequently associated with withdrawal symptoms when stopping, so tapering off is better. It would be good if there was a low strength of caps for tapering but the manufacturer doesn't market such a product.

What will you do next?

 

Re: cold turkey cymbalta-not working » SLS

Posted by ed_uk2010 on March 20, 2014, at 12:18:57

In reply to Re: cold turkey cymbalta-not working » joe f » ed_uk2010, posted by SLS on March 20, 2014, at 7:33:21

>I would just add that dizziness can also be a symptom of untreated depression (autonomic instability), but I doubt that it is of the same magnitude as that seen in SRI withdrawal.

I agree, it's just that the time frame of the dizziness suggested a withdrawal reaction.

>Is there any reason why you would not have someone who responds partially to Cymbalta 30 mg/day increase the dosage to 60 mg/day?

I don't know Joe's situation, but I wouldn't consider Cymbalta a failure until someone had been on 60mg for a few weeks at least. I must admit I assumed he was stopping because it wasn't tolerated, but I could be completely wrong. I've not heard of much success on 90-120mg if 60mg didn't work, but it's important to try at least 60mg unless side effects are prohibitive. Do you agree?

 

Re: cold turkey cymbalta-not working

Posted by joe f on March 20, 2014, at 14:44:28

In reply to Re: cold turkey cymbalta-not working » SLS, posted by ed_uk2010 on March 20, 2014, at 12:18:57

probably go to 60 or thinking of maybe paxil because perhaps it can help me sleep better with less klonopin and be more calming....any thoughts

 

Re: cold turkey cymbalta-not working » joe f

Posted by phidippus on March 20, 2014, at 18:20:27

In reply to Re: cold turkey cymbalta-not working, posted by joe f on March 20, 2014, at 14:44:28

I would see how a truly therapeutic dose of Cymbalta effects you. Anyway you can work up to 120 mg?

Eric

 

Re: cold turkey cymbalta-not working » ed_uk2010

Posted by SLS on March 21, 2014, at 1:12:21

In reply to Re: cold turkey cymbalta-not working » SLS, posted by ed_uk2010 on March 20, 2014, at 12:18:57

> >I would just add that dizziness can also be a symptom of untreated depression (autonomic instability), but I doubt that it is of the same magnitude as that seen in SRI withdrawal.
>
> I agree, it's just that the time frame of the dizziness suggested a withdrawal reaction.
>
> >Is there any reason why you would not have someone who responds partially to Cymbalta 30 mg/day increase the dosage to 60 mg/day?
>
> I don't know Joe's situation, but I wouldn't consider Cymbalta a failure until someone had been on 60mg for a few weeks at least. I must admit I assumed he was stopping because it wasn't tolerated, but I could be completely wrong. I've not heard of much success on 90-120mg if 60mg didn't work, but it's important to try at least 60mg unless side effects are prohibitive. Do you agree?


Totally. Even when we do disagree, you are usually right.

:-)

Your understanding of clinical psychiatry is amazing. I wish all doctors approached treatment as you do.


- Scott


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