Here’s the context: Me, sufferer of bad anxiety since a young age, switching my medication from Cymbalta to a better (for me) anti-anxiety medication. I’d been on Cymbalta from 2015 – 2018, 60-90mg dose. You can find which antidepressant is best for your body by completing a liver enzyme test.
I sat down in my psychiatrist’s room feeling like I was going to just yell at her to fix me NOW instead of having a regular appointment. It had been the worst week, medically, of my life so far. In fact, the only time I count as worse is the 24 hours I once spent exploding after getting food poisoning from bad fish. Sure, withdrawal and a raging return of my anxiety is horrendous, but at least I’m not having repeatitive flashbacks of the taste of that bad fish coming back up, right?
Instead of yelling I showed her the log I had been keeping. It’s a good idea to do this yourself; record the dose you’re at each day and the symptoms you felt, as well as scoring your mood and anxiety levels out of ten. This helps unmuddle your med-changing mind and helps you see progress. This bad week was when I presented my psych with a master list of symptoms titled ‘The Symptoms of Fucking Dying’. I was feeling hostile enough to not care about showing this dramatic title to a woman I respect. Thankfully, she didn’t cringe, but instead helped me identify which symptoms were directly withdrawal and which were symptoms of the now-unsuppressed anxiety and the dip in serotonin levels that occur when stopping any antidepressant medication. I want to seperate them here for you now so you can better understand what is happening when you get off Cymbalta, aka, Duloxetine.
Withdrawal from Duloxetine has it’s own name: Cymbalta Discontinuation Syndrome.
There are personal experiences posted on the internet that paint the process as being worse than their mental illness. Yes, getting off Cymbalta can make you feel mightily fucked and I don’t think it should be prescribed to patients unless it’s the only medication they can have… BUT try to not be frightened by this, remember that the process of withdrawal will feel worse than how your mentall illness has felt while you’ve been medicated because it is no longer being supported with medication. You are essentially being blasted with withdrawal symptoms and the resurgence of your mental illness at the same time. Here’s my first personal tips:
- I don’t reccomend getting off Cymbalta cold turkey. Lower the dose and wean. I weaned off this drug quickly; over 3 weeks I went from 90mg to 60mg to 30mg and then nothing. I have read other people’s accounts of dragging the weaning process out for months by splitting the capsules open and taking some of the balls out to swallow. I personally don’t like this approach because you cannot be certain what dose you are taking when you split the capsule, and you are also potentially prolonging withdrawal process. Withdrawal symptoms will persist for longer the longer you wean but going cold turkey is never recommended.
- I don’t reccommend stopping any antidepressant medication without medical support – please, get off Cymbalta with help from a good psychiatrist. See a trusted therapist weekly while you do this process. If you cannot see a professional as often as you feel you need, take advantage of online or phone services. Remember the coping actions you learn in therapy.
- I am not convinced that just seeing a GP before you begin is enough support because they do not have enough psychiatric expertise. No offense to GP’s, but if I’d left my mental health to you guys and not my great psychiatrist, I wouldn’t have ever combat my anxiety. If the only medical professional you can see during this process is a GP, make sure it’s one who can answer all your questions, who has helped patients with this process before (you can ask about their experience!) and who has a good history with you. Any GP who has misdiagnosed you before, isn’t experienced with mental illness treatment, has dismissed you or made you feel worse in the past – find a better doctor if you can.
Things you may experience while withdrawing:
I have split these into 2 categories, true withdrawal symptoms and resurfacing of mental-illness symptoms. Remember, you’ve had your anxiety and depression suppressed and supported with medication and now that the support is gone, the symptoms of your mental illness will resurface; you may confuse them with withdrawal symptoms.
- Brain zaps / body zaps
Cymbalta works with your nervous system and as you remove the drug, your nervous system is affected. Cold turkey can send your nervous system into shock and exacerbate the zapping
- Dry mouth
- Stomach cramping / diarrhea
- Low mood
Cymbalta helps balance the serotonin levels in your brain, removing the medication means your serotonin will lower
- Suicidal ideation
This side effect could be attributed to the above-mentioned lowering of serotonin levels, as well as the resurfacing of your mental illness’ own symptoms. Try to remember that this is a side-effect and it will get better as your serotonin levels adjust and withdrawal ends.
