Withdrawal and pain is becoming so bad
 

As some of you know, I have been tapering off of cymbalta due to osteoporosis. It is a s/e of cymbalta.

Yesterday, the pain was completely unbearable from my SFN. A little background, last Saturday I lowered my cymbalta from 90mgs to 60 mgs. The first s/e I had was severe nausea. That lasted for about 4 days. I was unable to really eat and had no appetite .

On Tuesday I had an IVIG Rx and my doctor ordered Zofran with my Rx and it helped since then the nausea has only been intermittent. Tuesday night after my Rx I could not sleep at all and my pain was unbearable. I did not sleep all night. Finally, at 6am on Wednesday I fell asleep just because I was exhausted. I was only able to sleep for 4 hours. I was in so much pain yesterday all I did was cry off and on. I did take Percocet 5mgs twice to help but nothing really made a difference.

I went to bed last night and took a Benadryl. I was still awake at midnight so I took another. I did fall asleep and slept through the night. Thank goodness! When I woke today the pain was a little better. Wondering if that is from using the mag lotion before bed. It is still worse than usual. I feel really anxious and I know it is the lower dose of cymbalta!

Now I have to decrease the dose again. I was going to wait till after the weekend but I think I am going to drop another 30mgs tomorrow. My husband will be home for the weekend. This way if things get too bad he'll be here.

I'm not looking forward to this. Mrs. D I know you recommended L-tryptophan. During research I saw it was counterindicated for those taking tramadol so I don't know if I should try it. I am going to get the multivitamin for the B6.

If I had know how hard it is to come off of cymbalta I would not have taken it. I'm a mess! Crying, anxious, severe pain! I actually feel terrible because I recommended this med to others.

For those of you who do, please say a prayer for me. I still have several weeks left to get through this. Hopefully, it goes better than this first week!!

Sorry for be so down. I'm bringing it here because I know all of you understand:(

Hopeful,

I am so sorry for all your pain. I can totally empathize with your pain.

I may have read your story but you know my memory is messed up with all the medications I am taking so please forgive me for not remembering it. I never tried Cymbalta though it was offered to me as an option just as Lyrica. I am taking Gabapentin. It is not the best medicines but at least its not metabolized in the liver (my major consideration).

I take 1800mg but since Dec 2013, I started taking 1500mg. To compensate for the reduced dosage, I am using a compounded cream (Clonidine, Ketamine, Baclofen and Gabapentin). It is helping me more than the full 1800mg I used to take. I was in pain at least 90% of the day since October 2011. The irony of it, not one of my 6 neurologists ever recommended (or even mentioned) about the compounded pain cream knowing how I was struggling with the pain -- it was my rheumatologist who recommended for me to try. Well, I basically tried almost everything out there so I thougth I'd lose nothing if I give it try.... I am glad i did.

I just dont know what would be the side effects in the long term. You know how these chemicals, there is nothing really 100% safe.

Why are you tapering off your Cymbalta? Is it not working anymore?

I hope you find some relief from your pain....

Mary

Hi,
I'm stopping the cymbalta because I had a bone density test that showed osteopenia in my left hip and osteoporosis in my lumbar spine. I had this test done right when I first got sick and had no osteoporosis.

With some help on this site I found out that cymbalta can cause osteoporosis. My rheumo said that is true and I needed to come off it. It actually worked very well for me. I wish it did not have this s/e.

Thanks for the support!

Just want to jump in quickly and ask if you receive any steroids as a pre-med to your IVIG? It is very common to pre-med the infusion with a single dose of IV steroids or even oral in some cases.

If so, I would consider this being your cause of osteoporosis instead of the Cymbalta.

Hi enbloc,
I did consider this. I do get 20mgs of solumedrol with each IVIG. I brought it to the doctors attention. He said it is too low of a dose to be the cause. I also have only gotten the solumedrol for about 5 Rx's.

What do u think?:confused:

I personally don't see much online for osteoporosis caused by cymbalta. Yes, it can be found but certainly not a major side-effect or one that is widely posted on reputable sites like drugs.com. Actually of the 40+ side effects listed, bone loss or osteoporosis is NOT one of them. Nor is it listed in the 20+ common side-effects. The only place I could really find something was comments on forums and they were not many.

