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Cymbalta Warning: Discontinuing May Result in Severe Withdrawal Symptoms

  [ 162 votes ]   [ 12 Comments ]
By Karen Lee Richards • www.ProHealth.com • March 10, 2014


Cymbalta Warning: Discontinuing May Result in Severe Withdrawal Symptoms
In 2008, Cymbalta became the second drug to receive FDA approval for the treatment of fibromyalgia. It was classified as a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant. At the time, the FM community was excited to have another medication available that would hopefully reduce pain for at least some FM patients. Little did we suspect the misery that could result when those patients wanted to stop taking Cymbalta.

The medical community has long known that abruptly discontinuing any antidepressant can result in Antidepressant Withdrawal Syndrome. That's why patients are (or should be) strongly urged not to suddenly quit taking an antidepressant but to talk with their doctor about gradually tapering off the medication.

Cymbalta Discontinuation Syndrome

However, neither physicians nor patients expected the severity of withdrawal from Cymbalta. In fact, it's bad enough to warrant its own diagnosis – Cymbalta Discontinuation Syndrome. An FDA advisory committee report about Cymbalta Discontinuation Syndrome states, “Much anecdotal evidence has accumulated documenting the injury, distress and life management impacts caused by discontinuation of Cymbalta. The effects of discontinuation can be severe and extend for weeks or even months.”

As you read through patient descriptions of their Cymbalta withdrawal experiences, it's not uncommon to see terms like “horrific,” “a nightmare,” and “going through hell.” Some of the withdrawal symptoms described include:

“Brain zaps”
(electric shock sensations)
Extreme mood swings
(“irritability that quickly turns to rage”)
Suicidal thoughts Paranoia
Dizziness Confusion
Nausea and Vomiting Limb pain
Headache Fatigue
Nightmares Insomnia
Diarrhea Anxiety
Excessive sweating Agitation
Involuntary crying or laughing Hypomania
Tinnitus Seizures

The Discontinuation Dilemma

When it comes to discontinuing Cymbalta, the prescribing information says, “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.”

While gradually reducing the dose sounds like a reasonable approach, there is one very big problem. Cymbalta is only available in three dosages: 20 mg., 30 mg. and 60 mg. To complicate things even further, Cymbalta is a capsule, not a tablet that can be cut in half. Adding insult to injury, patients are warned, “Cymbalta...should not be chewed or crushed, nor should the capsule be opened and its contents sprinkled on food or mixed with liquids.” So although Cymbalta manufacturer, Eli-Lilly, recommends gradually reducing the dose, there is virtually no way to actually do that.

What Can You Do?

If you're currently taking Cymbalta and want to stop, talk with your doctor about developing a discontinuation plan. Make sure your doctor is aware of how severe Cymbalta Discontinuation Syndrome can be and discuss possible options for treating the various symptoms that you may experience. Some doctors have tried switching patients to a different antidepressant that is easier to taper off of and then treating other symptoms with appropriate medications (like antiemetics, antihistamines, etc.) through the withdrawal process.

If you are contemplating whether or not to take Cymbalta, be aware of what you're getting yourself into. Trying to get off of the drug may leave you feeling far worse than the fibromyalgia symptoms you're trying to relieve. Thoroughly discuss the pros and cons with your doctor before making a decision.




Join the Discussion Post a Comment 


Exact same problem with Pristiq, when are drug companies going to be held accountable?
Posted by: aryiella
Mar 11, 2014
I am on Pristiq 50mg once a day and have been for a few years. I take it for depression and fibro. It is not helping my depression anymore but there is no way to get off of it! And so I am stuck on this stuff and cannot try any other meds until I am off this one! There is no smaller dose than 50mg and the tablet is time-released and cannot be cut or it will not release the medicine in the proper way. I would prefer to not switch to Effexor as a replacement due to the additional side effects I had when on that previously. Pfizer is extremely irresponsible for putting a drug out like this that CANNOT be properly tapered without EXTREME discontinuation symptoms. I have been contacting attorneys, but nobody is interested.
Reply Reply

 
Phone the FDA 1-800-FDA-1088 Mon–Fri between 8:00 a.m. and 4:30 p.m. EST
Posted by: Altostrata
Mar 12, 2014
Also make a complaint to Pfizer, Pristiq's manufacturer: (800) 438-1985 in the US.

Rxisk.org is also collecting complaints about Pristiq.

If you think your doctor has been remiss, file a complaint with your state medical board if you're in the US.

 


Please heed this article
Posted by: tbrhslp
Mar 11, 2014
I can attest to SEVERE withdrawl symptoms with Cymbalta. Without going into detail, please know that one should absolutely consult their physician before discontinuing and be prepared to have family or friends able and willing to help keep an eye on you during the discontinuation.
Reply Reply

You can open the Cymbalta capsules and count out beads
Posted by: Altostrata
Mar 12, 2014
You can indeed open the Cymbalta capsules and count out the beads, but you cannot dissolve Cymbalta in anything.

The gelatin capsule doesn't do anything. The coating on each bead protects it from being dissolved in your stomach. This destroys the drug. Cymbalta is absorbed further down in your intestines.

Many, many patients have found this is the way to taper off Cymbalta. Some people are so sensitive to dosage reductions, they can reduce only a bead at a time, by week or even by month.