- Flu-like symptoms have been reported by some, though it is not certain whether this is a true withdrawal symptom or if some people are getting a cold coincidentally. I was one of the people who had an actual cold (a throat infection) right when I started and I first mistook it as a withdrawal symptom
Symptoms that are the result of now-unsurpressed anxiety and depression
- Rapid heartbeat
- Hopelessness and good old existential dread
- Irritibility and hostility
- A drop in your self-esteem, worthlessness
- Trouble sleeping (full insomnia is more likely to be a symptom of withdrawal)
- Trouble with deep breathing due to anxiety
Psychiatric Drug Watchdog report on Cymablta Did you know that the makers of Cymbalta were sued by patients who experienced Cymbalta Discontinuation Syndrome? The drug’s makers downplay the severity of the withdrawal experience but thankfully – we have the internet! We can educate ourselves on what we might experience during this withdrawal process.
Tips for Getting Through
- Psychiatric support. Finding a psychiatrist that works well with your own attitudes, history and needs is a key to succeeding with mental illness. During times of crisis, like stopping medication, a good psych will guide you, assure you, monitor you and get you to the other side! It took me three tries to find a psych I made progress with so don’t despair if the first counsellor you go to doesn’t click with you!
- Support network prepping: let the people around you know what you’re doing and what are the expected symptoms and what needs you will have. Giving them good references to understand the process will help them help you.
- Read up on other people’s experiences to get some perspective. Rather than be caught off guard by symptoms and moods, you will be able to remind yourself that what you’re feeling is common and expected. Some posts online make the process seem very scary and very painful, so please remember that you may not experience the same things as that person! And remember that even those people got through it. You will too!
- Know this, you are not alone, not weak, not taking the process badly. I posted on my personal social media about the process and I was surprised by how many people on my friend’s list privately responded to me, outlining their own experiences with Cymbalta and getting off it – there may be people in your own life who have done this, you are not a weird one out!
- A good psychiatrist can prescribe you certain drugs that help manage the upsurge in anxiety during withdrawal, such as very small doses of Quetiapine or Diazapam. These should be taken strictly to your doc’s advice – the doses are small for a reason. Trust that you don’t need to take big doses to feel better quicker.
- If you’re changing medications rather than stopping medication, beginning low doses of your new medication quickly (for me, I began my new medication after just 2 days of no Cymbalta) will help restore the low serotonin ASAP. New medication will take a couple weeks to start working, so remember that the physical side effects of your anxiety or depression will start to lessen in time.
- Be kind to yourself. Watch the movies, have some food treats, talk to who you want and ignore who you don’t want. Avoid alcohol / illegal drugs so your body can adapt to the medication change without doing any extra work. Keep hydrated.
- Don’t do the withdrawal process while you’re busy with school finals. Don’t do the process during times of the year you hate (Christmas, anyone?) Don’t do the process while you’re busy at work. Try to schedule your retreat from Cymbalta within a holiday period or a time of low work. Like I said, be kind to yourself.
Remember above all else; withdrawal ends! You will zap when you move (eugh, I hate this feeling so so much) and you will have a low mood and you may feel like it’s not worth it but so far in all my reading and talking with other Cymbalta-withdrawers and talking with my therapist, withdrawal is not a lifelong sentence. The week you stop taking the medication will be tough and it will take some time for your new medication to work, or for you to adjust to life without medication managing your mentall illness’ symptoms, but the withdrawal period itself will end sooner than you think – especially if you remember what side effects are withdrawal and what are unmedicated mental illness. I have tried to keep my piece here focused on making the withdrawal experience clearer for you guys, from my own experience and others. I had a horrible first week without Cymbalta; I cried, I felt like dying, I got angry as fuck, I couldn’t sleep, I pooped more in a week than I had in the previous three… but I got through with the help of my psych, the extra drugs I got, my fantastically supportive partner aaaaand through not getting too focused on the really bad stories out there.
Keep going you guys. Oh and to any doctors who prescribe Cymbalta without trying other drugs first, or without doing a liver enzyme test to identify the best antidepressants for your patients, or who can be on another medication just fine, a big fuck you to you. Just remember that what you prescribe now is what your patient may end up suffering Cymbalta Discontinuation Syndrome from when they leave the medication.