Cymbalta Discontinuation Syndrome
Inappropriate prescribing of antidepressants has become a subject of concern, according to research published by the American Psychological Association, which shows a high volume of antidepressant prescriptions come from practitioners who are not mental health professionals.2
For many, the prescription was an inappropriate or premature response to their condition or initial symptoms. In fact, according to a study by Keks et al in 2016, researchers found that up to 66% of antidepressant users find the antidepressant did not alleviate their depression.1
The FDA approved duloxetine extended release for a wider range of symptoms compared to the majority of other antidepressants. These approved uses include major depressive disorder, generalized anxiety disorders, fibromyalgia, chronic musculoskeletal pain, and diabetic neuropathic pain management. This wide range of symptoms has expanded sales of this antidepressant beyond normal perimeters, despite its unremarkable efficacy.11,15
Surprising Stats on Antidepressant Efficacy
Something incredible to imagine is that the CDC reports in their 2020 Product Data Brief #377 that approximately 25% of American women over 60 are taking antidepressants. As are about 13% of all Americans aged 18 and over. And, these numbers are climbing.4 As cited above, the vast majority do not recover or get relief even if they try switching to another antidepressant or several, without success. And so they may decide to stop.
Generally, antidepressants have a lackluster clinical profile for efficacy, and duloxetine is no exception. 13,14
It is much easier to start taking antidepressants than it is to manage Cymbalta tapering correctly. This is because of the phenomenon known as “discontinuation syndrome.” Drug manufacturers under-reported these phenomena according to the FDA who found 44% suffered withdrawals, as opposed to the 1% that the manufacturer had reported. 3,16
Are Prescribers Informing Their Patients Adequately?
Are prescribers explaining to patients what to expect during Cymbalta tapering, sometimes called discontinuation syndrome? We know that typically, clients who come to us for help were never told how to stop, nor what to expect when they did stop.
However, it is the law to adequately inform patients before prescribing a drug. This ensures what is called “informed consent” which is a fundamental pillar of any patient’s rights and is a legal obligation that the prescribing physician MUST fulfill.5
Common Adverse Effects When Stopping Cymbalta
The mnemonic “FINISH” describes the most common adverse effects of stopping antidepressants as reported in a 2017 article by Gabriel and Sharma, published in the American Journal of Medicine. The letters stand for:
- Flu-like symptoms – lethargy, aches, sweating, headache, fatigue
- Insomnia – along with vivid dreams and nightmares
- Nausea – also vomiting
- Imbalance – vertigo, lightheadedness, dizziness
- Sensory disturbances – electric shock sensations, audio/visual hallucinations, burning, tingling
- Hyperarousal – irritability, anger, hostility, aggression, mania, anxiety, agitation, jerkiness, movement disorders such as akathisia, and other reactions 6
Other adverse effects that can be experienced during Cymbalta tapering or withdrawal include mood swings, deepened depression, suicidality, and others. All of these symptoms or any one of them can make coming off Cymbalta or other similar drugs catastrophic to the person, especially when no help or assistance has been given.
Prozac Crossover Method for Cymbalta Tapering
Because Cymbalta has a short half-life, and because the bead counting is laborious, some people may want to consider switching over to Prozac. Prozac has a long half-life, making it generally the easiest antidepressant to discontinue by using tapering methods.
Methods described below need to be talked about with a prescriber sensitive to your situation prior to attempting.
Prozac Crossover Methods should take into account:
- Not everyone can just switch over to a new medication, even a similar one, without complications.1
- The prescriber can opt to induct a small amount of Prozac BEFORE discontinuing Cymbalta. This helps to see if the Prozac is being tolerated.
- Utilize the lowest dose of Prozac, which is the 10 mg green elliptical.
- Under the doctor’s supervision, start 5 mg Prozac for one week (one-half tablet) while still taking Cymbalta.
- After a week, the prescriber can substitute half the Cymbalta, with an equivalent milligram dosing of Prozac to include the 5mg already being taken. For instance, from 30 mg Cymbalta, drop to 15mg Cymbalta, and go up to a total of 15 mg Prozac.
- Your prescriber can help you with this for a period of 1-2 weeks, leaning to the longer period, especially if you are still symptomatic after one week.
- If the above was tolerated, then the prescriber can convert over to all Prozac and again wait 1-2 weeks.
- From here, look at the Prozac tapering page with your doctor and use those instructions as your guide
- If the above is not well tolerated, then have your prescriber consider putting you back on your original dose of Cymbalta and consider the bead-counting method.
- By slowly going to Prozac, you are jumping from an SNRI to an SSRI. Again, it is generally easier to withdraw from Prozac. Prozac does not carry the stimulatory norepinephrine-uptake aspects of Cymbalta, so you may feel tired. But Prozac may help with things like brain zaps during Cymbalta tapering.
About Safe Cymbalta Tapering
One of the least understood processes in modern medical practice is how to do antidepressant tapering properly. Doctors prescribe drugs, millions upon millions of prescriptions every year, without being trained in how to stop taking Cymbalta without putting the patient through hell and introducing significant risk.9,16
Imagine training airline pilots how to fuel up, check all the controls, and take off perfectly, but neglecting to teach them how to land the plane. Starting a patient on this drug without instructions on a Cymbalta tapering plan is quite similar to not knowing how to land the plane. The consequences of lacking these skills, obviously, would result in a crash.
Training the Doctors on Proper Cymbalta Tapering
Some doctors are at least scrambling to voluntarily do non-certified courses and impromptu or weekend training sessions to try and get a handle on the problem of assisting their patients with how to get off Cymbalta safely. However, this problem of missing Cymbalta tapering guidelines cannot be laid entirely at the feet of medical doctors. It is not that reducing medication is an esoteric art. It is that today’s medical schools are simply not teaching physicians adequately how to put together a Cymbalta tapering schedule or other vital information. Adequate training on Cymbalta cessation help is glaringly absent from the current medical curricula.10
Cymbalta Tapering Plan
The first goal might well be to find a caregiver that has expertise and knowledge in weaning off Cymbalta. You don’t want to fall into the still too-common situation of finding yourself in the care of a prescribing doctor or even a clinic without the know-how. A physician needs knowledge, experience, and some familiarity to guide their patients safely, so as to avoid the terrible side effects of stopping Cymbalta abruptly or more aggressively than the person can handle.
Alternative to Meds Center is the world’s leading facility in drug tapering and has helped thousands of clients get off Cymbalta and other meds for over 15 years. Our protocols have been researched and refined for client safety and comfort.
If you are someone or know someone who has tried to quit Cymbalta without success, let us help put a plan for tapering Cymbalta into action in our lovely and pristine inpatient facility, surrounded by compassionate and competent support.
Some Common Reasons to Consider Cymbalta Tapering Treatment
- A very common reason for considering stopping Cymbalta or other antidepressant drugs is the lack of results from drug treatment. According to research studies done and published by the National Institute of Health, two-thirds of those suffering from major depressive disorders find the first medication prescribed has no effect on their symptoms.1 And, according to established protocols, the person would be taken off that antidepressant and put onto another.
PLEASE NOTE:
Abruptly switching medications can be disastrous if done without gradual Cymbalta tapering –allowing for a “wash-out” period between the first medication and the next. In the main, physicians do not receive training or guidance on such protocols. As a further note, about 75% of those who are switched to a second antidepressant also receive no benefit, and “standard” protocols would then suggest trying a third, fourth, etc. Any switch in medications must be done with care and oversight, as doing so carries significant risks. In fact, doing so may further complicate extant health issues. This is especially true where physical conditions and illnesses had not been fully investigated and treated before opting for treatment with medications. - Medications can produce intolerable side effects of some severity and may make continuing the medication unworkable. Known side effects of antidepressants may lead to the decision to begin tapering Cymbalta for relief. However, do not make the mistake of stopping Cymbalta abruptly.
