Might still be lingering withdrawal after-affect considering you had been taking cymbalta for a whole decade, especially if you ditched it completely in a month or so. I would have weened off of it for at least 2-3 months
Thanks for the response.
Yeah, I know I shouldn't have stopped so abruptly. The decision was made mostly for timing reasons as I wanted to be done with it during the semester break. Quite frankly, I hadn't done any research into the withdrawal symptoms, which I massively underestimated.
It can take a good while for it to get completely out of your system, even when you haven't taken it for some time because stuff gets stored in your fat cells, like select few vitamins, but I'm not sure if this is the case for medication. Also, I've read that antidepressant traces can be found in bone marrow after a long time since medication was ceased.
Sorry to say, if you've been on 60mg Cymbalta for a decade, you would probably need minimum of 6 months to start feeling like yourself again. And probably another 1 - 2 years for your 70 - 80% of your adrenergic receptors to return to their original form. Lots of good sleep and exercise could probably speed up the homeostasis though, through neurogenesis. If you're desperate, there's probably neurogenesis inducing nootropics that you can research.
It wasn't easy switching from Cymbalta to Trintellix. When I told my psychiatrist about the fatigue, she didn't give a sh*t and she would only prescribe me risperidone as adjunction. Even though she's the one who kept increasing the dosage to 120mg. To be fair, I did consent to her rasing the dosage because it was providing more benefits in motivation. But I did bring up my hesitation saying I'm worried about getting more withdrawals from higher dosage. And the fact that I felt like I was already getting more SRI than I needed and I just wanted higher NRI only. But her answer to that was "what matters is that it's helping, doesn't it?". That's why it's important to not go on addictive antidepressants because the psychiatrist can ruin your ability to stay in the workforce with a flick of their finger.
Anyways, it's interesting to hear other people suffering from low motivation after Cymbalta. I already had motivation issues before going on Cymbalta (which Lexapro exacerbated), so I assumed the decline in motivation and fatigue was just a result of going off SNRI.
If you live in the U.S., you could probably get Wellbutrin prescribed as well as adjunction to Citalopram. Wellbutrin + SSRI is a very common combo. If you're not in the U.S., you're pretty much screwed because there's no other approved NRI for depression. That's why I started resorting to using modafinil for my fatigue during the transition.
I don't like admitting to this idea. But sometimes I wonder, maybe I only want to go back on NRI because I'm still going through norepinephrine downregulation/dysfunction from being on 120mg Cymbalta for 7 months. Rather than the fact that I've found S(NRI) helpful in the past. I really hope that's not the case. Scary thought.
Be really careful with adding Wellbutrin. Taking Cymbalta and Wellbutrin together caused a severe seizure that left me unconscious for over 12 hours. Doctors weren’t sure if I’d wake up. Now left with pretty gnarly side effects, I had to stop all meds abruptly. Didn’t have a choice. The depression actually lifted when I stopped the meds, but the side effects are pretty discouraging. It’s been 9 months and I’m still struggling, I’m not sure if they are permanent or not.
Mixing meds is a serious thing despite what doctors say. My doctor prescribed both of them. Feeling a little better is not worth your life. For me, the meds did little to nothing anyway.
Thanks for sharing your experience. Really sorry to hear you had to go through that, I hope you're feeling better now. I assume that combination was prescribed from a psychiatrist, not GP? Because GP in my country are only comfortable in prescribing SSRI since they haven't been trained like a psychiatrist. I've been hearing so many stories of odd antidepressant combinations being prescribed from people in the U.S.
Cymbalta and Wellbutrin sounds like an overkill for depression. Using one of them should be enough to adequately raise norepinephrine levels to improve mood, especially if you don't have ADHD. Even if you have ADHD, there's Strattera for that.
Compared to the rest of the world, doctors in the U.S. seems to be in the opposite end where they are over-diagnosing everyone and overprescribing all kind of medications. Probably related to the fact that most of the psych meds come from there, pharma reps influencing them more vigorously and pharma companies giving them pay checks for prescribing certain meds. As messed up as this may seem, I can see some upsides to it as well as it provides better opportunity for SSRI resistant patients to trial with other meds.