I'm not saying it isn't caused by cymbalta, but I certainly believe the risk is MUCH higher for ANY steroid use...and 20 mg of IV solu-medrol is not really a low dose. It is not a huge dose, particularly since it's just once a month, but the risk is still higher.

There are other factors that must be considered in your development of osteoporosis. Age, menopause, exercise, diet, etc. ALL of these are significant to developing this, especially coupled with steroid use and maybe the cymbalta.

Hi,
I found a few research studies concerning cymbalta snd osteoporosis. Not really all that many. When I went to my rheumo I brought a few studies with me but I didn't need to show him. He already new that cymbalta can cause osteoporosis. That's why I figured it was that. I believe it is a s/e that has only been discovered recently. Actually, what I found in research is that the FDA originally ok'd cymbalta for osteo pain.

I just wish I knew for sure but I can't take the chance. I am also on a hormone replacement so it is not from that. I also have a decent diet. As for exercise, I did not do much in the last 3 years but before that I was at the gym 4-6 times a week. Use to weight lift 25/30 lbs. I don't know if your bones could be that effected in a few years of not exercising. I have exercised since I was 18 through pregnancies etc.. That was one reason I always thought I would be safe from osteo.

I appreciate your help!

Here is a paper that explains this problem in more detail:

http://www.hindawi.com/journals/jos/2012/323061/

The serotonin reuptake inhibitors were not really studied in depth
(or those studies have been withheld by the drug companies) when they went on the market.

Because serotonin is a biogenic amine which in the body does many jobs, there are potentials for problems and side effects which only now come to light.
The obvious ones on the GI system (since serotonin is a neurotransmitter in the gut) were first listed because they are so common. But the effects on bleeding (on the platelets) were only discovered as post marketing events. This new information on bone modeling is similar.

Here is an article explaining most of the actions of serotonin in the body:
http://www.medicalnewstoday.com/articles/232248.php

I certainly don't doubt it can cause bone loss. It's obviously just not as common as steroids and it's known history for causing it. You seemed to go from NO bone loss to osteopenia in one area and full blown osteoporosis in the other...in a relatively short time period. That is significant. So I don't think it came from just one source, particularly a source that you have to dig to find reports showing its relation. I really believe that you got this from the cymbalta AND steroids...and even just the aging process (HRT is fine but i doubt the same levels as a younger full hormone woman).

I can just see you going through this process to get off the cymbalta (that works well for you) and the bone scan might not improve. However, I do understand you having to do all you can to try and this should be considered. But I would look at the known source first, then secondary sources. Just my opinion, of course.

Hopeful... I am going to suggest you try something.

If you have some Sudafed PE or regular...brand or generic on hand, or want to buy some (generic is less $$). 30mg tablets for sudafed or 10mg tables for PE (phenylephrine).

Your Cymbalta has two components, a norepi reuptake and the serotonin one.

If you have NO problems with blood pressure etc, you could try one of the phenylephrines in the morning and see if your day is less painful. I discovered this effect when I had my sinus neck problem I had to take some of this medication to open my blocked sinus and I found it helped tremendously with my pain issues too. This would lessen the withdrawal of the norepi part of the Cymbalta. I think the discontinuance agonies for this drug that we see online are because of the dual action of the product. If you don't see any benefit, then just save them for a rainy day cold or sinus attack in the future.

Hi,
I thought about this a lot yesterday. I have an appt with my rheumo in April. I'm going to bring up the use of steroids with my IVIG. They r increasing my Rx. to twice a month so I'm getting 40mgs of solumedrol a month. Not sure I want to continue with that because of the osteo.

I'm not sure about the aging factor. I'm sure it doesn't help but my mom is 82 and doesn't have osteo. I've only been menopausal for 2 years. ( hope not TMI).

So much to consider and question:confused:

Thanks again for the help!

Just because your Mom is 82 and doesn't have it does not mean anything. She could develop it later on or not. Men also can have osteo. There are many, many things that can come into play for developing it. Steroids is just one thing. Here is just one site:

http://www.niams.nih.gov/Health_Info...porosis_ff.asp

Hi Mrs. D.
Thanks for the articles. As I'm writing this , my husband is on his way to the drugstore for the sudafed. PE. What you say makes sense. I'm going to give it a try. I'll keep u posted. Hopefully, it will help. I may not trying it till tomorrow. It is 2:30 pm here. I'm having so much trouble sleeping with all of this, I don't want to risk it making that worse.

