I’ve used a lot of time and space on this blog writing about anti-depressant withdrawal. Back in 2017 (and 2018 and 2019 and 2020…), I wrote about Effexor withdrawal, which was pretty hellish. More recently, I’ve complained about Cymbalta, and that’s today’s topic as well.
Quick backstory: I used to be on a high dose of Effexor, and I found it really hard to come off. Tabitha, my former psychiatric nurse, worked with me for more than three years to help me come off it, and along the way, had me start taking 40mg of Cymbalta (aka duloxetine). She told me that it would affect me somewhat like the Effexor, so it would be a substitute and make it easier to come off the Effexor. Then later, I could taper off the Cymbalta, and that would be much easier.
I don’t know why she thought it would be easier to come off the Cymbalta. For me, at least, it hasn’t been easier. Last summer, on Tabitha’s advice, I reduced my dose by 25 percent, from 40 to 30mg per day. After seven weeks, during which the tingling and negative thoughts and despair and discomfort and sleep disruption did not improve at all, I saw a different psych nurse and ended up going back to my full dose of 40mg.
But I still want to stop taking this drug. I’m convinced that I don’t really need it anymore. I also feel that it makes it harder to take medications I DO need, because both it and Effexor seem to interact with other meds for me (that is, when I try a new medication for something else, I often develop side effects that include tingling and other effects that I get from withdrawal). And I’ve come to resent these medications and don’t want to pay for them or depend on them in any way. It’s completely possible that they are great for other people. But for me, no, I don’t think so.
Anyway, now that the days are getting longer again and the sun peeks out every now and then, it’s time to try again. This time, Kelly (new psych nurse) recommended that I go back to the method I used to get off Effexor: open up the capsules and take out just a few beads of the medication at at time.
“You’ve already shifted to taking half your dose in the morning and half at night,” she said. “Now, before you take the nighttime dose, open the capsule and take out 10 percent of the beads.”
“Ten percent?” I asked. “That might be too much. Remember last year, when I went down 25 percent, it was way too much for me.”
“I remember,” Kelly said, “but you won’t be changing your morning dose at all, so this is just a five percent reduction overall. It’s pretty conservative. I think you’ll be fine. We’ll have you stay at that level for a month, and then we’ll check in and see about doing down some more.”
Okay, I thought, that sounds reasonable. So beginning last Thursday evening, I opened the capsule over a little silver plate and painstakingly counted the 69 tiny beads. Then I put 62 of them back into the capsule, not a simple task, since they are so small that it’s easy to drop a couple on the floor. But I managed. Friday night, I counted 71 capsules and again removed 7 of them.
By Saturday morning, that familiar and incredibly unpleasant tingling feeling was showing up in my arms and legs. More alarming were the intrusive thoughts of self-harm that appeared, seemingly out of nowhere. I should burn myself, my brain told me. And it went on from there.
No way, a healthier part of myself responded. We are not going down this road again. It took me a long time to stop the self-harm. I lost enough time to the maddening tingling. I am getting too old to waste my life this way.
I emailed Kelly:
I know you probably won’t check your email on the weekend, and I don’t expect you to respond. I’m just letting you know that the effect is big and dramatic, and I don’t want to just let it be this way. Tonight I am going to change to an even smaller reduction of the medication and see if that is more tolerable.
Saturday night, I painstakingly counted out 68 beads and removed three of them. Sunday, I didn’t bother to count the beads and just took out three, and I’ve continued this since then.
And it was the right move. I still have a little bit of tingling. I can tell that my focus and concentration are off. I have needed to take a nap each day; my energy is really low. But the tingling is low and not crazy-making. And the thoughts of self-harm have taken themselves for a walk somewhere far away, thankfully. So this reduction, of about 2.5 percent, this seems to be tolerable.
This must sound really crazy to anyone who hasn’t had a similar experience. I told Kelly, “I feel like the princess in the story, the one who sleeps with a pea under her 10 mattresses and complains about how terribly she slept.” I am very sensitive to the accusation of being overly sensitive or complaining too much. My first husband used to say that about me, when I’d cry after he’d treat me like shit (rolling my eyes now at the memory).
Maybe it IS a little crazy to be so sensitive. But so what?!? That’s my honest experience. I am not making it up or exaggerating. Something about the way duloxetine, and before that venlafaxine, work in my body makes it extremely uncomfortable and even potentially dangerous to reduce the dose. I’ve decided I’m going to honor both my desire to get off the damn drug and my need to take it really slow. I’m going to take care of myself.
(After all, lovely little Hannah, now five months old, needs her grandmother around to dote on her, right?)
IMAGE CREDIT: Photo by Christina Victoria Craft on Unsplash.com
Sage Burning 
Hannah! 5 months, how adorable!
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She interacts and laughs and makes funny sounds and cuddles. I love her so much!
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You are NOT extra sensitive. You are NOT crazy. Human brains were never meant to tolerate this kind of medication! Your ex also sounds like an a$$, good riddance.
I have some really good resources for you, which will help you understand what we’re up against. I’ve been on a long journey myself. Almost 30 years on SSRIs (Effexor, yes, I’m afraid), among others.