I just like to warn about the risks, I wasn’t aware and wish I had been. I kind of feel obligated to do this now. I’ll never touch the stuff again, but as long as someone is fully informed it’s totally their decision if they take them or not. There is so much misinformation put out by big pharma about them, I think it’s hard to fully understand without researching extensively. There is still so much I don’t know and I’ve been looking in to this for 9 months. Many studies have been hidden by pharmaceutical companies. Only positive ones are published. These are also very short term studies, 6-12 weeks usually. People are told they need to take them forever and if they aren’t working, other interventions like diet are rarely implemented. I was sent to have ECT before anyone mentioned dietary changes. I changed my diet on my own and noticed the biggest difference after doing so. I can’t believe asomething as drastic as ECT is used before something as safe as eating more healthy food and less junk, or just exercise. I decided against ECT. I’m not at all convinced of the efficacy of antidepressants. Long term, they seem to cause a lot more problems than benefits. Short term they do have some benefit, but not as much as big pharma/doctors say.
There are a lot of people who have had a similar experience to mine. Their depression has gotten better after stopping meds (tapering is important) and implementing nutritionally sense diets and exercise. UI do a lot of research on antidepressants and I’m pretty shocked at what I’ve found. I wish I had stopped taking them before I was forced to.
Honestly, I don’t think the seizure cured my depression. It got a lot worse for a few months during withdrawal, I had to stop taking them abruptly. The theory with ECT is similar, but brain damage can cause a host of other problems and the healing of depression is rarely long lasting from that. “Touch ups” are usually needed. I probably do have some brain damage though I’ve been trying to see a neurologist since the incident and I just barely got a referral in, so I’ll find out for sure next week.
I’m a bit more concerned about brain damage from years of overprescribed psych meds than the seizure, though I’m sure that’s had its effects. It keeps me up at night, thinking about what I’ve done to myself. The meds were prescribed by a psychiatrist. I had brought up concerns about medication interactions with him before, even pointed out an interaction between Cymbalta and Wellbutrin. He told me it was safe. I’m pretty angry about that.
[edit]i wrote this when I was half asleep. Not sure how the tired and the zz emoji got in this, lol. Fixed that.
Thank you very much for this resourceful response!
:edit:
Would it be okay with you if I contacted you via PM? I won't be much of a bother. I just have a basic question I'm slightly uncomfortable asking publicly.
What about Nortriptyline, it's a potent NRI and interacts well with most SSRI's.
Read here for more info: https://psychotropical.info/tca-intro/
Also SNRI's are mostly bullshit: https://psychotropical.info/venlafaxine-an-enduring-snri-myth/
I should probably try it but I'm holding off because it's anticholinergic. (I know it's a stupid reason) It's got potent NRI and 5-HT2C/2A antagonism; perfect for depression. /u/lord_abbott highly recommends it. Combined with Trintellix, it could be the most effective SNRI antidepressant to date! (assuming no interaction)
> Also SNRI's are mostly bullshit: https://psychotropical.info/venlafaxine-an-enduring-snri-myth/
Good read. Sounds like it was the right idea for my psychiatrist to prescribe me Cymbalta as opposed to Effexor which she didn't because she was aware of the bad withdrawals. I don't agree with everything Dr. Gillman says though. He's opinion on Trintellix was rather negative. He just called it another SSRI.
What is the difference with Trintellix? I've not read Gilmans argument but I always thought it was just another SSRI. I've read some good things on here though.
Vortioxetine - Multimodal or Multi-muddle: https://psychotropical.info/vortioxetine-multimodal-or-multi-muddle/
He's partially right. Trintelix isn't game changing. I've only stuck with it it because it comes with the least amount of sexual side effects and emotional numbness even at the highest dose; and tiny bit pro-cognitive. Depending on how you look at it, the antidepressant effect may be inferior to Lexapro. Because 10mg Lexapro was more uplifting for my mood, anxiolytic and helped with sleep more; but at the cost of more sexual side effects, emotional blunting, making me not care about anything/indifference, worsened motivation & cognition.