I have been taking Benadryl that last 4 nights to sleep and realized the morning that's not the right answer for me. I woke with a major headache and congested sinuses this morning.

Thanks again for all u do!:hug: ps: no B/P issues

As I understand it Sudafed is sold at the pharmacy counter with some requirements in order to buy it. Maybe it differs state by state.

http://www.sudafed.com/know/buying-sudafed-ingredients

Sudafed PE is on the shelf-- contains 10mg
Of phenylephrine.

Sudafed is pseudoephrine 30mg and is behind
the counter and has to be signed for.

They are both decongestants.

I pretty much figured that. Thanks.

Just an update. I have not been on because of struggling so horribly with my withdraw from cymbalta.

I have been having terrible nausea, terrible headaches. Had a migraine two nights ago. Couldn't keep my eyes open. Went to bed at 9 and slept till 8 the next day. I have lightheadedness, dizziness, and extreme pain.

I spoke with the doctors office this morning. I was down to 30mgs and now I have to go back up to 60mgs every other day.

At least the thoughts of suicide have gone for now. Not that I ever would do it but I felt like I wanted to. Also a lot of crying.

Mrs. D I did try your sudafed idea. It actually did help a little with the pain. Thanks.
I remembered this morning at 1:30 that I could take dramimine for the nausea. It also put me to sleep which was great.

Hopefully, going back up to 60 every other day will help for now. I'm going to be reading all the post but probably not write anything rather than updates for a while.

I'm praying every night for all of us to get some relief for our pain.

Withdrawal
 

Cymbalta withdrawal took me by complete surprise. My Doctor told me to take a week off work as I had to stop the drug completely and have it totally out of my system before she could commence me on a new drug.

Work was chaotic we were facing the GFC crisis. I was responsible for developing the selection criteria for redundancies (including my own), researching job roles and compiling statistics from company personnel files of employees who met the criteria. I worried for everyone jobs, I felt I had to be sure not one individual was incorrectly treated. I cried almost non stop, walked around with a hot wheat pack on my head and my hand to my forehead. I felt sick and was an emotional wreck, everyone witnessed my every weakened moments and those in a position to be able to help all they did was talk about me behind my back rather than offer assistance.

It was one of the worst weeks of my life, BUT, I do know, that it was worth it, the following week one of the oldest gentleman workers came in to see me two days after being made redundant and bought me a bottle of champagne. He said to me, I know what you did for me. You see, his was one of the jobs that could be done without. I heard from other gloating cost saving senior mgt he was upset over where the company was headed under the new regional GM and he intended to resign. I caught him on the staircase going to the meeting and I said to him, Jim, follow my lead. He worked 7 hours a week doing the garden beds. As was my responsibility I lead the conversation. I launched in immediately stating I had heard the rumour he was going to resign but that he had changed his mind and intended to stay. Jim nodded, I went on and said unfortunately the job he fulfilled could be handled by the maintenance team and the role was no longer required, as such he qualified for severance pay and redundancy. Jim was 72 had a heart of gold and a true gentleman who had given many years service to the company, week in and out, never missing a week and the garden beds were immaculate. He didn't have a pot to P155 in, he and his wife lived in a caravan and life was tough. If he resigned as the finance director and RGM gleefully stated to me, he would get nothing, just his accrued holiday pay. They treated him with such disrespect and the way they behaved over the redundancies atrocious. so, I made sure he was treated well, by the time I was finished he got accrued holiday pay, 4 weeks severance pay, an additional week for every years service as he was over 45 plus the redundancy package. Jim got over $15k. Not bad for working 7 hours a week and intending to resign. Now I know only to well many would frown on me for what I did saying I didn't do right by the company. But, I don't care, on this occasion I did what was right for a human being. He deserved that payment, without that job and at his age, no one else would employ him and allow him to work those hours at the pace he did. I have no regrets.

It was the knowing I wanted to do right by everyone that got me through that week. I considered daily ending my life I was in the darkest and deepest of holes and felt never ending pain and nausea. It passed though, and two weeks later in the new drug I was able to look back. I feel for you, I know how hard the withdrawal is from that drug as I did it cold turkey with nothing offered to make it easier. It truly was work that got me through. I am intrigued to read about your osteopenia, I too didn't have it, but after cymbalta I developed it. I have never even considered it contributed.

