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dmajor7th · 07-19-2005, 01:04 AM

Hi Eddie, I don't know about Cymbalta, but have been reading about it-sure you have too. One thing I read is to open up the capsules or cutting the pills and taper down that way. I also read that is Cymbalta is similiar to Effexor. So I would suggest looking into opening the capsules and tapering that way. Found this:

Each person will respond differently to stopping serotonin boosters, or Selective Serotonin Reuptake Inhibitors (SSRI's). By stopping cold turkey, serotonergic activity will drop drastically. Hence withdrawal side-effects may appear such as electrical surges/shocks in the head (brain shivers) and/or body, pins and needles on the skin, feelings as being on the verge of losing consciousness, blackouts, short term memory problems, etc.. Above mentioned side effects refer to epileptiform activity, or electrical discharges, in the brain. When dosages are cut back, (withdrawal) side-effects are at least minimized. No one should stop taking their medication cold turkey, but anti-depressant use should be tapered off very, very slowly.

The Right Way to Wean Off an (SSRI/SNRI/SSNRI) antidepressant
How should I taper off and how long should I take to taper off?
Work closely with a doctor. Don’t go off medication without medical supervision. The best way to minimize withdrawal side effects is to wean off the medication. By reducing the dosage in small increments, your serotonergic system can gradually take over it's own natural serotonin producing activity and slowly adapt to living without the drug. This process may take up to a year or longer. (*)Some doctors are halving the dose every week or two. We do not recommend to taper off that fast. Nor do we recommend to skip daily doses. Taper gradually with an absolute maximum of 5% per week. When it gets down to the smallest dose, (10mg capsule), you can try "The Orange Juice Bit", "Cutting Tablets" or "Oral Suspensions-Liquid Preparations":

"Orange Juice Bit"
pour a glass of orange juice
pull apart the capsule and stir into the orange juice
drink 9/10 of it and repeat this every day until the 7th day
the next week drink 8/10 of it until the 14th day, then 7/10 until the 21th day, 6/10 until the 28th day, and so on...
repeat the "orange juice bit" several weeks until you've totally come off your (SSRI) antidepressant...
Never ever use Grapefruit Juice. Grapefruit juice is an inhibitor of the cytochrome P-450 enzymes. These enzymes are known to metabolize (break down) (SSRI) antidepressants in the liver. Drinking grapefruit juice whilst you are taking an (SSRI) antidepressant can create a serious toxic reaction, because the chemical ingredient will build to toxic levels in the bloodstream!
"Cutting Tablets"
If you don't take capsules but tablets, you can try to chip smaller doses off the tablets. Unfortunately this is a very uneasy task. (*)You could order a pill cutter or pill splitter at your local pharmacist to facilitate this procedure. Pill-cutters aren't that expensive.
"Oral Suspensions-Liquid Preparations"
A much better way to wean off when it gets down to the smallest dose is simply to turn to your doctor who can provide you a liquid preparation (oral suspension-10 mg./5 ml.) of Paxil, Prozac or Zoloft and possibly more liquid versions of other SSRI's. Most people don't know about it, or don't consider it because it's supposedly for kids. It's very easy to use and more reliable then chopping up tablets. Ask your doctor for it !"

(*)Some of this sounds like a little much. I am tapering twice as fast as I read what was recommended and so far I'm doing fine. But at least it gives you an option.
So I would talk to your doctor and either buy a pill cutter or do the orange juice thing with the capsules.
(*) You can also ask pharmacists to cut the pills. At least I have. But you would know more about this than me.
Good luck Eddie!!
Sincerely, Cate.

07-19-2005, 01:04 AM	#2 (permalink)
dmajor7th Member Join Date: May 2005 Location: Vancouver BC Posts: 92	Hi Eddie, I don't know about Cymbalta, but have been reading about it-sure you have too. One thing I read is to open up the capsules or cutting the pills and taper down that way. I also read that is Cymbalta is similiar to Effexor. So I would suggest looking into opening the capsules and tapering that way. Found this: Each person will respond differently to stopping serotonin boosters, or Selective Serotonin Reuptake Inhibitors (SSRI's). By stopping cold turkey, serotonergic activity will drop drastically. Hence withdrawal side-effects may appear such as electrical surges/shocks in the head (brain shivers) and/or body, pins and needles on the skin, feelings as being on the verge of losing consciousness, blackouts, short term memory problems, etc.. Above mentioned side effects refer to epileptiform activity, or electrical discharges, in the brain. When dosages are cut back, (withdrawal) side-effects are at least minimized. No one should stop taking their medication cold turkey, but anti-depressant use should be tapered off very, very slowly. The Right Way to Wean Off an (SSRI/SNRI/SSNRI) antidepressant How should I taper off and how long should I take to taper off? Work closely with a doctor. Don’t go off medication without medical supervision. The best way to minimize withdrawal side effects is to wean off the medication. By reducing the dosage in small increments, your serotonergic system can gradually take over it's own natural serotonin producing activity and slowly adapt to living without the drug. This process may take up to a year or longer. ()Some doctors are halving the dose every week or two. We do not recommend to taper off that fast. Nor do we recommend to skip daily doses. Taper gradually with an absolute maximum of 5% per week. When it gets down to the smallest dose, (10mg capsule), you can try "The Orange Juice Bit", "Cutting Tablets" or "Oral Suspensions-Liquid Preparations": "Orange Juice Bit" pour a glass of orange juice pull apart the capsule and stir into the orange juice drink 9/10 of it and repeat this every day until the 7th day the next week drink 8/10 of it until the 14th day, then 7/10 until the 21th day, 6/10 until the 28th day, and so on... repeat the "orange juice bit" several weeks until you've totally come off your (SSRI) antidepressant... Never ever use Grapefruit Juice. Grapefruit juice is an inhibitor of the cytochrome P-450 enzymes. These enzymes are known to metabolize (break down) (SSRI) antidepressants in the liver. Drinking grapefruit juice whilst you are taking an (SSRI) antidepressant can create a serious toxic reaction, because the chemical ingredient will build to toxic levels in the bloodstream! "Cutting Tablets" If you don't take capsules but tablets, you can try to chip smaller doses off the tablets. Unfortunately this is a very uneasy task. ()You could order a pill cutter or pill splitter at your local pharmacist to facilitate this procedure. Pill-cutters aren't that expensive. "Oral Suspensions-Liquid Preparations" A much better way to wean off when it gets down to the smallest dose is simply to turn to your doctor who can provide you a liquid preparation (oral suspension-10 mg./5 ml.) of Paxil, Prozac or Zoloft and possibly more liquid versions of other SSRI's. Most people don't know about it, or don't consider it because it's supposedly for kids. It's very easy to use and more reliable then chopping up tablets. Ask your doctor for it !" ()Some of this sounds like a little much. I am tapering twice as fast as I read what was recommended and so far I'm doing fine. But at least it gives you an option. So I would talk to your doctor and either buy a pill cutter or do the orange juice thing with the capsules. () You can also ask pharmacists to cut the pills. At least I have. But you would know more about this than me. Good luck Eddie!! Sincerely, Cate. __________________ If you're going through hell, keep going.