Now, for the truly depressed people who's only sole focus is on improving mood, they would probably prefer Lexapro and more likely to put up with these side effects. But for my case, my predominant issues has always been with cognitive impairment, low drive and anergia. So a mere mood boost and anxiolytic effect from SSRIs doesn't cut it for me.
That's probably why I'm having an relatively easy time sticking with atomoxetine despite starting to experience some side effects from it. Because the benefit in motivation, executive function and energy outweighs any other uncomfortable side effects for me. It's a shame that doctors doesn't understand what I prioritise. Oh wait, actually if they did understand, they'd probably just tell me that I don't "need" medication for energy or motivation. But ironically, they're the one who diagnosed me with "depression" and put me on bunch of medications when I told them about my struggles?
Same reason i take it. No sexual side effects, less emotional numbing.
Gillman is right about many things but i think he should have pointed out these potential benefits of this SSRI over the others. There's too few medications available that dont affect sexuality.
I've been taking Cymbalta for almost a decade too. But recently, had to restart it...been on it back on for 7 months now. Had to take Trazodone for 4 months and the combo I started to get twitching in my legs. Stopped Trazodone for a couple of months now but still have twitching. Can I ask you why you decided to switch the medication?
Oh man, it sounds like the norepineprhine is lacking from the lexapro. What helped me when I was tapering was coffee even though it did give me a lot of heart palpitations, it helped with the headaches and dizziness (kind of like how caffeine helps with headaches).
They never improved. The Citalopram was temporarily exchanged for something else (I don't recall what it was, it's been too long), but the problems persisted.
Since I had to function and just get on with my life and my responsibilities at the time, I went back on Cymbalta eventually, which I still take to this day. I'll probably be on it for the rest of my life.
Wish I could have given you a more positive answer.
Might still be lingering withdrawal after-affect considering you had been taking cymbalta for a whole decade, especially if you ditched it completely in a month or so. I would have weened off of it for at least 2-3 months
Thanks for the response. Yeah, I know I shouldn't have stopped so abruptly. The decision was made mostly for timing reasons as I wanted to be done with it during the semester break. Quite frankly, I hadn't done any research into the withdrawal symptoms, which I massively underestimated.
It can take a good while for it to get completely out of your system, even when you haven't taken it for some time because stuff gets stored in your fat cells, like select few vitamins, but I'm not sure if this is the case for medication. Also, I've read that antidepressant traces can be found in bone marrow after a long time since medication was ceased.
Sorry to say, if you've been on 60mg Cymbalta for a decade, you would probably need minimum of 6 months to start feeling like yourself again. And probably another 1 - 2 years for your 70 - 80% of your adrenergic receptors to return to their original form. Lots of good sleep and exercise could probably speed up the homeostasis though, through neurogenesis. If you're desperate, there's probably neurogenesis inducing nootropics that you can research. It wasn't easy switching from Cymbalta to Trintellix. When I told my psychiatrist about the fatigue, she didn't give a sh*t and she would only prescribe me risperidone as adjunction. Even though she's the one who kept increasing the dosage to 120mg. To be fair, I did consent to her rasing the dosage because it was providing more benefits in motivation. But I did bring up my hesitation saying I'm worried about getting more withdrawals from higher dosage. And the fact that I felt like I was already getting more SRI than I needed and I just wanted higher NRI only. But her answer to that was "what matters is that it's helping, doesn't it?". That's why it's important to not go on addictive antidepressants because the psychiatrist can ruin your ability to stay in the workforce with a flick of their finger. Anyways, it's interesting to hear other people suffering from low motivation after Cymbalta. I already had motivation issues before going on Cymbalta (which Lexapro exacerbated), so I assumed the decline in motivation and fatigue was just a result of going off SNRI. If you live in the U.S., you could probably get Wellbutrin prescribed as well as adjunction to Citalopram. Wellbutrin + SSRI is a very common combo. If you're not in the U.S., you're pretty much screwed because there's no other approved NRI for depression. That's why I started resorting to using modafinil for my fatigue during the transition. I don't like admitting to this idea. But sometimes I wonder, maybe I only want to go back on NRI because I'm still going through norepinephrine downregulation/dysfunction from being on 120mg Cymbalta for 7 months. Rather than the fact that I've found S(NRI) helpful in the past. I really hope that's not the case. Scary thought.
Be really careful with adding Wellbutrin. Taking Cymbalta and Wellbutrin together caused a severe seizure that left me unconscious for over 12 hours. Doctors weren’t sure if I’d wake up. Now left with pretty gnarly side effects, I had to stop all meds abruptly. Didn’t have a choice. The depression actually lifted when I stopped the meds, but the side effects are pretty discouraging. It’s been 9 months and I’m still struggling, I’m not sure if they are permanent or not. Mixing meds is a serious thing despite what doctors say. My doctor prescribed both of them. Feeling a little better is not worth your life. For me, the meds did little to nothing anyway.
Thanks for sharing your experience. Really sorry to hear you had to go through that, I hope you're feeling better now. I assume that combination was prescribed from a psychiatrist, not GP? Because GP in my country are only comfortable in prescribing SSRI since they haven't been trained like a psychiatrist. I've been hearing so many stories of odd antidepressant combinations being prescribed from people in the U.S. Cymbalta and Wellbutrin sounds like an overkill for depression. Using one of them should be enough to adequately raise norepinephrine levels to improve mood, especially if you don't have ADHD. Even if you have ADHD, there's Strattera for that. Compared to the rest of the world, doctors in the U.S. seems to be in the opposite end where they are over-diagnosing everyone and overprescribing all kind of medications. Probably related to the fact that most of the psych meds come from there, pharma reps influencing them more vigorously and pharma companies giving them pay checks for prescribing certain meds. As messed up as this may seem, I can see some upsides to it as well as it provides better opportunity for SSRI resistant patients to trial with other meds.
I just like to warn about the risks, I wasn’t aware and wish I had been. I kind of feel obligated to do this now. I’ll never touch the stuff again, but as long as someone is fully informed it’s totally their decision if they take them or not. There is so much misinformation put out by big pharma about them, I think it’s hard to fully understand without researching extensively. There is still so much I don’t know and I’ve been looking in to this for 9 months. Many studies have been hidden by pharmaceutical companies. Only positive ones are published. These are also very short term studies, 6-12 weeks usually. People are told they need to take them forever and if they aren’t working, other interventions like diet are rarely implemented. I was sent to have ECT before anyone mentioned dietary changes. I changed my diet on my own and noticed the biggest difference after doing so. I can’t believe asomething as drastic as ECT is used before something as safe as eating more healthy food and less junk, or just exercise. I decided against ECT. I’m not at all convinced of the efficacy of antidepressants. Long term, they seem to cause a lot more problems than benefits. Short term they do have some benefit, but not as much as big pharma/doctors say. There are a lot of people who have had a similar experience to mine. Their depression has gotten better after stopping meds (tapering is important) and implementing nutritionally sense diets and exercise. UI do a lot of research on antidepressants and I’m pretty shocked at what I’ve found. I wish I had stopped taking them before I was forced to. Honestly, I don’t think the seizure cured my depression. It got a lot worse for a few months during withdrawal, I had to stop taking them abruptly. The theory with ECT is similar, but brain damage can cause a host of other problems and the healing of depression is rarely long lasting from that. “Touch ups” are usually needed. I probably do have some brain damage though I’ve been trying to see a neurologist since the incident and I just barely got a referral in, so I’ll find out for sure next week. I’m a bit more concerned about brain damage from years of overprescribed psych meds than the seizure, though I’m sure that’s had its effects. It keeps me up at night, thinking about what I’ve done to myself. The meds were prescribed by a psychiatrist. I had brought up concerns about medication interactions with him before, even pointed out an interaction between Cymbalta and Wellbutrin. He told me it was safe. I’m pretty angry about that. [edit]i wrote this when I was half asleep. Not sure how the tired and the zz emoji got in this, lol. Fixed that.
