Update on Cymbalta Tapering, Dr. Pundy and Chin Strap

Good afternoon on a rainy day: This is my update. I went to see Dr. Pundy last night, psychiatrist, who had to taper me off Cymbalta the right way for back pain. My Primary apparently wanted to drop me off at 30 mg. This physician is having me compound the Cymbalta to 15 mg (half) for 1 whole month. Next month 10 mg or 7.5 for a whole month and then 5 mg for a whole month and then off. So 3 months total. Instead of 1 month. I stopped going to my Primary and found another one. She agreed with me too but did not know the exact "tapering formula."

Chin Strap: I use the AirFit nasal pillows P10 and use a heavy chin strap. I tried not using the chin strap last night for the first time and this was not good for me unfortunately. I woke up with a mouth that felt like glue had been stuck on it in the middle of the night. I am taking Melatonin 200 mcg before I go to bed (didn't help that much) and woke up at 230 am for no reason, and should have taken another 200 mcg but was too tired and thought I could fall asleep on my own. I have used everyone's suggestions on here regarding Tapering Cymbalta and even the name of the doctor who happens to work at the same hospital as me, Chin strap, and Melatonin. Thank you all for your help, and I have been helping members as well. Thank you again.

Are you sure the strap is doing a good job? They're great at keeping your jaw closed, but you can still lose a fair bit of air through your lips. If that's not an issue, I'm sure others more familiar with the meds, etc. will chime in here.

Yes, the chin strap is what I need. I tried last night without it, and although I still get air going out of my lips with a chin-strap, it is better than no chin strap. I suggest to anyone opposed to using a chin strap, please try it. It is cumbersome and somewhat of a hassle, but it stops the air from going out but not 100%.

Luthie2006: Sounds like you are on the right path and using all the medical help you can get. For other folks stuck in a drug rut this may be useful:
People tapering off a drug like Cymbalta, which the OP mentioned (others drugs include: benzos, sleeping pills, opiates, AD meds and so on) often think it is easier than it actually is. This is because going from full dosage in one or two months down to the 50% level is relatively easy. Next, it's a bit harder going from 50% to 25%, but certainly doable for most people. The toughest part, disparagingly so, is often getting from 25% to 0% and that's because you begin to encounter complex rebound reactions (eg. the original insomnia or anxiety attacks return), plus psychological complications can occur as your body adjusts to life without the drug in your system. On the other hand, some people can drop just about any drug in a month... tho results may vary. Who knows why? I, for instance, can shake the flu in a couple of days (dumb luck?)

Some experts and new studies claim that the last 10% step down is the hardest. Reflecting that, the current progressive recommendations for tapering off your dependent/serious drug are now much longer periods of time depending on your psychological makeup; length of time using the drug; your body chemistry; and most importantly your general state of health. Often people in these last exit stages think it's okay to go back to their drug (or another brand in the same class), reasoning that it's safe to use it for emergencies - or as a one-off for a well earned vacation from sobriety. Yes, the mind can play evil tricks on you and even a healing brain can be a dangerous brain. Some experts recommend up to six months of tapering for certain individuals who are dependent on really insidious drugs.

I know it's hard to read this, however my advice is to be prepared for the worst and hope for the best, as they say. Your doctors are an important part of the equation, which can’t be emphasized enough. Talk to them about your plans to taper off. And good luck.

Sir NoddinOff wrote: The toughest part, disparagingly so, is often getting from 25% to 0% and that's because you begin to encounter complex rebound reactions (eg. the original insomnia or anxiety attacks return), plus psychological complications can occur as your body adjusts to life without the drug in your system. Dieters can confirm these principles.

Hi Luthie... I agree 150% with what SNO said... especially the above. Your plan of action is certainly better now, but I still don't think you're going slow enough. You may want to think about doubling the length of time to stay on a particular dose. That said, maybe you'll be one of the very lucky people who have no trouble tapering any dose.

If you haven't already, read (or reread) the site that 49er posted in your original thread. Keep us posted on your progress.

Thanks SirNoddingOff and ems: I think this should be ok, or at least I hope so. Who knows? I am on a 3-month taper down plan and I will try that. It's a risk not to go longer, but I am hoping it should be fine. The new psych told me that "millions of people" taper off of this even a little faster. So I am fine with a 3 month taper. If at any point, I get sick or feel bad, I will let him know and perhaps I can stay on it longer. I so appreciate the comments. I never would have known any of this.
And back to the chin strap.

Luthie, I don't have any expertise to contribute on this issue, I just wanted to say that I enjoy reading your updates and wish you well in your taper and your other issues. I tapered off Effexor years ago, and it sucked.

