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Dr. Bob is Robert Hsiung, MD,
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Posted by Avalon on May 23, 2006, at 23:50:17
In reply to Re: Cymbalta withdrawal, posted by secretme on May 23, 2006, at 22:45:09
Secretme, I normally try not to even read the side effects ahead of time because I don't want to psych myself out and maybe not give the medication a sufficient trial run. (I do read the drug interactions and warnings, however.) Whenever I do read the side effects, I feel like they are worst-case scenario and probably don't affect the majority of patients that way, including hopefully me. So, with that said, I found the information below on the Cymbalta.com website under "Prescribing Information". It lists the possible risks of "abrupt" discontinuation of treatment. It pretty much describes the symptoms we're all having. If I were reading this before taking the med, I would think a gradual reduction would prevent this -- in fact, it pretty much says that. As we all know, that is NOT the case. This warning needs to be much more specific about the serious withdrawal risks, gradual or not gradual. Here's what it says:
Discontinuation of Treatment with Cymbalta — Discontinuation symptoms have been
systematically evaluated in patients taking Cymbalta. Following abrupt discontinuation in MDD
placebo-controlled clinical trials of up to 9-weeks duration, the following symptoms occurred at
a rate greater than or equal to 2% and at a significantly higher rate in Cymbalta-treated patients
compared to those discontinuing from placebo: dizziness; nausea; headache; paresthesia;
vomiting; irritability; and nightmare.
During marketing of other SSRIs and SNRIs (serotonin and norepinephrine reuptake
inhibitors), there have been spontaneous reports of adverse events occurring upon
discontinuation of these drugs, particularly when abrupt, including the following: dysphoric
10
mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric
shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia,
hypomania, tinnitus, and seizures. Although these events are generally self-limiting, some have
been reported to be severe.
Patients should be monitored for these symptoms when discontinuing treatment with Cymbalta.
A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible.
If intolerable symptoms occur following a decrease in the dose or upon discontinuation of
treatment, then resuming the previously prescribed dose may be considered. Subsequently, the
physician may continue decreasing the dose but at a more gradual rate (see DOSAGE AND
ADMINISTRATION).
Posted by Nick K. on May 24, 2006, at 1:15:49
In reply to Re: Cymbalta withdrawal, posted by Avalon on May 23, 2006, at 23:50:17
There should be an obvious warning ON THE BOTTLE regarding the complications of withdrawal from Cymbalta. Something like: "DO NOT STOP TAKING THIS MEDICATION ABRUPTLY" I'm looking at the bottle right now... there is a warning "do not drink alcoholic beverages", "may cause dizziness", "may cause drowsiness". Nothing about withdrawal. Even missing one days dose by accident can cause near hypopsychosis. Psychiatrists and prescribers should be forced to warn patients of the severity of withdrawal symptoms. It sounds like most people abstaining from this medication had no idea what they were in for. Many of us should be awarded compensation for our unwitting suffering.
Posted by Avalon on May 24, 2006, at 10:24:35
In reply to Re: Cymbalta withdrawal, posted by Nick K. on May 24, 2006, at 1:15:49
Nick, I agree. My doctor was surprised to hear I had ANY withdrawal symptoms. He told me in advance about the potential side effects, but no mention of withdrawal. If I had been warned about this in advance, I never would've started on it. I would be curious to know if there are ANY people who've gone off Cymbalta without withdrawal symptoms. I'd be curious to know whether anyone has been warned by their doctor in advance about the withdrawal. I do not think we should let this issue die -- this is serious stuff that needs to be known by the public who are seeing those d*** "where does depression hurt" commercials! I was only on it 3 weeks and got completely nauseous after tapering it down for 3 days and then being off it 3 days. I have been on other anti-depressants in the past and have never experienced anything like this!
Posted by Nick K. on May 24, 2006, at 19:32:09
In reply to Re: Cymbalta withdrawal, posted by Avalon on May 24, 2006, at 10:24:35
I'm not an attorney and I don't know much about law, but it would be interesting to hear if a legitimate lawyer thinks we have a case or not. I think we have more than enough compelling testimony for a successful law suit. It may be sort of a lost cause to go up against a pharmaceutical giant like Lilly. I'm pretty sure these sorts of cases cost a lot of time and money, and theres no guaranteed positive outcome.
I'm interested in learning/hearing more about this.