I'm praying for you that by today things are easing a little for you and there is a drug replacement ready for you to take as soon as you are able. So sorry about the lengthy diatribe and waffle. It will get better I promise you. This all happened to me in 2008 and here we are now in 2014, I can look back and acknowledge it was tough and one day so will you. We are all amazingly strong people on here, daily facing extraordinary battles. You can get through this and come out the other side with a smile, even if it is a wry one. :hug:

Hi Pamela June,
That is awesome that you did that for the gentleman. The job you have must be extremely stressful!

All the symptoms you said you had are exactly what I'm going through. It's so difficult. I just told my husband today that the thought of suicide came to mind many times since I've tried coming off of this drug. Don't worry I would never consider it. Wouldn't do that to my family. The pain, nausea and feelings of depression just gets so bad.

I do have to say I am feeling better today. I went back up to 60mgs today. Guess it is just going to take much longer to come off.

As for the osteopenia and cymbalta connection, look in this thread for the sites Mrs. D. sent to me. There is a connection. Who would have thought.:)

Thank you so much for your inspiration and prayers!!:hug:

Thinking of you.

You will get through this. You are not alone.

Each day you will find it a little easier, or sometimes perhaps the same as the day before, but never worse! You are getting better. You will be better. Soon.

If it were me (and it will likely be some day) I know I'd fill a thread full of anger and sorrow, all those mixed up feelings we get when things don't make sense. And I'd know you would be reading my words with love and care.

If you need to scream, come here and scream at us. Over and over again if you wish. Absorbing your words of frustration, pain and despair is the one thing we can do to help you. And we want to help.

This is an incredibly accurate and poignant tale of what corporate life is like today. My husband deals with the "Sharks in Suits" every day, and I am thankful I don't have to. Just wow.

You can even TURN YOUR CAPS ON. :D

Doc

Still in my thoughts hopeful. :) Really hope you are catching some breaks, getting some sleep.

Mr Smith. Every time I read your signature I think of the "I'm your Pain" song from Alice Cooper. And I wonder how halarious it would be to hear his rendition now, the examples of pain would be quite different I'm sure. :D

Are you too young to remember the original? He said it in (nearly?) every episode...

Dr. Smith's Pain

Doc

Hi Aussie,
Thank you so much for your words of comfort and support. They are so appreciated!! This makes me want to scream at times. I'm having a little reprieve now. I went back up to the 60 mgs every other day. It helps somewhat with the horrible symptoms. I have also been taking. Dramimine every night. I hope it is safe to do that but I need it.

Dr. Smith,
Good idea on screaming in CAPS you may see some of that after this week when I go back to 30 mgs everyday!!! You make me smile!!!

To everyone,
Thanks so much for your kind words and support. I don't know what I would do without all of you. I would probably lose my mind!:)
Hopeful:grouphug:

I understand wanting to address the osteoporosis and the best way is to go to the source. But since you take more then one thing that can be the problem, and the cymbalta is so hard to get off of, have you considered just treating the osteoporosis?

If you still take steroids and even increase to every week vs once a month, then your osteoporosis numbers may not improve when you get off the Cymbalta...and may even get worse with the increase in steroids.

There are several options to treat osteoporosis...in the bisphosphonate class. I have had osteoporosis (from steroid use) from years. I cannot take oral bisphosphonates due to gastroparesis, but I get IV Reclast...just once a year and my numbers have greatly improved even though I must take IV steroids before each IVIG infusion. Just a thought.

Thank you for this information.

Actually, I just got home from having IVIG. I'm going to speak with my rheumo when I next see him about medication for the osteo. I was considering taking supplements for a year and have another bone scan and if it is worse then considering medication.
Thanks again:)

hopefull, hang on it will get better, I went through hell ,when I weaned myself off Lyrica. Sometimes things work, sometimes they don't, but we all keep trying. When I asked my rhum. about benfotiamine and lipolic acid, he said try it wont huirt you, its worth trying/

Hi Kitt,
To be honest maybe my mom could get it but it wouldn't be unusual at her age. Actually she only has one small area of osteopenia. She is a walker and always has been.

I read the article. Thanks! I have a few of the causes. I am kinda small, white and a woman. My calcium levels are 10. My D is low just ordered it. As for my estrogen. I been on replacement for a while. I don't smoke. Drink very infrequently. Until the last three years I was into a strong exercise regime including pretty heavy weight lifting. I have always eaten veggies and fruit and taken at least a multi-vitamin before I got sick.