The first one is Robert Whitaker – of Mad in America, an American medical journalist. Mad in America is the name of his podcast, website, and YouTube channel. He was the start of the giant movement of anti-psychiatry in the U.S. His first book, also Mad in America, lol, digs deep into how mental illness became a “chemical imbalance” and why that is FALSE. He also wrote the article that saved my life. If you check out the article, it explains quite clearly WHY it’s so hard for us to try to get off these meds.
https://www.psychologytoday.com/us/blog/mad-in-america/201106/now-antidepressant-induced-chronic-depression-has-name-tardive-dysphoria
madinamerica.com (good info, articles, blog style)
The second one is Joanna Moncrieff – she is a British psychiatrist and co-founder of cepuk.org, which is Council for Evidence-Based Psychiatry. Another founder is James Davies, who is really interesting to listen to. On their website is a ton of info, including video testimony from people who came off meds and their journey. This summary was really helpful to me (there is a spot where it says “link” to download it):
http://cepuk.org/unrecognised-facts/
cepuk.org
The third one is Peter Breggin. He is an author and has a YouTube channel. He has written quite a few books about withdrawing from psych meds, which were really helpful when I was deciding what to do. I got the 10% rule from him, and also the idea that everyone is different. I knew the difference between relapse and withdrawal. I also had one time where I tried a taper and had to go right back up because it was too much – we had a flood and I couldn’t deal with the stress AND the taper. I was a mess. I went back up, and I was fine. You go at your own pace. Also, some medications are more difficult. Effexor is said to be the hardest to come off.
Those are my top three.
I want you to know that I read about a mental health practitioner, I think he was a psychologist, who had to do the EXACT same thing you are doing to come off his SSRIs. I am sending you this information because I want you to know – THIS IS NOT YOU FAULT! We spend so much time blaming ourselves, because we’ve been told we’re “too sensitive’ (I heard it my whole life), we have a “chemical imbalance” (it turns out that’s bull$h*t), it’s genetics (PROVE it), blah blah. It turns out most of it is TRAUMA based. Yep. More and more people, REAL thinking people, are coming out and suggesting psychology and psychiatry need to be overhauled. Not based on illness, not based on medical “science”‘ lol. No, they need to be trauma informed. Heck, when I needed that the most, I was MORE f**king traumatized by people who were NOT informed!
I know this is a lot. There is a lot more, I’m a tech/info junkie, lol, but it’s a good start. 🙂💯
Hugs and Prayers for strength as you work on your taper. I need to get started on my next one. Been putting it off, waiting for a break in my life stressors. Lol. Never gonna come, is it? Nope. So…. I have to get myself to my best place and do it.
Namaste
Elle
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Elle, I want to thank you so much for this wonderful collection of resources. I wasn’t familiar with any of them. I KNOW it is going to help me to go through these things and learn. Many, many thanks for taking them time to share them. Namaste, Q.
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I’m glad to share what I’ve discovered. If anything I do eases someone else’s journey – my life is complete. That’s my mission – to help people who are struggling like me.
I’ve really enjoyed reading your blog. You write with a unique voice. You are so open, vulnerable, and detailed. The insight you have regarding your own psychological processing is remarkable. I am having a tough time figuring out what the heck I’m feeling other than good, bad, fine, or ok. Lol. I’m more of a cerebral person. I got stuck in my head quite a few years ago decided I like that a whole lot better than depression. So….. I’m still stuck there.
Kinda tells you how powerful our minds are. 😵💫
Elle
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I’m really sensitive to medication too, despite how I’ll need them for probably a long time while I continue to do therapy and other self directed stuff to heal my trauma. When the time comes, I hope I won’t have to count tiny beads inside capsules!
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I hope you won’t have to either! But if you do, you can imagine that I’m next to you, keeping your company, reminding you to use a dark plate and a good light so you can see all the tiny beads!
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Haha, yeah, those beads are soooooo tiny indeed! ❤️
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I would absolutely hate having to count them all out like that! Good job for doing what’s best for you though.
I had a rough week last week and relapsed with the self harm so I totally understand your feelings. It’s not a road anyone wants to go back down.
Isn’t it such a fun age??? My little guy just turned 4 months today 😍 I love it
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Hi Alana. I’m also having a self-harm issue. I have a rash, I’ve had it since late summer of 2021. I think it’s fungal/yeast. I pick at it. For hours sometimes. It’s all over – my face, under my breasts, under my tummy, groin area, back, shoulders, feet, toenails, hands, fingernails…. Sometimes I pick too deep and I bleed, cuz my skin is really thin. I have no idea why, but it changed around the time I got this rash. I pick with tweezers. I have stuff coming out of my pores – I pull it out.
I guess this is called excoriation. Whatever. You know the shrinks have to name everything. I call it having a rash and picking my skin cuz I hate having a f**king rash. Apparently no, “normal” people don’t pick their skin for hours…. with tweezers.
Congrats on the new baby!
You said you relapsed? So that means you were able to quit. Awesome! Be proud of yourself. Reward yourself for your accomplishment. Relapse is normal, especially during times of stress. So, you start again. Eventually, you won’t have to start again. You’ll know when you’re done for good. 🙂
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It sounds like your little guy is just four or five weeks younger than my darling granddaughter. Many congratulations to you, and much admiration for the very, very hard work of raising three small children. I know you have very rough days at times–well, any parent does, and the addition of health issues for everyone and mental health struggles for you, it’s a lot. But it’s very apparent that you notice the sweetness of your boys and that you overflow with love for them.
I’m sorry you relapsed. That can be discouraging, but don’t forget that it’s NORMAL and happens to all of us. Please don’t judge yourself. We are all human, and being human is a fucking bumpy road sometimes.
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