You can search the Web and find many, many reports of severe Cymbalta withdrawal syndrome, and many people tapering by the bead-counting method because it's the only way to go off gradually enough.
Reply Reply

hell
Posted by: catz902001
Mar 12, 2014
I was on 60mg twice a day for 7 yrs along with blood pressure meds and sleeping pills. One day I just decided that I was sick of taking all the meds and I stopped cold turkey. It was hell for a few weeks and my husband and family really suffered with me. But I did it and by adding a few supplements I did really good for about a year. But we had a death in the family and all the stress set off a horrible flare. Now I am back on all of them again. I have been in a bad flare for 2 months but as soon as it breaks, I am going to try again
Reply Reply

Same story, different med
Posted by: Juloo
Mar 13, 2014
I'm in the process of going from Effexor (venlafaxine) to Welbutrin (bupropion). While ramping up with the new med, the doctor had me slowly reducing the Effexor from 150 to 73 to 37.5, then opening the capsules and using half the grains, a quarter, etc.

After a couple of weeks of the last step, I stopped all Effexor. I was relieved to have weathered the switch so smoothly.

Then about a week later, 'discontinuation symptoms' like those listed above set in. Within a few days, I was very emotionally changeable (so not me) running between anger and tears daily. And the brain zaps! It was no different than the weekend I was traveling and had forgotten to bring my meds...from 150 to 0. Awful! Except that this time the jump had been from about 15 mg to 0 - and with support from another med!

Suspecting this might be the case, I counted out a few grains - I figure altogether under 1/10 of the 37.7 capsule, so under 4 mg - and after fits and starts, take this daily until I can see my doctor. I may need to be in this holding pattern a little longer and taper grain by grain. Even several months!

After reading this article, I did more research online and found a study that suggested those tapering off Cymbalta are about 3 times more likely to experience this sitation than Effexor users. My most sincere sympathies to all here undergoing this transition with this reaction. I wouldn't wish it on my worst enemy.

Effexor was a god-send
Reply Reply

 
Hmmm
Posted by: Juloo
Mar 13, 2014
I don't know why that 'Effexor was a god-send was dangling there...although it was true when I began and for the 7 years I took it until it gradually stopped working. But it isn't giving up the ghost quietly!

Edit...150 to -75- to...

I'm posting from an iPad, so entering text is sometomes hit and miss...

 


Effexor Withdrawal
Posted by: mrswoody
Mar 16, 2014
I took Effexor for years too. I started on it right after it came out when they were still figuring out the dosage. I was on 450mg a day for 4 years when I decided I wanted to stop it. I tried telling my doctors that I had "electric head"(my name for the brain zaps)and horrible anxiety, nausea, etc. but they just didn't believe me. My doctor said to me "you are the only person I know who could get addicted to an antidepressant". After the DSM finally listed the withdrawal symptoms and I showed it to my doc, he started tapering me off. It didn't come in a capsule then so I had to cut up the pills once I got to the lowest dose pill which was 37.5. I got all the way down to a little crumb and I just could not get completely off. It took a full year of reducing it by one a week, then every 5 days, 4 days, etc. before I was finally able to get off it. That was 10 years ago and I still have "electric head".

I recently went on Cymbalta for depression and fibromyalgia but after reading this I am not taking it anymore.
Reply Reply

Lily website
Posted by: Zachary1018
Apr 4, 2014
So I go to the Lily website because I could swear they tout that it isn't a narcotic. If you go to the products page you can click on every product. Except Cymbalta. Try it and tell me whether or not I'm crazy. If it is blocked out, then why?
Reply Reply

 
Reply to Zachary1018
Posted by: katkar
Apr 4, 2014
You're right. I couldn't click on Cymbalta either. You can still click on the Prescribing Information and the Patient Information but not on the product name. I"m not sure what that's about.

I can tell you, however, that Cymbalta is not a narcotic; it's an antidepressant. Most of us tend to think of withdrawal as only happening when someone stops taking narcotics (opioids). But there are a number of other drugs that result in withdrawal symptoms if you stop taking them abruptly. That's true of most antidepressants. Judging from what many patients and some doctors have said, though, SNRI antidepressants in general and Cymbalta in particular seem to have more severe withdrawal symptoms than some other types of antidepressants. So it's important to taper off of those medications as gradually as possible. – Karen

 


Cymbalta Withdrawal
Posted by: JanisMarie
Apr 9, 2014
I was on Cymbalta for fibro for 18 months, and it gradually became ineffective. It took MONTHS to get off, which I did very gradually. The brain zaps drove me crazy and frightened me. Then I developed Periphial,neuropathy, since my B12 was extremely low. I'm missing the intrinsic factor in my gut which breaks down the B12 from food. Causes pernicious anemia, which used to be fatal, until B12 shots could be given.
Well, the neuropathy was absolutely horrible...made fibro seem like a walk in the park! Of course, guess what relieved the neuropathy? Yep! Cymbalta. It has now been over 18 months and once again losing it's effectiveness. Now I'm going to go through the misery of withdrawal all over again.
I used to be such a healthy person:(
Reply Reply

Oh my gosh
Posted by: Drifter110
Jul 22, 2014
I went to my rheumatologist today to discuss the next steps as in the past 4 months I have weaned off of 100mg Pristiq and was switched to 60 of Cymbalta for my fibromyalgia. After two weeks on Cymbalta I did not like the side effects and she had me wean off by taking every other day then every two days then three days then none. In speaking with her of the terrible side effects, suicidal thoughts, extreme anger and stomach issues etc she told me I needed a psychologist as I have sever mental issues and NEVER had she EVER heard anyone have these symptoms and that I was probably Bi-Polar and should switch from my shitty therapist to a psychologist immediately. She suggested I find a psychologist immediately as must have a sever imbalance in my brain that would cause these side effects and there was no way these drugs caused me to feel that way.
Needless to say, I am not going back there. So happy I found this page as I know I am not bi-polar or insane and think my doctor was way out of line. Thoughts?
Reply Reply


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