Posted by secretme on May 25, 2006, at 8:28:05
In reply to Re: Cymbalta withdrawal, posted by Nick K. on May 24, 2006, at 19:32:09
I asked the same question several months ago, but there was no response. One person offered something along the lines that we all take so many other medications, how can we pin it on Cymbalta? Then why are we going through this exercise with each other? I don't have any experience with the law, but I think a class action lawsuit might be possible with all the people who have poured their hearts out on this website. These are not isolated incidents, and there are many more of "us" out there who need to do something about this for ourselves and for those unsuspecting patients who see the TV, Internet and prints ads and just can't wait to try Cymbalta! Yesterday, when I accompanied my son for a visit to the head of the neurosciences department at a major teaching hospital, this doctor mentioned alternate medications for my son's OCD, and one of them is Cymbalta! He got an earfull from me, although he probably thought I needed to be committed.
secretme
Posted by Doccybear on May 25, 2006, at 12:13:05
In reply to Re: Cymbalta withdrawal, posted by Jaspar on April 26, 2006, at 13:20:37
Hello I just wanted any one to know who's having problems with cymbalta withdrawal;
I was on 60 mg and had horrible withdrawal if I took it more than an hour later than scheduled;
However GOOD NEWS: Switch to an SSRI, and there is virtually no withdrawal symptoms (as noro-epinephrine does not create withdrawal.)
I personally used Lexapro, my old stand-by; and I went right to 15mg (not recomending this, I know by my own experience I can tolerate higher levels of this one but some people get very stimulated at 5mg.) Any way I used this amount (even though my doctor gave me 10mg) to account for the serotonin levels @ 60mg Cymbalta.
Im just writing to help b/c I know it's torture to come off these meds but you really can switch from one to another fairly easily with your doctors aproval. I am a good judge on that b/c I am sosososososoosos incredibly sensitive to SSRI and SNRI withdrawal.
If you have any questions for me I will check back the posts everyonce in a while (don't wanna leave my email in case there's any creepy folk scoping the internet)
God Bless you all,
Most sincerely,Amanda S.
Posted by Jaspar on May 25, 2006, at 14:06:27
In reply to Re: Cymbalta withdrawal, posted by SLS on May 23, 2006, at 9:23:31
> The drug manufacturer does include a precautionary statement regarding the occurrence
> of withdrawal symptoms upon the discontinuation of Cymbalta. I'm not sure why
> this information is not being offered to patients on a regular basis. I guess it's time
> for doctors to read the label.Yes, the doctor didn't tell me, but even the warning does not suffice, because it says to taper off... and the tapering needed for some people (such as myself) is IMPOSSIBLE and ridiculous, especially given the dosages Cymbalta comes in.
Like the idea of a Cymbalta withdrawal kit. A month of counting down granuls from about 10 mg was necessary for some of us.
-Jaspar
Posted by Jaspar on May 25, 2006, at 14:13:29
In reply to Re: Cymbalta withdrawal, posted by Nick K. on May 24, 2006, at 1:15:49
> Even missing one days dose by accident can cause near hypopsychosis.
> Psychiatrists and prescribers should be forced to warn patients of the
> severity of withdrawal symptoms.Oh this is SO TRUE! I would get so ill within 16 hours of a single missed dose. I understood people going to a pharmacy and holding it up in order to get their drug! Yes - it was THAT BAD!
And Yes, if I HAD KNOWN how bad the withdrawal could be, I would NEVER NEVER NEVER have taken that first pill. It would not have been worth it to me to even try - there was a lot else I could have tried so it wasn't like it HAD to be Cymbalta.
-Jaspar
Posted by gapsgal on May 25, 2006, at 15:01:24
In reply to Cymbalta withdrawal GOOD NEWS / Trying to HELP, posted by Doccybear on May 25, 2006, at 12:13:05
Amanda,
My doctor told me it could cause some syndrome that is potentially fatal to switch before I am completely off of the Cymbalta. The doctors are oh so amazed that I am having withdrawals at all.
> Hello I just wanted any one to know who's having problems with cymbalta withdrawal;
>
> I was on 60 mg and had horrible withdrawal if I took it more than an hour later than scheduled;
>
> However GOOD NEWS: Switch to an SSRI, and there is virtually no withdrawal symptoms (as noro-epinephrine does not create withdrawal.)
>
> I personally used Lexapro, my old stand-by; and I went right to 15mg (not recomending this, I know by my own experience I can tolerate higher levels of this one but some people get very stimulated at 5mg.) Any way I used this amount (even though my doctor gave me 10mg) to account for the serotonin levels @ 60mg Cymbalta.
>
> Im just writing to help b/c I know it's torture to come off these meds but you really can switch from one to another fairly easily with your doctors aproval. I am a good judge on that b/c I am sosososososoosos incredibly sensitive to SSRI and SNRI withdrawal.
