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Sunday, April 22, 2012

My Cymbalta Withdrawal - Return of the Mind

This is my third post regarding the continuing saga of my withdrawal from the SSRI antidepressant Cymbalta.  It may be helpful to read my earlier posts on this topic: (1) Bipolar Treatment Update - Cymbalta Wars and (2) My Cymbalta Withdrawal - The Syndrome Strikes Back


I have been on Cymbalta for six years.  It was added to augment Wellbutrin, my primary antidepressant, and improve treatment of lingering depression symptoms.

Although it worked for several years, I have come to believe that Cymbalta is no longer effective for me as an antidepressant.  It's known that antidepressants can be effective for a period of time (months or years) and then stop working.

Poop Out
A loss of effectiveness during antidepressant therapy can occur with most antidepressants.  A sustained, effective response from antidepressant treatment is not always achievable 

Unfortunately, it's not fully understood what causes this so-called "poop-out" effect, or why it occurs in some people and not in others.  This effect could relate to the disease itself, pharmacological effects, or a combination of the two. 

Tapering - The Slow Withdrawal

I began tapering down from 120 mg/day of Cymbalta (a very high dose) on 3/20.  I dropped to 100 mg/day for the first week without significant problems.  

But when I went down to 80 mg/day at the start of my second week all hell broke loose.  It felt like a depression alien life form came and infiltrated my mind.  Since then I have had many days with mostly severe depression.  Not good.


Well, my withdrawal from Cymbalta took another big turn lately. This time for the better! My depression has began to lift again. The intensity of my symptoms really dropped and since last Tuesday I've had mostly mild depression!! I remain in communication with my psychiatrist throughout this withdrawal process. We almost went back up to 100 mg/day at the beginning of last week because things were so bleak. On Monday we decided to stay at 80 mg/day for a few more days and see what happens.  It turns out that was a good move!
By the Way 

Adverse withdrawal effects and the discontinuation syndrome from Cymbalta are real.  They can be devastating to a certain percentage of users.  If I recall correctly this figure is in the 10 to 20 percent range.  Withdrawal effects are mostly overlooked by Pharma.  Because of this patients get taken by surprise when they try to get off the drug and experience a debilitating withdrawal process instead.

There are numerous papers, articles, and web sites that specifically address Cymbalta's under reported withdrawal effects.  Cymbalta Withdrawal Forums is a site I found helpful.  It used by folks dedicated to rooting out and addressing the adverse effects that can arise while getting off of Cymbalta.  Cymbalta Attorney gives you direct access to lawyers specializing in Cymbalta withdrawal and injury cases.  I'm sure they'd take my money, but I think I'll pass. is another site that addresses Cymbalta withdrawal only.  It's not a good site but thought I'd include it for no specific purpose anyway.  

What's Next?

I will discuss my situation via email with my pdoc tomorrow.  Since things have lifted for several days in a row now she may okay lowering my Cymbalta dose some.  

I'm leaning towards remaining at 80 mg/day for another week to be safe.  This stuff is dangerous!  Also, we need to figure out how what the next tapering dose will be.  

Another 20 mg/day reduction in dosage is an overall drop of 25 percent.  Hmmm.  Maybe a bit much?  

How much would you decrease the next dose?


  1. Hi there! When it comes to titration schedules, cautious is always best, but sometimes, if it is going to be "ugly" regardless, I say just get it over with. On the face of things, 20/mg per wk appears very sensible indeed. Aren't 20mg. the smallest Cymbalta caps? If I were you I would try to hang in there through the pain at a 20mg/wk reduction, but if it somehow becomes unbearable, just open up those capsules, divide the powder in half, and go for 10mg/wk.
    Have you ever done much reading on "long-term destabilization and kindling effects" of anti-depressants? It looks like you were on 3 different anti-depressants at the same time. New data supports increase concern on this topic, anti-D's can cause Much More cycling in one's future than they ever were going to have naturally from bipolarism. Personally, I refuse to touch them for a variety of reasons...oh, I get depressed, but I can't even risk the possible chance of the initial "flip/switch" into mania, let alone long-term destabilization/kindling. GOOD LUCK!!! Melinda

  2. Hi Melinda!

    I appreciate the input on this "front burner" issue for me. Haven't read much about destabilization and kindling, but I've heard of them. Do you have good links on these?

    The doc says stay at 80 mg per day for four more weeks before trying to lower dose again! I'm going along with it for now. If I take 2 20mg and 1 30mg I'll be at 70 mg per day for the next step down, which seems fine to me. We'll see.

    Thanks for stopping by and commenting!


  3. Hello again Jeff! Here is the best link I have, a long article complete with statistics, charts, and graphs.
    Hope it provides some food for thought, & if you go back to"home" it is a nice beefy website. My Dr. laughs that his patients come in two varieties: the bold ones who will try any pill w/o worry and the very nervous ones (like me) who fret endlessly! But even he doesn't want me on anti-d's unless I'm beyond desperate. They don't agree with my chemical make-up(?). Best wishes & I'll be checking out your cool blog again soon. Melinda

    1. Hi Melinda! Sorry for the lag in responding. I thought I had it set up to where I get an email notification every time somebody leaves a comment. Hmmm. I better check on that.

      I really like the site. Dr. Phelps explains things in a way that is understandable. Great info!

      I used to be the bold type that would go on and off meds without concern. But not any more since things started going south with my Cymbalta withdrawal. Now I'm not sure what I am:)

  4. Jeff -- P.S. If you go to this site, I hope you check out "Antidepressants That Aren't Antidepressants", and "Stopping Antidepressants in Bipolar Disorder". Take Care Friend! Melinda

    1. Melinda - I've been manic and distracted for the last couple of months and missed your comment above, sorry. I have been on Dr. Phelp's website ( many times. He is a wealth of leading edge information! I reviewed the two pages you mention above and they are certainly helpful and explain a lot. Thank you.

      I'm doing pretty well with my Cymbalta withdrawal at this point in time (just dropped from 60 to 50 mg/day w/o problems so far). I'm keeping his website "nearby" so I can refer to it often.

      Take care, Jeff

  5. I hope your tapering off Cymbalta went well.

    Antidepressants can indeed cause adverse effects "kindling" symptoms that look like bipolar disorder. However, gradually tapering relieves these adverse effects and in most people, it's not true bipolar disorder.

    By the way, a truly slow taper takes more than 6 months and may go on for years. You might visit, a peer support site, for more information on tapering.

    1. Altostrata - Thanks for stopping by and providing helpful information. I went by and find it to be a helpful forum for those undergoing withdrawal.

      I am not yet off Cymbalta. The two manic episodes I just had derailed things a bit. I just went down to 50 mg/day and things seem fine. Will wait several weeks before going down to 40.

      Thanks for your proactive stance and helping those of us undergoing this sometimes debilitating process.