Wearing off fast...

[Mark13]

...so I think I'll be changing my meds again. I've got an appointment with my favourite GP in 9 days time - till then I'll keep taking the duloxetine at 60mg.

This past week, with no major stress at all, has seen a big increase in my agitation and physical anxiety symptoms (shakes, cold sweats, chills, tight throat etc).

On the plus side I'm not ruminating or obsessing as I once was but I was off sick today because the anxiety was so bad. My only mental fears at the moment are caused by the physical symptoms and the belief the drug is "pooping out" on me.

It was at the same 4 month point that pregabalin stopped working too, although I was up and down on that where I've been constantly "OK" on duloxetine.

I want to change before it gets worse though. No point in waiting until I go back to square one.

[SarahH]

Mark,

So sorry this is happening to you again....it must be very frustrating for you.

Have you any ideas about what next?

Sarah

[Mark13]

Hi Sarah

I've discussed it with the GP in the past as I don't like to think I'm out of options.

Next step I think would be to come off duloxetine, then increase my mirtazapine, a few days later adding amitriptyline as needed for insomnia.

I never managed more than 2 weeks above 15mg on mirtazapine in the past because of the insomnia returning, but as I've gone through most drugs and combinations now, my GP is happy to prescribe these 2.

I always see the same Doc if I can because others aren't so willing to use augmentation, combinations or just to experiment :)

[SarahH]

Hope it works Mark.......maybe Zopliclone if necessary! xx

[*willow*]

Hi Mark sorry to read the Duloxetine isn't working for you anymore. I know how frustrating it is.

I hope you get your meds sorted out soon, and if you come off the Duloxetine, the withdrawals aren't too bad.

Take care.

Lynn

[Mark13]

I hope you get your meds sorted out soon, and if you come off the Duloxetine, the withdrawals aren't too bad.

Take care.

Lynn
Glad to hear that Lynn. As I'm not looking forward to it. Wish I could just jump straight to the new regime (whivch I have in the past).

But as I'm on mirtazapine, and I want to go to amitrityline before upping the mirt, you're supposed to cross-taper, but that'll be out for me as it'll mean me being on 3 ADs at once, albeit at low doses - a real recipe for serotoning syndrome :scared15:

So I presume I'll have to fully wean off duloxetine first and take just mirt for a few days before introducing the new drug.

This is the bit I hate, being in limbo. Knowing I'll be coming off a drug, but can't taper myself until I've OK's it with the GP and I'll need lower doses prescribing, as I'm certainly not opening the capsules as some folk do and counting the little balls :ohmy: :D

---------- Post added at 23:12 ---------- Previous post was at 23:07 ----------


Hope it works Mark.......maybe Zopliclone if necessary! xx
Thanks Sarah.

Adventurous though my GP can be, he's pretty much against benzos and the new Z non-benzo drugs too.

He's pretty good, but wary when it comes to combining drugs he's not used to giving out.

That's why he agreed recently to try me on amitriptyline with mirt if the duloxetine didn't work out as he knows the drugs well and doesn't anticipate any problems.

Whether I'll feel better I don't know, but the side effects should be tolerable as I'm fine on 15mg mirt, was fine at 30mg too for a couple of weeks till the insomnia made me reduce it. And I've been on TCA's before.

Just impatient to get started and still off work but expecting to be back on Friday at the latest - got to push myself to get back to the everyday world :)

[*willow*]

The withdrawal for me has been yuk. I was never intending to come off meds, but after 2 days of nothing, the withdrawal hit, and I felt absolutely terrible my stomach was churning and acidy. I couldn't face starting the Reboxetine, so I just thought I'd give it another day and see, and it just carried on from there, waiting and seeing how my stomach felt day after day, until I decided I wasn't going to start the new meds

It's been 2 weeks now and I feel crappy one day, then next I feel okayish. My main symptoms are feeling sick I can't eat much or drink a full cup of tea (that probably ads to the way I feel, because I do like a cuppa lol), headaches and sometimes feeling as if I've got the flu but without the sneezing and coughing etc.

On the plus side though I have 2 symptoms that I'm not too distressed over. 1 is because I can't eat, my podgy tummy isn't so podgy, and I'm usually a 20 plus a day smoker, now I'm down to about 13-14 a day and I can't smoke a whole cigarette without putting it out at about halfway:yesyes:

I hope your withdrawal goes well, and your switch to your new meds also. Just try to take the taper slowly and don't do what I did:wacko:. Slowly slowly catchy monkey.

