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TRISTAN
24-02-17, 19:01
Coming off this is the worst feelings and withdrawal I have ever had in my life , take last 30 tomorrow and ****ing dreading it

Has anyone on here been through the same thing ?

panic_down_under
24-02-17, 22:17
Coming off this is the worst feelings and withdrawal I have ever had in my life , take last 30 tomorrow and ****ing dreading it

Has anyone on here been through the same thing ?

Unfortunately, the SNRIs can be hard to quit for some, mostly because they have very short half-lives and their slow-release formulation prevents cutting back the dose by small amounts, although there are ways around this. This is one of the main reasons I try to steer folk to the TCAs.

That said, withdrawal is not just a matter of chemistry and biology. Psychology is at least as big a factor. Believe you will suffer greatly and your mind may well deliver the full catastrophe for you. As an example, epileptics generally have fewer problems quitting benzodiazepines than we do despite often being on much higher doses for longer. The difference seems to be they lack anxious minds (the greater experience of neurologists may also be a factor).

How long have you been on 30mg?

TRISTAN
25-02-17, 09:53
I was on 120 and been cutting back by 30mg every 5 days , I only have 2 30 mg left now and feel like my life is over for sure x

panic_down_under
25-02-17, 12:37
I was on 120 and been cutting back by 30mg every 5 days , I only have 2 30 mg left now and feel like my life is over for sure x

For future reference, the better way of quitting the serotonergic SNRIs - duloxetine, venlafaxine (Effexor) and desvenlafaxine (Pristiq) is to switch to fluoxetine (Prozac) and once stabilized to an equivalent dose wean off it. Fluoxetine has a very long elimination half-life, about 6 days for fluoxetine itself, and 16 days for its active metabolite so it takes a couple of months to be completely metabolized and eliminated, compared to 4 days for duloxetine. That long half-life makes fluoxetine essentially self-tapering.

Some open the duloxetine capsules and gradually remove more and more of the beads to reduce the dose, but they require careful handling to preserve the enteric coating covering each bead. Stomach acid will destroy the drug in damaged/crushed beads.

Skipping doses on alternate days is NOT a good idea. It just produces a yo-yo withdrawal effect which can be far worse.

TRISTAN
25-02-17, 14:43
I am doing it under instruction of mental health doctor and she has added a new one at same time , does life ever get better as lost all hope now

---------- Post added at 13:43 ---------- Previous post was at 13:41 ----------

Vortioxetine I think it's called , also taking lyrica 400 mg a day and quetiapine 150 mg at night

MyNameIsTerry
25-02-17, 15:04
For future reference, the better way of quitting the serotonergic SNRIs - duloxetine, venlafaxine (Effexor) and desvenlafaxine (Pristiq) is to switch to fluoxetine (Prozac) and once stabilized to an equivalent dose wean off it. Fluoxetine has a very long elimination half-life, about 6 days for fluoxetine itself, and 16 days for its active metabolite so it takes a couple of months to be completely metabolized and eliminated, compared to 4 days for duloxetine. That long half-life makes fluoxetine essentially self-tapering.

Some open the duloxetine capsules and gradually remove more and more of the beads to reduce the dose, but they require careful handling to preserve the enteric coating covering each bead. Stomach acid will destroy the drug in damaged/crushed beads.

Skipping doses on alternate days is NOT a good idea. It just produces a yo-yo withdrawal effect which can be far worse.

And if you open the capsules you need to put them back into a capsule as those beads are known to cause throat irritation. People often weigh them instead.

The generics offer an alternative in that they don't use beads, the capsule contains a tablet. The obvious trouble there will be enteric coating which will prevent cutting unless there is a way to deliver it with a capsule? I can't remember if the branded are enteric capsules too without checking but enteric capsules can be purchased empty.

The generics also produce a 20mg so I guess you can reduce how step the drops are a bit.

The advice for taper off SNRI's here is the same as SSRI's. The switch to Fluoxetine is an alternative for cases where it is a struggle.

---------- Post added at 14:04 ---------- Previous post was at 14:02 ----------


For future reference, the better way of quitting the serotonergic SNRIs - duloxetine, venlafaxine (Effexor) and desvenlafaxine (Pristiq) is to switch to fluoxetine (Prozac) and once stabilized to an equivalent dose wean off it. Fluoxetine has a very long elimination half-life, about 6 days for fluoxetine itself, and 16 days for its active metabolite so it takes a couple of months to be completely metabolized and eliminated, compared to 4 days for duloxetine. That long half-life makes fluoxetine essentially self-tapering.

Some open the duloxetine capsules and gradually remove more and more of the beads to reduce the dose, but they require careful handling to preserve the enteric coating covering each bead. Stomach acid will destroy the drug in damaged/crushed beads.

Skipping doses on alternate days is NOT a good idea. It just produces a yo-yo withdrawal effect which can be far worse.

And if you open the capsules you need to put them back into a capsule as those beads are known to cause throat irritation. People often weigh them instead.

The generics offer an alternative in that they don't use beads, the capsule contains a tablet. The obvious trouble there will be enteric coating which will prevent cutting unless there is a way to deliver it with a capsule? I can't remember if the branded are enteric capsules too without checking but enteric capsules can be purchased empty. I would have to check if the tablet inside is enteric or just the capsule since the former would allow for cutting.

Obviously there should be no cutting of a slow release med.

The generics also produce a 20mg so I guess you can reduce how step the drops are a bit.

The advice for taper off SNRI's here is the same as SSRI's. The switch to Fluoxetine is an alternative for cases where it is a struggle.

panic_down_under
25-02-17, 22:32
And if you open the capsules you need to put them back into a capsule as those beads are known to cause throat irritation.

Mixing the beads in apple sauce or juice (https://www.ncbi.nlm.nih.gov/pubmed/18691989) may prevent this. Pity about the chocolate pudding though!! :weep: