My mom has been taking 30 mg of Cymbalta daily for chronic pain since Jan. 2009. She said it doesn't help and wants to stop taking it, her doctor wants her to continue using it. I'm afraid she will stop it suddenly and have withdrawal symptoms and suffer more. She had problems with other depression and anxiety meds that she abruptly stopped in the past and went thru major withdrawal. Is there a right or wrong way to wean off the drug?
What is the correct way to discontinue use of Cymbalta?
Question posted by Anonymous on 12 Sep 2009
Last updated on 23 July 2013
27 Answers Page 2
I have a friend who just discontinued.
Her doctor prescribed 20 mg down from 30mg for one month to whean off the drug.
there are some residual symptoms, but she is now completely off and doing fine.
I wish you the very best but PLEASE hear all of us that are warning you to wien / taper off the drug or you WILL have a very unpleasant experience, and if she is on other medications might add to the problem of stopping.
Hi, Pyewacket,
I'm sorry to hear about your mother. I had been taking Cymbalta for about 3 years now, but only for depression. I do suffer from severe pain due to a bad hip and osteomyelitis, and have heard that Cymbalta has pain-relieving qualities, but I have not experienced this benefit from the medication.
Regardless, getting off Cymbalta involves a closely monitored weaning protocol, much like the process used for other antidepressants similar in nature, like Effexor. I had been taking the 60mg dose, three times a day, which I really felt was too high, and wanted to reduce my dosage to a much lower amount. I'll adapt the weaning protocol I followed to fit your mother's current dose of 30mg per day.
One thing you or your Mom might not know is that it is completely safe to open up a Cymbalta capsule and sprinkle the tiny white beads contained within over applesauce or oatmeal, or something similar. This is the method of administration suggested for those who otherwise might have difficulty swallowing an entire capsule.
My 60mg capsules contain about 1/16 of a teaspoon (or approximately 350) of the tiny white beads, so a 30mg capsule should contain half these amounts. Believe it or not, the beads from a 30mg capsule poured onto a clean, very flat, non-white surface will be very easy to see when clustered together. Using a razor blade, divide the cluster in half. Depending on how steady you are, you could pour each half into each of the empty capsule shells, or use two small, preferably glass, containers (unmarked shot glasses work very well) to store the contents, and cover with aluminum foil. While still taking 30mg per day, your Mom would instead be taking 15mg of Cymbalta over the course of two daily doses.
Follow this reduced regimen for Days 1-7. Then, starting with Day 8, continue splitting the capsule's content in half, only take one of the halves (i.e., 15mg) per day for Days 8-14. If your Mom starts experiencing uncomfortable withdrawal effects, the split can be halved again, with one quarter (7.5mg) being taken in the morning, and the other quarter in the evening. In either instance, continue at the 15mg/day rate from Day 8 through Day 14.
Now, I would most likely be able to stop taking the medication altogether beginning on Day 15, but everyone is different. If your Mom stops on Day 15, but begins to experience uncomfortable withdrawal symptoms, she should take a quarter of the beads (7.5mg) for another full week. Beyond that, she should be good to stop all together. Minor side-effects might linger, but should be minimal and very transient, going away altogether after 2 or 3 days of the medication's cessation.
I hope you find this helpful. If by the time you've read this, your Mom is still taking Cymbalta and decides to try this approach, let me know how it goes for her. Please tell her NOT to abruptly stop the medication - it is NOT a pleasant experience - trust me, I've done it before, sometimes by accident and (usually) other times with full (stupid) intent, so I know what it's like.
Regards,
Duckworthy
Great advice however you may want to mention the "uncomfortable withdrawal effects" that some & not all may get and remember ("FDA" this site warnings side effects by reducing dosage) headache, vertigo, stomach upset, flu-like symtoms, diarrhea, vomitting, nausea. Please remember the risk may greatly outdo the benefit. Consult Your Dr. before doing so. :)
Thanks so much for your post, I wished I had of started my research 4 days ago. I was taking 60mg per day (each morning), 4 days ago I reduced it to 30mg and have felt awful, I seem to have all the side effects (dizzy, nausea, diarrhoea, insomnia, headaches an irritability). I've been back to the doctor today as I feel so awful and he suggested I had a viral infection, they know nothing about the drug at all.
I'm so angry I feel like this and would be so greatful for any suggestions.
I'm not going back up to 60mg, as I can't stay there for ever, I've been feel great although pitting on weight, thus thought I was ready to come off.