>
> If you have any questions for me I will check back the posts everyonce in a while (don't wanna leave my email in case there's any creepy folk scoping the internet)
>
> God Bless you all,
> Most sincerely,
>
> Amanda S.
Posted by kparis on May 25, 2006, at 15:23:03
In reply to Re: Cymbalta withdrawal GOOD NEWS / Trying to HELP, posted by gapsgal on May 25, 2006, at 15:01:24
I'm stopping my Cymbalta today. I was on 60mg for over a year, the last month on 30mg (with no side effects whatsoever) and now cold turkey. My doc said that it wouldn't be easy and if it got bad to let her know and a single dose of prozac should do the job as it has a 1/2 life of about 3 weeks. I'm a bit nervous about this, but I'm willing to do it as I want my body to be clean of all drugs. I'm feeling so great being on a lower dose. I'm also hoping that getting off of this drug will help me lose the weight I put on while on the drug. Any thoughts from anyone? Thanks!
Kparis
Posted by Avalon on May 25, 2006, at 15:56:09
In reply to Re: Cymbalta withdrawal GOOD NEWS / Trying to HELP, posted by kparis on May 25, 2006, at 15:23:03
> I'm stopping my Cymbalta today. I was on 60mg for over a year, the last month on 30mg (with no side effects whatsoever) and now cold turkey. My doc said that it wouldn't be easy and if it got bad to let her know and a single dose of prozac should do the job as it has a 1/2 life of about 3 weeks. I'm a bit nervous about this, but I'm willing to do it as I want my body to be clean of all drugs. I'm feeling so great being on a lower dose. I'm also hoping that getting off of this drug will help me lose the weight I put on while on the drug. Any thoughts from anyone? Thanks!
> KparisYes, please keep us posted. My withdrawal symptoms didn't start until 3 days after I stopped. (And I was only on it 3 weeks.) It will be interesting to see whether anyone is able to get off this with no withdrawal. Good luck!
Posted by gapsgal on May 25, 2006, at 16:04:48
In reply to Re: Cymbalta withdrawal GOOD NEWS / Trying to HELP, posted by kparis on May 25, 2006, at 15:23:03
I actually suggested prozac to my doc and was told absolutely not because it can cause a fatal reaction.
I am so confused i dont know what to do...
> I'm stopping my Cymbalta today. I was on 60mg for over a year, the last month on 30mg (with no side effects whatsoever) and now cold turkey. My doc said that it wouldn't be easy and if it got bad to let her know and a single dose of prozac should do the job as it has a 1/2 life of about 3 weeks. I'm a bit nervous about this, but I'm willing to do it as I want my body to be clean of all drugs. I'm feeling so great being on a lower dose. I'm also hoping that getting off of this drug will help me lose the weight I put on while on the drug. Any thoughts from anyone? Thanks!
> Kparis
Posted by gapsgal on May 25, 2006, at 16:09:20
In reply to Re: Cymbalta withdrawal GOOD NEWS / Trying to HELP, posted by Avalon on May 25, 2006, at 15:56:09
What mg. prozac? Yes you will need something if you plan to go cold turkey...I had gotten down to 7.5 mg before trying cold turkey and had the worst symptoms since I quit effexor...so I have no doubt you will develop them, just be prepared...I am tempted to order the prozac online and actually thought of doing just that until I asked the doctor and was told it could be potentially fatal if mixed because it could cause some type of syndrome...can you inquire with your doctor about this and see what his thoughts are?
Donna
> > I'm stopping my Cymbalta today. I was on 60mg for over a year, the last month on 30mg (with no side effects whatsoever) and now cold turkey. My doc said that it wouldn't be easy and if it got bad to let her know and a single dose of prozac should do the job as it has a 1/2 life of about 3 weeks. I'm a bit nervous about this, but I'm willing to do it as I want my body to be clean of all drugs. I'm feeling so great being on a lower dose. I'm also hoping that getting off of this drug will help me lose the weight I put on while on the drug. Any thoughts from anyone? Thanks!
> > Kparis
>
> Yes, please keep us posted. My withdrawal symptoms didn't start until 3 days after I stopped. (And I was only on it 3 weeks.) It will be interesting to see whether anyone is able to get off this with no withdrawal. Good luck!
Posted by Avalon on May 25, 2006, at 16:10:28
In reply to Re: Cymbalta withdrawal, posted by Jaspar on May 15, 2006, at 12:35:18
Jaspar, first off -- how are you doing? I think you've been off C-word for 10 days or so?
