Thanks mrs D. The nose bleeds and sores only started when I had been diagnosed with RA - I thought perhaps it was because of the methotrexate but it continued after I stopped. I knew that Aspirin worsened them because I was on it for ten days at 300mg x 3 daily a few weeks ago for the Erythromelalgia burning. It didn't do much in that time apart from ease the stiffness a bit - but the nose bleeds became torrential and an ER doctor told me to stop. The tummy pain was bad too despite takjng Ranitidine to protect it. This is when I decided that enough was enough and I needed to know for myself what was drug side effect and what was me and came off Cymbalta - felt terrible - went back in it and weaned off more slowly over 2 weeks. But obviously not slowly enough from what everyone is saying!

It's been a week now since I last took it. I felt marginally better last night and took a sleeping pill as I'm travelling today for work.

Apart from the neuropathic pain and stiffness - the other stuff with tummy and has gathers momentum over the day and is worse by evening - I have an impulse to be sick after food because it seems stuck between my throat and my upper abdomen. Horrible! This in tirn makes my breathing laboured abd chest feel tight.

I know my doctor is wrong - I just hope my experiemce shows them (GPs) that this drug can indeed be very hard for patients to get back off and patients who start it should be warned about this and have a proper weaning protocol as they do with steroids. I had to try and invent my own and obviously it was too quick.

I will stay off it now because I'm cautiously optimistic that things are slightly improving - mind you I did go to sleep at 9.45pm and it's now the early hours here when I usually feel better tummy wise.

I've been getting these nose bleeds and crusty sores for a few years now. The dryness is defintely the problem in the immediate sense and my eyes are dry too. I keep forgetting to use Lacrilube at night and drops during daytime so this is probably not helping with the nose bleeds and dryness. However my nose also aches presently along with my jaw and ears and this is new. It started at the same time as Dukoxetine and I had to start using a moulded mouth guard at night. I also started having a dry tickly cough so funny things seem to happen with the Duloxetine - from nose and mouth drying up and cough and nasty gnawing pain in my guts worsening.

Could just be coincidence though - but nose bleeds come and go and are just as bad in the summer months - always have to be careful not to bump or snag my nose and use Naseptin when I remember. Was assuming this is Sero negative Sjogrens until this Vasculitis man mentioned Wegener's Gramulatosis/ GPA. Apparently you do not always get the organ involvement early on and it would have improved while I was on Methotrexate for two years and would explain my high ESR and CRP too and defintely explain the PN/ SFN and could well support the GI problems also. But it was the crusting and nose bleeds that made him feel it is a strong contender. Have you heard of this rare type of Vasculitis?

Hi Lara - no I didn't have rheumatic fever as a child but I was starved as a baby and very nearly died. A professor I saw said this could be the reason my body went into flight or flight and a trigger for years of ill health, severe eczema and Alopecia and for my autoimmunity now perhaps.

Coincidentally my GP phoned me back wheh I was at my worst ebb a few nights ago. She will run a full blood count for me on Monday prior to seeing my rheumattologist in two weeks time and also has refered me to the gastric surgeon here to decide what tests to run for my stomach. I had my ESR taken yesterday as she was hoping that if it's high again (often up in 50s or 60s) this would probably suggest it's nothing to do with Cymbalta withdrawal and I'm flaring with RA perhaps. If it's normal or even low - then we have to assume it's the withdrawal side effects. She said she would phone with the results last night as I'm travelling off island this morning for a few days work. But she hasn't phoned so I'll phone in and pick up the results on way to the airport in a few hours. I think this must mean it's only around 30 - my normal range.

From everything I've read here this problem is from me coming off Cymbalta too quicky- but as I had no help from my doctors with this I don't feel too much to blame. Also I've been getting the nose sores and bleeds for ages now and I think the are part of my seronegative condition whatever this may be. No one really believes in seronegativity on my health team - that's the problem!

I will try to let you know my ESR and will keep an eye on the renal function results when they are taken on Monday. I always get print outs. When on methotrexate and two other DMARDs I was regularly monitored but now I only get my blood count done every six months or so if I ask. I have a lot of pain in my back and down in my bladder area just now too so have stopped paracetamol for a bit and an drinking water like a fish in the hope that this helps flush the Cymbalta out of me sooner. I will stick with it now having come this far.

Ps ESR was only 30 as I predicted. I feel vindicated now!