Good luck to all and thanks for all the posts,
I am on Cymbalta and have noticed the same side effects as everyone has described. My doctor said that studies have shown that 120 mg work better than 60. Well now I have to taper off from 120 mg. I am down to 90 mg and trying to taper down to 60. I am doing it very slow. I am taking 90 mg for three days and then 60 on the 4th and will continue to do this for about a month. I then go to 90 two days a week and then 60 on the third. I definately feel the side effects even tapering off this slowly. I would watch your mother like a hawk if she goes off cold turkey. She may be ok since she is on a very low dose. I think the capsules come in a 20 mg. see if you can get her to drop down to 20 for a month or at least a couple of weeks.
I am currently in the process of coming off Cymbalta. It is good to talk w/ your dr. but the best person to talk to about meds is your pharmacist!!! The dr. had told me one way of tapering down but the pharmacist said no,no no, not to do it that way!!! I was on 2 60mg caps a day. He had me go to one a day for 1 week, then 1 every other day for 2 weeks, then 1 every 3 days for 2 weeks, then stop. I have not had any problems doing it that way. I ran out one time for 3 days and it made me psycho and homicidal. I am now taking Pristiq instead, for depression, and no problems. I was gaining 5# a week when taking 2 Cymbaltas a day and I was also sweating like a pig!!! Good luck to you. I think going cold turkey off the Cymbalta was 1000 times worse than going off narcotics. Once again, best wishes. Don't forget about using your pharmacist. That's what they go to school for.
I agree with what you are saying. I had to wean off of Effexor and the Fentynl patch at the same time. The side effects I was having from the Effexor detox where definitely worse than the Fentynl detox. People do not believe me. I had capsules I took once a day (I think) 75mg to 150mg (my family physician put me on it but my Psychiatirst helped me get off of them.) I would pour out 25% of the capsule contents for one week, then 50% next week, then 75%. During that time, I had such bad symptoms that on some days I would just take the full dosage because I couldn't stand it anymore. So I probably agree with you and your pharmacist about slowing down to 1 every two days then 1 every three days etc. I think that would have definitely been better. I wonder if you gradually reduced daily if you could replace the missed dosage amount with another small amount from another medication to slowly reintroduce another antidepressant.
Like if you reduce your Cymbalta or Effexor 25% then take a 25% dosage of another type of antidepressent, then the next week reduce the Effexor or Cymbalta 50% while taking a 50% dosage of something else like Lexapro or something. I guess I good Physician or Psychiatrist would have to figure that one out. I would not suggest anyone to do that on their own. By no means do not mistake that! I am just thinking out loud. What makes sense to me may not make any sense to a physician or pharmacist. Always get a professional opinion.
laurajary, I want to come off of Cymbalta for the same reasons you were experiencing! I am only taking 1 Cymbalta 60mg tab a day and sweat like a pig. I am going to speak with my MD about coming off of it as well, he provides me with samples because I have no insurance the medication is over 200 bucks a month!!!
First of all, her Doctor cannot force her to take this medication if she does not want it. Cymbalta was a miracle drug for me at first, but eventually if just stopped working, so I can relate to her situation. She CANNOT come off this medication abruptly due to side effects. Also, it could throw her into a higher level of depression that could have some not so could results. You talk to her DR and explain that she is going to stop with or without his help and you need advice on how to wean her from it. If he will not help her, and she is adament about not taking it any longer, you guys come up with a plan to slowly wean her. Do it slowly since you are doing it without a physician assistance. But do not let her just stop taking it. Watch her closely and head for the DR, or ER if she starts feeling or acting differently. I really think if you the DR. know that she is going to stop, he will wean her... he has his license to consider. Good Luck...
Hello, call the dr first thing. If she insists on stopping it, again, this is a medication that should not be abruptly discontinued due to potential withdrawl symptoms. Best Wishes.
hello pyewacket. to respond to your question about cymbalta. 30mg is not a lot. ask your mom to talk with her doctor about increasing the dose. i'm not sure what chronic pain she is taking cymbalta for but i started 9 months ago for depression that goes a long with chronic pain. it took 2 months and uping my dosage to 90mg's to see a difference. and it is truely a good thing for me. it have chronic lower back pain and have been on all of the popular depression medications. and nothing worked until cymbalta. without it i get mean and sad and mad at myself and everyone because i can't do what i want to accomplish in life. and time is ticking. i'm 50 now. but been dealing with this for 15 plus years. i have been on most all narcotics also. clear up to oxycontin, which i hated. now i take 90 mg's of cymbalta a day and a non narcotic pain realiever tramadol/ultram.
it has improved some but not to the point i thought it would. so a friend suggested i have my thyroid checked. low and behold my thyroid is off. not severely. but enough to cause a host of problems. now i'm on synthroid 25mg for 3 weeks and can see improvement already. so this my also be an option for your mom. so talk to her doctor about increasing the cymbalta. maybe adding a non narcotic pain realiever and checking her thyroid. it's a simple blood test. as far as going off the cymbalta. start with 30mg's every other day for a week. then 1 every 2 days for a week. she's at such a low dose that she shouldn't have any withdrawal side effects. BUT. I AM NOT A HEALTH OFFICIAL OF ANY KIND. NOR DO I CLAIM TO BE.