Also, here's where I am in my tapering schedule: I'm on the 30 mg and have been slowly spacing them out further and further, to the point where I'm at every other day. And now I'm dumping out increasing numbers of granules each time. The doctor said they don't come any smaller than 30 mg (even though the website said they come in 20) and I don't want to contradict him since he's the one who prescribes my pain meds. I'm almost out of 30 mg pills, but I still have 60's so I think I'll just divide up the granules in each cap into lower and lower numbers. What a pain in the a**. At this rate it will be Christmas before I'm done! Does this schedule sound OK to you? Thanks.
P.S. Coincidentally, a Cymbalta commercial is on as I write this!!! Should I throw something at the TV???
Posted by gapsgal on May 25, 2006, at 16:13:12
In reply to Re: Cymbalta withdrawal - Jaspar, posted by Avalon on May 25, 2006, at 16:10:28
Actually they do come in 20 I have them, my doctor said that are not used much though.
> Jaspar, first off -- how are you doing? I think you've been off C-word for 10 days or so?
>
> Also, here's where I am in my tapering schedule: I'm on the 30 mg and have been slowly spacing them out further and further, to the point where I'm at every other day. And now I'm dumping out increasing numbers of granules each time. The doctor said they don't come any smaller than 30 mg (even though the website said they come in 20) and I don't want to contradict him since he's the one who prescribes my pain meds. I'm almost out of 30 mg pills, but I still have 60's so I think I'll just divide up the granules in each cap into lower and lower numbers. What a pain in the a**. At this rate it will be Christmas before I'm done! Does this schedule sound OK to you? Thanks.
>
> P.S. Coincidentally, a Cymbalta commercial is on as I write this!!! Should I throw something at the TV???
Posted by Doccybear on May 25, 2006, at 16:53:27
In reply to Cymbalta withdrawal GOOD NEWS / Trying to HELP, posted by Doccybear on May 25, 2006, at 12:13:05
The cymbalta has such a short half life that there shouldn't be a fatal interaction. I'm not a doctor but it's out of your blood in about 24 hours. At this time something else can replace it (I did it even sooner.)
Alot of people go from one to another like water so as long as you fully stop the other the doctors seem to do it pretty readily.
I didn't bother tapering down from Cymbalta before starting another; it would have been too hard for me.
DEFINETELY do the prozac thing. One dose, sometimes a second is necessary after a week has had really good results.
Posted by Doccybear on May 25, 2006, at 16:56:40
In reply to Re: Cymbalta withdrawal GOOD NEWS / Trying to HELP, posted by gapsgal on May 25, 2006, at 16:09:20
Hi, well you can't start prozac and take ANY cymbalta at all that WOULD be potentially fatal, but you may switch immediately onto the other.
Let us know if you do Prozac; I wouldn't mind trying that one if I had to.
Posted by Jaspar on May 25, 2006, at 17:13:30
In reply to Re: Cymbalta withdrawal - Jaspar, posted by Avalon on May 25, 2006, at 16:10:28
> Jaspar, first off -- how are you doing?
> I think you've been off C-word for 10 days or so?Instead of the weird visual thing every few minutes, I am getting it now just about a dozen or so times per day. That is immense improvement!
On the downside - my nerve pain is back full-force, and with it, muscle spasms. But it is funny - after going through the depression and torture of withdrawal, I view the nerve & muscle pain as relative... I am going to learn to live with it a different way.
>
> I'm at every other day.I chose to take it EVERY day, but just in decreasing amounts. I could not go a day without the C-word without severe symptoms.
>The doctor said they don't come any smaller than 30 mg
I had 20mg pills. It May be more difficult with 30mg but the process is the same.
You can ask the doctor to just write out the prescription for the 20mg and you'll worry about getting it (since you know it exists).
> At this rate it will be Christmas before I'm done!
> Does this schedule sound OK to you? Thanks.What can I say... it took me 6 months to come off the 60mg. The slowest part was the last 10-15mg or so.
> P.S. Coincidentally, a Cymbalta commercial is on as I write this!!! Should I throw something at the TV???Only if it is soft. My family might be tired of hearing me rant everytime the commercial comes on, but I guess they are polite and don't say anything.
-Jaspar
Posted by Jaspar on May 25, 2006, at 17:17:23
In reply to Re: Cymbalta withdrawal GOOD NEWS / Trying to HELP, posted by gapsgal on May 25, 2006, at 15:01:24
> My doctor told me it could cause some syndrome
> that is potentially fatal to switch before I
> am completely off of the Cymbalta.Serotonin Syndrome.