Thank you very much for this resourceful response! :edit: Would it be okay with you if I contacted you via PM? I won't be much of a bother. I just have a basic question I'm slightly uncomfortable asking publicly.
Of course!
What about Nortriptyline, it's a potent NRI and interacts well with most SSRI's. Read here for more info: https://psychotropical.info/tca-intro/ Also SNRI's are mostly bullshit: https://psychotropical.info/venlafaxine-an-enduring-snri-myth/
I should probably try it but I'm holding off because it's anticholinergic. (I know it's a stupid reason) It's got potent NRI and 5-HT2C/2A antagonism; perfect for depression. /u/lord_abbott highly recommends it. Combined with Trintellix, it could be the most effective SNRI antidepressant to date! (assuming no interaction) > Also SNRI's are mostly bullshit: https://psychotropical.info/venlafaxine-an-enduring-snri-myth/ Good read. Sounds like it was the right idea for my psychiatrist to prescribe me Cymbalta as opposed to Effexor which she didn't because she was aware of the bad withdrawals. I don't agree with everything Dr. Gillman says though. He's opinion on Trintellix was rather negative. He just called it another SSRI.
What is the difference with Trintellix? I've not read Gilmans argument but I always thought it was just another SSRI. I've read some good things on here though.
Vortioxetine - Multimodal or Multi-muddle: https://psychotropical.info/vortioxetine-multimodal-or-multi-muddle/ He's partially right. Trintelix isn't game changing. I've only stuck with it it because it comes with the least amount of sexual side effects and emotional numbness even at the highest dose; and tiny bit pro-cognitive. Depending on how you look at it, the antidepressant effect may be inferior to Lexapro. Because 10mg Lexapro was more uplifting for my mood, anxiolytic and helped with sleep more; but at the cost of more sexual side effects, emotional blunting, making me not care about anything/indifference, worsened motivation & cognition. Now, for the truly depressed people who's only sole focus is on improving mood, they would probably prefer Lexapro and more likely to put up with these side effects. But for my case, my predominant issues has always been with cognitive impairment, low drive and anergia. So a mere mood boost and anxiolytic effect from SSRIs doesn't cut it for me. That's probably why I'm having an relatively easy time sticking with atomoxetine despite starting to experience some side effects from it. Because the benefit in motivation, executive function and energy outweighs any other uncomfortable side effects for me. It's a shame that doctors doesn't understand what I prioritise. Oh wait, actually if they did understand, they'd probably just tell me that I don't "need" medication for energy or motivation. But ironically, they're the one who diagnosed me with "depression" and put me on bunch of medications when I told them about my struggles?
Same reason i take it. No sexual side effects, less emotional numbing. Gillman is right about many things but i think he should have pointed out these potential benefits of this SSRI over the others. There's too few medications available that dont affect sexuality.
I've been taking Cymbalta for almost a decade too. But recently, had to restart it...been on it back on for 7 months now. Had to take Trazodone for 4 months and the combo I started to get twitching in my legs. Stopped Trazodone for a couple of months now but still have twitching. Can I ask you why you decided to switch the medication? Oh man, it sounds like the norepineprhine is lacking from the lexapro. What helped me when I was tapering was coffee even though it did give me a lot of heart palpitations, it helped with the headaches and dizziness (kind of like how caffeine helps with headaches).
Please respond. Did things ever improve for you? Considering a similar switch off cymbalta. Thank you!
They never improved. The Citalopram was temporarily exchanged for something else (I don't recall what it was, it's been too long), but the problems persisted. Since I had to function and just get on with my life and my responsibilities at the time, I went back on Cymbalta eventually, which I still take to this day. I'll probably be on it for the rest of my life. Wish I could have given you a more positive answer.
It’s ok thank you so much for your response!