- After 6 weeks of taking antidepressants, or even less, stopping Cymbalta can produce side effects of stopping Cymbalta. This is true for any antidepressant medication and requires gradual Cymbalta titration over time for safety. It is important for caregivers to know that tapering Cymbalta or stopping any antidepressant medications, must be done gradually and should only be attempted with careful oversight and guidance, as well as compassion.3
MAJOR WARNING: Due to the effects that antidepressants have on neurochemicals, there is one circumstance that does require abrupt emergency Cymbalta cessation. Where too much serotonin has been activated in the system, called serotonin syndrome, the situation can quickly become life-threatening. Therefore, serotonin syndrome does require immediate emergency hospitalization, and immediately stopping Cymbalta. It is important to note that during switching antidepressants, the risk of serotonin syndrome is heightened significantly.- Placebo-based trials showed that a wide range of Cymbalta’s adverse events occurred 2X to 4X compared to placebo, including lack of appetite, weight loss, liver damage, anxiety, insomnia, sexual dysfunction, blurred vision, and many others.15
NOTES ON PREGNANCY & CYMBALTA
If a woman becomes pregnant or feels it is possible that pregnancy may occur, she may want to consider Cymbalta cessation to prevent damage to the unborn child. Studies that were done from 2004 through 20117 showed that out of 233 pregnancies where the mothers were taking Cymbalta, 90 had negative outcomes involving birth defects or other complications. Some of these outcomes included but were not limited to the following abnormalities:
- Spontaneous miscarriages (41 of 233)
- Premature births (19 of 233)
- Still-births (3 of 233)
- Congenital defects (6 of 233)
- Ectopic pregnancies (3 of 233)
While more conclusive studies still need to be done, these observed rates of abnormalities are higher in comparison to pregnancy statistics where the mothers were NOT on antidepressant medications. The DEA has classified duloxetine as a Category C drug, meaning the risks related to pregnancy and birth defects cannot be ruled out because studies have not been done on humans but birth defects and AEs were documented in animal drug trials.16,17
Considering these and other reasons one may conclude that trying to quit Cymbalta is a wise personal health choice, especially if one is planning a future pregnancy. Be sure to seek competent help and guidance before embarking on a Cymbalta tapering program.
Strategies Used in Cymbalta Tapering at ATMC
Clients enrolled in our medically monitored Cymbalta tapering program benefit from individually tailored cessation programs which are augmented with a wide array of helpful therapeutic services, delivered under medical oversight and attentive staff care. Examples can include therapeutic massage, neurotransmitter rehabilitation, neurotoxin removal, orthomolecular medicine to modify the diet, IV treatments, nebulized glutathione, appropriate supplementation, CBT and other counseling, acupuncture, and many more. Please visit our services overview pages for a more detailed description of how lab testing and other services are blended into the most effective program possible.
The overall goal of Alternative to Meds Center is to attain mental health naturally. This means ultimately without the need to rely on harsh and toxic medications. The medications you were prescribed did not, and ultimately, could not solve anything. We offer superior solutions.
At Alternative to Meds Center, clients experience their individualized Cymbalta tapering plan, delivered in a warm and nurturing in-patient setting. In fact, the whole program is designed for client comfort and wellness. Please ask us about the numerous holistic treatments that the program uses to soften discomforts and ease Cymbalta tapering.
Want More Information on Cymbalta Tapering at Alternative to Meds Center?
There is never going to be a one-size-fits-all when it comes to Cymbalta tapering that will be exactly right for each person.
Instead, the best way is to carefully design a Cymbalta tapering program that is able to uniquely address chemical sensitivity, lifestyle, health history, and personal health goals. These factors are crucial in making a Cymbalta taper not only safe but life-restoring and remarkably tolerable.
Please contact our informed and friendly Alternative to Meds Center staff for more information on safe Cymbalta weaning and titration protocols in a restful, pristine, and compassionate inpatient setting.
There are 2 really important points when considering duloxetine AKA Cymbalta tapering. One is to only do it with the guidance and oversight of a knowledgeable, trusted medical professional, and the other is never to abruptly stop taking Cymbalta. Tapering Cymbalta can reduce the severity and longevity of the withdrawals.