Just saying I did mostly everything I could to avoid this from happening. That's why I was so shocked when they called to say my scan showed osteo of the spine.

I was the one in my family always encouraging my sisters to exercise and eat right. Do you know they use to laugh and tell me I was the one that would get sick! Turns out they were right. Guess you never know no matter what you do.:(

Hi Joe,
Thanks for your words of encouragement. It's always nice to hear from people who have gotten through the same thing. Gives me hope. I think it is just going to take me longer to get through this.

I do take R-lipoic acid but not benfotiamine. From all I read that is for those who have diabetes. I'll go back in the search and look it up.
Thanks again:)

Just a little update on my cymbalta withdraw. I'm currently taking 30mgs a day. I've done this for the past four days. It is continuing to give me headaches and nausea.

My rheumo ordered me some zofran and it helps a little. The pain is still really bad. Such as the stabbing pain, electrical saps and hot poker feelings. Hopefully, it will lessen after this is done.

Thanks for listening to my venting!
Hopeful

Hi everyone,
Just a little update. I am down to 20mgs a day of the cymbalta. I also started on the Wellbutrin 150mgs. I believe that is the lowest dose.

I'm sleeping a little better. The nausea is a lot less. The pain not so great but slightly better.
My emotional reaction is getting better too. Not as many tears. Yay!!!

Even though the cymbalta was for pain and not depression, I'm sure the Wellbutrin is helping a lot with the tears slowing down. Thanks Mrs. D.

Next week I'm going to start 20mgs every other day. And then every third day the following week. Hope to be off completely in three weeks. I hope I never have to go through anything like this again. I can somewhat understand why people who do drugs try to stop and go right back. They must be so sick.

Again, I want to say thanks for all the comforting posting and prayers! You are all great!
Hopeful

I am so glad you are starting to do better!! I have been thinking about you, so glad you posted!!

Hope you keep getting better every day!! :hug:

Thank you for the update. :)

Life does go on, but a few times during my day I find my thoughts turning to you, hoping you are starting to win the battle. Windering how you are doing. This certainly sounds like you are turning that corner. So good to hear.

Still a way to go, but I hope your journey gets better every day. Don't rush it if its too hard. A slow journey will still eventually reach destination.

Stay strong! :hug:

I am glad you are doing better, now, Hopeful...:hug:

So glad that you are doing better hopeful. :)

You sound so much better and more optimistic-praying it continues :)))

Hopeful, we are all here for you. I so understand what you are going through and you are incredibly brave to share your experience with us.

Your comment re addicts struck a chord with me. Yes, I can completely understand bad choices led them to unhealthy circumstances and a part of me wonders if the general population knew and understood the withdrawal anguish that comes from prescribed medication alone, perhaps they would be less willing to "just try" these substances for supposed "recreational purposes". The "it won't happen to me" surely must be a tiny lingering thought in the back of their minds?

I had absolutely no clue what I was going to face further down the track when I began cymbalta as prescribed to me for both depression and pain. The information leaflet really didn't give too much away about the withdrawal horror and nor did my psych. Xanax withdrawal was even worse.

Hang in there and know that we are all here praying for you :hug:

Thanks PamelaJune,
You are so right the pamphlet does not address the withdrawal actually it claims only 1% of people get withdrawal symptoms. That is why the FDA did its own research on it last year. They found 47-51% had severe withdrawal symptoms.
They basically lied!

I am so sorry you had to go through this with more than one medication.
I felt like I was getting so much better. I'm down to the 20mgs and it appears my tears have been replace with crankiness by mid afternoon. My poor husband!! :hug:
Hopeful

Hi everyone,
Today was my first day with no cymbalta. I'm going to take 20mgs every other day this week. So far so good just slight nausea.

I have soooo much more energy in the last week on 20mgs. I'm so happy about that.
Mrs. D did tell me the Wellbutrin could give me energy so maybe it is a combo

The severe headaches I had a few weeks ago are COMPLETELY gone!!

I'm sleeping better too. I'm wondering if that could be the vitamin D3. I found out I was deficient.

One more week and I'll be completely done with this. Thank God!

I want to say thanks to all of your support through this.
Hopeful