> The doctors are oh so amazed that I am having
> withdrawals at all.Mine also. I guess the pharamceutical reps negelected to tell him that part.
-Jaspar
Posted by gapsgal on May 25, 2006, at 17:24:43
In reply to Re: Cymbalta withdrawal GOOD NEWS / Trying to HELP, posted by Doccybear on May 25, 2006, at 16:53:27
What strenght prozac? Just get up and instead of taking Cymbalta take prozac? and then dont worry about it after that one dose?
> The cymbalta has such a short half life that there shouldn't be a fatal interaction. I'm not a doctor but it's out of your blood in about 24 hours. At this time something else can replace it (I did it even sooner.)
>
> Alot of people go from one to another like water so as long as you fully stop the other the doctors seem to do it pretty readily.
>
> I didn't bother tapering down from Cymbalta before starting another; it would have been too hard for me.
>
> DEFINETELY do the prozac thing. One dose, sometimes a second is necessary after a week has had really good results.
Posted by Avalon on May 25, 2006, at 18:58:08
In reply to Re: Cymbalta withdrawal GOOD NEWS / Trying to HELP, posted by gapsgal on May 25, 2006, at 17:24:43
Since none of us know much about how to get a class-action suit started, at least we can try to make the public aware of this problem. I just sent an e-mail to the health reporter at our local news station (in a major city). I've heard them do stories like this before, so I suggested publicizing this as a warning to anyone considering Cymbalta, especially since the commercials are so visible these days. We'll see how it goes. They may not want to do a negative story about a sponsor, but that doesn't mean we shouldn't try. I think if we all start to spread the word on this, it could really make a difference! What do you think, folks?
Posted by kparis on May 26, 2006, at 7:11:19
In reply to Re: Cymbalta withdrawal GOOD NEWS / Trying to HELP, posted by gapsgal on May 25, 2006, at 17:24:43
> What strenght prozac? Just get up and instead of taking Cymbalta take prozac? and then dont worry about it after that one dose?
I'm not sure. I didn't ask. But I'll let you all know when I find out.
I'm off completely for 36 hours now with no withdrawal symtoms yet. Maybe it is too early to tell.
KParis
>
>
>
>
>
> > The cymbalta has such a short half life that there shouldn't be a fatal interaction. I'm not a doctor but it's out of your blood in about 24 hours. At this time something else can replace it (I did it even sooner.)
> >
> > Alot of people go from one to another like water so as long as you fully stop the other the doctors seem to do it pretty readily.
> >
> > I didn't bother tapering down from Cymbalta before starting another; it would have been too hard for me.
> >
> > DEFINETELY do the prozac thing. One dose, sometimes a second is necessary after a week has had really good results.
>
>
Posted by secretme on May 26, 2006, at 9:27:08
In reply to Cymbalta withdrawal - Publicity, posted by Avalon on May 25, 2006, at 18:58:08
Unfortunately, I don't live in New York City, but the New York Times has a day on which there is a section devoted to Science (Science Times?). They might consider doing a story on this. Also, The Wall Street Journal has a science writer/reporter who might be willing to listen. The edit page is conservative, but the rest of the paper usually is not. And these newspapers have all the advertising they need, so telling the truth about Cymbalta shouldn't hurt their revenue.
In reading the flurry of postings lately, I worry about some of the advice on mixing medications. What is good for one person may not be good for another, and something significant could happen to permanently injure someone. My family wanted to admit me to the hospital because my withdrawal symptoms were so serious. Using the Benadryl seemed to be the most benign antidote, and it did help. At the same time, I HAD to take my cancer medication, BP medication, a statin, and withstand all the side effects in combination with Cymbalta withdrawal. My oncologist told me that while getting rid of this medication to drink lots of water. It helps get this crap out of your system.
secretme
Posted by secretme on May 26, 2006, at 9:43:28
In reply to Re: Cymbalta withdrawal GOOD NEWS / Trying to HELP, posted by kparis on May 26, 2006, at 7:11:19
By the way, there is a Dr. Bob, right? Can't he weigh in on some of these postings, or is there some kind of legal/ethical issue preventing him from responding? Do you think he still reads all this? Personally, I'd like to know HE is there and listening. How about it, Dr. Bob? Do our exchanges help you in treatment, education, etc.?
secretme
Posted by SLS on May 26, 2006, at 10:24:09
In reply to Re: Cymbalta withdrawal - Publicity » Avalon, posted by secretme on May 26, 2006, at 9:27:08
Hi.
Do you think that publicity and more visible caution statements are enough, or would you like to see Cymbalta removed from the market?
- Scott
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