I also was someone who stopped mouth breathing by <whispers> taping, but I know that's not for everyone. It worked pretty well, and I don't need to do it any more.

I should have paid more attention to this thread than my a Doc.
I asked him if I could taper off of Metorolol which I had been taking for almost 4 years. I thought I was taking it for Atrial Fibrilation.
He said no problem just stop cold turkey. I did.
My blood pressure jumped all over the place, as high as 170/110.
I said to myself "self, this is not good". I waited about a week, little improvement.
I started on half dose for a week. Not much change.
Now I am back on full dose and still see 150/90 or 140/85.

First I wish I had known the purpose of the drug. When I started a bad day was 140/85 with no drugs. Typical was 120/80 or lower.

Now I am confused and disappointed.

I have not had any symptoms beyond what my blood pressure cuff tells me, throughout the 4 years.

bwexler wrote:I should have paid more attention to this thread than my a Doc.
I asked him if I could taper off of Metorolol which I had been taking for almost 4 years. I thought I was taking it for Atrial Fibrilation.
He said no problem just stop cold turkey. I did.
My blood pressure jumped all over the place, as high as 170/110.
I said to myself "self, this is not good". I waited about a week, little improvement.
I started on half dose for a week. Not much change.
Now I am back on full dose and still see 150/90 or 140/85.

First I wish I had known the purpose of the drug. When I started a bad day was 140/85 with no drugs. Typical was 120/80 or lower.

Now I am confused and disappointed.

I have not had any symptoms beyond what my blood pressure cuff tells me, throughout the 4 years.

bwexler... something just doesn't sound right to me. Any chance you could see another doctor? It is my understanding that you can't "just stop cold turkey" with this type of drug.

Doctors and pharma REALLY hate to acknowledge that their drugs have to be tapered off of.

archangle wrote:Doctors and pharma REALLY hate to acknowledge that their drugs have to be tapered off of.

what? I don't understand... what do you mean someone wants to "stop taking" our drug? what do those words mean?

Luthie2006 wrote:Thanks SirNoddingOff and ems: I think this should be ok, or at least I hope so. Who knows? I am on a 3-month taper down plan and I will try that. It's a risk not to go longer, but I am hoping it should be fine. The new psych told me that "millions of people" taper off of this even a little faster. So I am fine with a 3 month taper. If at any point, I get sick or feel bad, I will let him know and perhaps I can stay on it longer. I so appreciate the comments. I never would have known any of this.
And back to the chin strap.

Hmm, Dr. Pundy certainly is much better than your old PCP regarding tapering but the line that millions of people taper faster is really getting old. I do hope that you will be honest with him if you start feeling sick or bad.

Even slow withdrawals aren't going to be symptom free. But the idea is to taper slowly enough so they don't interfere with your quality of life. I am not sure why that is so hard for doctors to understand.

Thanks for the update Luthie and best of luck to you.

archangle wrote:Doctors and pharma REALLY hate to acknowledge that their drugs have to be tapered off of.

I think if a doctor can't adequately explain how he/she will taper you off of a drug that is prescribed should not be allowed to write a prescription for the med. And sorry, if he/she says, we'll cross that bridge when we come to it, should be looked at with great suspicion.

Kudos to Luthie's new PCP for admitting she didn't know how to taper Cymbalta but that makes me wonder how many doctors are prescribing this drug with no clue as to how to taper it off?

And BWexler's doctor telling him it was ok to cold turkey a beta blocker is a disgrace when it is well known that drug has to be tapered. Unbelievable.

49er

Any drug can become a pharmacological prop that holds up your body. Kick the prop from a leaning building, what happens? The building collapses. Unless you have fixed the underlying problem, gradual withdrawal should be the standard method of stopping treatment unless you are stopping because of side effects or it is not working.

49er wrote:

archangle wrote:Doctors and pharma REALLY hate to acknowledge that their drugs have to be tapered off of.

I think if a doctor can't adequately explain how he/she will taper you off of a drug that is prescribed should not be allowed to write a prescription for the med. And sorry, if he/she says, we'll cross that bridge when we come to it, should be looked at with great suspicion.

Kudos to Luthie's new PCP for admitting she didn't know how to taper Cymbalta but that makes me wonder how many doctors are prescribing this drug with no clue as to how to taper it off?

And BWexler's doctor telling him it was ok to cold turkey a beta blocker is a disgrace when it is well known that drug has to be tapered. Unbelievable.

49er

I agree with everything you said. The sad thing is that "maybe" there are a handful of doctors in the entire country who actually get the importance of slow tapering. You would think that after years of hearing/reading/knowing the importance of slow tapering a bell might go off and they might give a s**t. The money involved here is off the charts.