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Duloxetine Tapering

This entry was posted in Antidepressant on by .
Medically Reviewed

Last Updated on July 20, 2021 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

Antidepressant medications present their own hellish challenges when it comes to tapering and withdrawal. Our expertise has given rise to effective, comfortable duloxetine tapering protocols.

We use holistic and scientific modalities to determine the cause(s) of symptoms such as depression. Then we create a custom-tailored program to provide the opportunity for successful duloxetine (Cymbalta) tapering.

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Duloxetine Tapering Programs

Duloxetine tapering programs may be recommended where persons have become dependent on this SNRI type antidepressant. Duloxetine (sold under various brand names including Drizalma Sprinkle, Cymbalta, pervades the CNS in ways that are, though not completely understood. Therefore, when stopping duloxetine, a slow pace is important, and within the recommended guidelines provided by the FDA.1

FDA guidelines are sparse, leaving most prescribing physicians at a real loss when it comes to detailed protocols or steps to use for duloxetine tapering. This is because neither the art or science of how to get off duloxetine or other SNRIs is what physicians are taught at medical school. Sadly, this makes for a glaring absence in training. And sadly so, since such a large percentage of the population has become subject to over-prescribing prescription drugs in this modern age. And as more researchers study these drugs, the controversy as to whether antidepressants work to treat depression any better than placebo continues.3

duloxetine withdrawal symptomsWhat we have seen is that in as little as six weeks a person trying to quit duloxetine will run into problems which can be exacerbated greatly if trying to quit duloxetine too quickly or all at once. Even a slow taper where basic nutrition, sleep, neurotoxin removal, or other important factors are neglected, can result in much discomfort for the person.

Like a car with no brakes traveling down a winding mountain road, this missing expertise concerning duloxetine cessation puts many people at risk each day. At Alternative to Meds Center, our programs can help with getting off duloxetine safely, gently, and comfortably.

Duloxetine Tapering Prior to Pregnancy

There may be a concern if a woman is planning to get pregnant while taking duloxetine. Duloxetine is thought to be possibly linked to some birth defects. Some research, such as that sponsored by Eli Lilly report no increased risk of birth defects,4 while other research referred to on the FDA drug label of 2017 warns of fetal/neonatal adverse reactions such as seizure, tremors, hypoglycemia, constant crying, and many other adverse effects in infants whose mothers were taking duloxetine. There have been no actual clinical trials on pregnant women taking duloxetine as to do so would be outside the ethical lines that govern testing procedures.5 Even though these researchers are noncommittal on the subject, a woman may want to consider the health of the infant as a possible motivation for duloxetine tapering before becoming pregnant.

Finding Competent Help for Duloxetine Tapering

duloxetine side effectsA person who has become dependent on antidepressant medications, or is experiencing unmanageable symptoms may decide that it’s time to begin trying to quit duloxetine. The side effects of SNRI medications can be harsh and may outweigh any perceived benefits of drug treatment. For many reasons, one may decide it’s time for getting off duloxetine.

Other side effects like insomnia and the resulting sleep-deprivation may make life and work quite difficult for anyone. There can be many reasons for an individual to consider getting off duloxetine.

But now the reality hits. The doctor who prescribed the medication may not know how to proceed. A significant challenge arises in finding qualified and competent help (beyond best-guesswork) concerning stopping duloxetine.2 Doctors are typically not trained on how to administer medication tapering, and though they generally are trying their best, that often means little more than guesswork.

If the duloxetine was in solid pill form, the prescribing doctor might give the patient a number of pills which can be “cut” with a special pill cutter, according to a suggested schedule. However, where the SNRI is a timed-release version or comes in “sprinkles,” the pills cannot be simply cut. So, a patient may be switched to another type of medication, making it easier to control the dosage.

However, sometimes there can be problems with switching over from one drug to another, which may further complicate getting off duloxetine smoothly. Another option exists called “cross-tapering.” Cross-tapering can sometimes be used to smooth out the transition from one drug to another, where the second drug is hoped to cause less intense side effects. These types of actions are best done within a treatment center where a person receives constant monitoring, and are considered not suitable for self-administering due to their sometimes unpredictable outcomes.

Self-Administered Duloxetine Tapering vs Monitored Inpatient Tapering Treatment

A person’s doctor may tell the person to “take half a pill daily for two weeks and then come back and see me.” So for those two weeks, the person is basically doing a self-administered duloxetine tapering process. For some, the person who has become disorganized in their life, with each day an uphill struggle of tasks that involve both self-care and care of family members or struggling with a work situation, these sorts of real-life factors almost guarantee that the schedule will not be followed exactly, and this can introduce even more complexity.

Other complications can arise, especially where a person is doing duloxetine tapering using a timed-release version. The physician may need to write a prescription for a liquid form of the drug and may give directions for measuring exactly to achieve a 20% or 40% reduction, or whatever has been suggested. To complicate what sounded straightforward and simple in the doctor’s office, some responses to reductions in dosage might not occur right away but may set in after a couple of days or even longer. There can be many variations and “tweaks” that may need to be alertly responded to during the course of duloxetine tapering to try and keep pace with emerging side effects and reactions.

One is seeking to achieve a reduction as the goal of reducing or stopping duloxetine without running into unmanageable withdrawal effects. For instance, brain zaps are a common duloxetine withdrawal symptom, along with insomnia, nausea, and a possible host of other common withdrawal symptoms. Should these become too intense this scenario might bring trying to quit duloxetine to a disastrous crashing halt.

If the person who is attempting the duloxetine tapering is already feeling unwell, already experiencing harsh side effects and unpredictable mood swings, lapses in memory, and other troubles, it may be too burdensome to expect a person in such a weakened condition to be their own duloxetine tapering administrator. It does not have to be this difficult.

Duloxetine Withdrawal at Alternative to Meds Center

duloxetine tapering sedona arizonaIf you or your loved one has been considering getting off duloxetine, perhaps you are not confident about how exactly to proceed. You may also be looking for holistic options that you want to explore. If so, we invite you to find out more about how our program works. Please feel free to contact us directly. We are here to help. We can give you more information on the many treatment protocols (i.e., metabolic testing, neurotoxin removal, rebuilding the neurochemistry, integrative psychiatry, organic nutrition and supplementation, and much more) that are designed to soften the whole duloxetine tapering process and to provide a compassionate, warm, and welcoming space in which to experience a true resurgence of health. Find out why we feel our duloxetine tapering program is the best in the world, but more importantly, how it has been designed to create a revitalizing experience, focused on helping our clients regain natural mental health and vitality.

1. FDA Duloxetine label [cited 2019 Sep 29]

2. Harvard Health Publishing, “How to Taper Off Your Antidepressant” Harvard Women’s Health Watch [INTERNET] 2010 Nov, updated 2020 Jan 29, [cited 2019 Sep 29]

3. Stegenga J “The Evidence in Favour of Antidepressants is Flawed” Aeon [INTERNET] 2019 Mar [cited 2019 Sep 29]

4. Hoog, Cheng, Elpers & Dowsett, “Duloxetine and Pregnancy Outcomes-Safety Surveillance Findings” International Journal of Medical Sciences [INTERNET] [cited 2019 Sep 29]

5. FDA label Duloxetine, Section 8.1, “Pregnancy” [cited 2019 Sep 29]

Originally Published Nov 1, 2019 by Lyle Murphy

This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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Duloxetine Tapering
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Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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