I HAVE SIMPLY GONE THRU SOMETHING SIMILAR. I SUGGEST YOU CHECK WITH HER DOCTOR BEFORE DOING ANYTHING.
good luck to you. gaygaysa.
Hi gaygaysa, I just added you to my list of friends. I was trying to send you a PM but I guess I can't since we've never talked before. I was reading the comments about coming off Cymbalta, and I really feel I needed to mention something my pharmacist had told me. I, too, was on Cymbalta, and dr. wanted to put me on Tramadol for pain, but there's a serious interaction w/ tramadol and cymbalta, it can cause seizures. The pharmacist told me it was not a matter of "if" it was a matter of "when." I don't mean to upset you and I hate to say something negative about something that seems to be working so well for you. Goodness knows, we all have enough problems to deal with , but my conscience wouldn't let me not tell you about it. Just ask your pharmacist, they have a wealth of knowledge about the meds they dish out. I only have your best wishes in mind. Peace. L.
tramado/ultram NOT a narcotic? Well it is
molecularly structured as an opiate, so technicnally no it is not a narcotic/ opiate. Its an analgesic, but it binds to your opiod receptors, and acts as an opiate.
Helen39
Discuss the situation with your doctor. There are often extremely severe side effects to rapid discontinuation of a drug. I cannot stress how important it is to talk with your doctor- he may be able to try a different medication if he knows that your mom is determined that the Cymbalta is not helping and that she is going to stop taking it.
She needs to call the doctor and find out how to taper that down properly. If you come off antidepressents cold turkey, you may feel like you have the flu and you may have a depression issue show up. Call the doc.
My problem is the doc. I am in the process of changing the doc but she order my script wrong and never called me or the pharmacy back so I would have had to go cold turky if the pharmcy had not helped me out. I start getting depressed if I am just a few hours late taking it.Talk to the pharmicist also they can be a VERY BIG HELP !I had to pay cash but I got enough meds till next week.I am 56 and have had depression since my teens and tho I may not feel the diffence just stopping the meds cold turkey does make a HUGE difference. The last time something like this came up I had to check my self into a psych unit because of the really bad effects. So call someone even ask a nurse would be a good resouce,
This is nothing you just stop. You need your doctor in your corner and at the same time you need to find out why she wants to stop it. Sounds like it is working especially since she has been on it since January. If she says it is because it is not working anymore, tell her this is not a drug you can feel. You just know it is working. Withdrawls is no fun. She could wind up in the hospital if not done right.
Taking prescriptive drugs is no fun infact it is boring. Everyone knows this and they get to a point no more. But I know she can work through this with her doctor. Maybe more talking with her therapist just might be the answer.
Wishing you the best
Does you mother have an open mind? If so I would suggest her go to a senior center and see if they have a senior yoga class. She needs someway to channel her anxiety and depression. If she does slowly stop cymbalta at least she will have something to fall back on.
Getting back to her thinking she is well enough to get off her medication. She must realize that she may not feel that she is much better with the medication. But she most assuredly know when she stops it !! Contact me at itsmetoo at earthlink.net and maybe I can be of further help.
Best Wishes
Pyewacket, the best way to discontinue any of these drugs is to wean. Some people can handle large drops in the dose, others have to taper very very slowly. It is different for everyone. However, if your mom has had trouble with other meds in the past, I'd recommend a slow taper.
This is a good forum and may help http://www.cymbaltawithdrawal.com/index.php
actually i am going through a tough time today. I am very sorry about your mom. You sound very close. I wish I had that . I would not stop anything on a whim. Check with you dr. If he or she thinks she can deal with it without going through wd. or gives her something to replace it ... I don't know... I am not a dr. Go with your heart. Do what you feel is right... I am sorry..Kim
I Myself Is Also Trying To Stop Taking My cymbalta 30mg now i was on 60mg so i started this week & doc told me to take 1 pill and then next day skip pill next day.. omg!!! its not working for me so far ive been crying most of the day! also get very dizzy & headaches. so i took my pill today. i usually take it at night. but i couldnt cope with myself or others today so i had to take it about 1 hr ago. The Reason why i like taking it at night is because i get very nauseated. so now ive got to go take my nausea pill.. so Goodluck for youre mom im still going to keep trying to get off this cymbalta. Thanks, Lisa
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Further information
- Cymbalta uses and safety info
- Cymbalta prescribing info & package insert (for Health Professionals)
- Side effects of Cymbalta (detailed)
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