This post has turned out to be long, I'm sorry about that.

Take care.

Lynn.

[Mark13]

Thanks for the info Lynn.

I'm hoping that my withdrawal will not be as bad as I fear.

From scouring the web there seems to be some anecdotal evidence that cod liver oil can lessen the brain zaps (I take this anyway, but I'll double up).

Also, I'm also hoping that the mirtazapine I take will lessen the effects.

I've even read of fluoxetine being prescribed short term, because it's a relatively easy switch and prozac tapers itself due to it's huge half-life.

I'll see what the Doc says on Thursday, I know he's against benzos so that route's out. He did warn me withdrawal was bad which is more than I can say for most GPs who rarely take notice of cessation effects.

[*willow*]

You're welcome.
Maybe the other meds will help lessen the withdrawals for you.

It's such a pain having to take pills just to feel 'normal' (what ever that is).

The last couple of days I've felt okayish, but I'm trying not to get too excited over this because I don't know whether I have more withdrawals looming! I have a gp's appointment on Wednesday, I'm seeing a new doctor, so I'll wait and see what his thoughts are, but I've considered Prozac but I had a bad experience on that years ago. I was soooo dizzy and I lost a lot of weight, but maybe a very low dose and for a short period won't be so bad? I hope!

I still haven't plucked up courage to take a Propanolol! I'm too chicken lol.

Hope everything goes well for you on Thursday.

Lynn.

[Pipkin]

Mark,

You might find this a useful guide for changing ADs in preparation for your appointment with your GP on Thursday:

http://www.sabp.nhs.uk/moodhive/Documents/D3.31a.pdf

Pip

[Mark13]

Wow, Pip, I never found that in my searches. Thanks, it's much appreciated.

It's more in plain English than the MIMS site I looked at.

Looks like abrupt cessation of duloxetine is a no-no. I went without one yesterday felt fine, took one today and anxiety sky high.

I'm sure the GP will want me to withdraw fully from duloxetine before swapping that to amitriptyline but I don't want to wait 4 weeks before starting the new regimen. The switch is complicated by the fact I'll be remaining on mirtazapine, so cross-tapering is out.

There's the possibility of going onto Prozac for a week instead of duloxetine as that tapers itself, but although my Doc is pretty understanding he's told me before he won't prescribe drugs to treat side effects of another drug, so I doubt he will for withdrawal symptoms either.

Even though I felt fine yesterday without the drug I know it's half-life and that would be the calm before the storm of withdrawal symptoms.

Si I'm going for 60 mg every other day till I see him, then 30mg for as long as he sees fit.

Thanks again for the info Pip.

Mark

[Mark13]

Even though abrupt cessation is not advised I am trying it for one reason.

The drug switching chart shows that you can go straight from duloxetine to mirtazapine without tapering. Now, I'm already on mirtazapine so that might lessen any withdrawal effects.

Also I've found anecdotal evidence on the web and in this forum that high-dose EPA (in fish oil) can protect against the brain zaps.

I normally take cod liver oil daily but I've found one with more EPA and am taking plenty of that now.

I've had one duloxetine in 4 days, I missed out Saturday, took one Sunday, none yesterday or today. Plus I've taken leave from work for the rest of the week so I can stay in bed if it becomes necessary :)

I feel like I have a hangover, but otherwise not too bad. I stopped drinking 10 years ago because beer didn't agree with my medication, plus I wasn't much of a drinker anyway, so this feeling is not very welcome but it could be worse :)

I'll be seeing the Doc on Thursday and I'm hoping he'll be OK with my withdrawal strategy. That said if I feel really awful on any day I'll restart the drug and taper gradually but I'd like to get started on the new regime (mirt and amitriptyline ASAP).

Hope everyone who reads this is doing OK.

[SarahH]

Hi Mark,

Hows it going with the withdrawal???

It took a while for me to find this thread as I dont know how to "follow" threads.

I am hoping you are feeling ok and by now you are on the new regime.

Best wishes

Sarah

[Tufty]

I'm interested too Mark, I've followed your progress since your Pregabalin days!

I've recently started on a tricyclic too - Dosulepin and wondered how you were getting on with Amitriptyline.

Hope the change over is going well for you

Sam