Question about switching antidepressants

[jkw86]

Hello. I am currently on Cymbalta. After I had my daughter i was having alot of body pain (also going through PPD) and noone could figure out why, so they put me on cymbalta. I have been on AD for about 10 years for mainly anxiety. I really want to switch my cymbalta to something else...in the SSRI group, because my insurance doesn't cover Cymbalta well and it's expensive! One problem. I tend to get BAD withdrals from just going down on antidepressants. More physical than anything. Anxiety, fast heartbeat, etc. I am currently on 60mg of Cymbalta. My dr said I could go down to 30mg of C, while adding 20mg of Prozac for 2 weeks. Then discontinue the cymbalta. I am weary of that because I was thinking when i discontinue the cymbalta to go up another 20 on Prozac, to make it 40mg all together, to lessen any effects. I know Prozac may take a but longer to get in your system. I am scared of this switch about side effects from cymbalta. Does this sounds like a good cross over to you, or would anyone recommend anything else? Thanks!!

[muddy008]

Did you do the switch over? If so, how's it going?  I switched from 60mg of Cymbalta to 20 then 40 mg of Prozac 5 weeks ago.  It's been a hell of a ride!

[jkw86]

Yes i haven't either. I was terrified to even do a switch over from Effexor to Zoloft. But i had no side effects with that. But my doctor did the cross over well because she knows i'm sensitive to meds. I think in a way these meds are the devil, lol. I know they can save lives and be super helpful, i just wish they didn't have the discontinue syndrome.

[ticked]

For sure. There I something about cymbalta that totally messed me up and whenever I researched this I heard nothing good coming off of it. I wish I never went in it however it did help with anxiety a lot so it's too bad. Good luck on the switch over :)

[jkw86]

No you are fine! :) Everyone has their own experiences.

[ticked]

Makes sense now I thought that you were coming off completely sorry if I scared u lol

[jkw86]

Thanks! I think I may have confused people....i am actually going to switch my antidepressant. I am not wanting to actually go 'off ' an antidepressant right now. I did fine going from Effexor to Zoloft. Not quitting Effexor with nothing...i don't think i would have been fine then. lol.

[Paxiled]

I would say as well the taper needs to be much slower from this med, and usually the Prozac isn't added until toward the end of the taper, not at the beginning when you're still on a high dose of another serotonin-affecting medication.  It also won't do anything about the norepinephrine effect, which ssris don't target and snris do.  So I'd go slow and easy, if you're doing fine you can do the taper that suits you.  Toward the very end adding Prozac might help.  This is done because Prozac is believed to be easier to quit, since it stays in the body much longer and therefore any withdrawal wouldn't come for about a month, so it's basically getting you unhooked from one drug by hooking you on another that's believed to be easier to come off of, but what you don't want is a combination of drugs at full strength targeting serotonin at the same time.  I believe many just use liquid Prozac for this and use just a little, not a full dose.  These are questions you can read about and ask your doc about.  Good luck, you might not have any problems if you did Effexor easily!

[jkw86]

Funny because i talked to like 3 different pharmacist and of course they said it all depends on the doctor. But that it should be fine going from 60mg of cymbalta, to 40mg of prozac the next day! :-0

[jkw86]

Thanks for the advice!! I may do that. I have actually switched SSRI's overnight with no problem, but i have never switched from a SNRI to SSRI except 1 time. Thank you for the advice!

[cj29]

I probably sound like an echo here, but I agree with nursegirl a 100% here.  It does sound like your doctor is knowledgeable and as long as you have an open line of communication with him, why not go slower?  I know whenever I would come off of a medication and noticed problems, I would go back and be very proactive with my prescribing doctor about it and ask if I could do it slower, which helped me in every case when I have come off of something.  I also used my pharmacist as a great reference as well to ask opinons about these sorts of questions.  Just always be sure to do any of this under a doctor's supervision.  Keep us posted!

[nursegirl6572]

Hi there!

Of course, everyone is different.  While ticked had a nightmarish experience, you may do much better (hopefully).  Actually, Effexor is one of the hardest meds, historically to come off, and you did fine, so you DO truly never know.

Here's what I would personally recommend, just to be on the safe side, to minimze any shock to your system....I would ask the doctor to do the transition MUCH slower.  To cut a dose in half for a dosage reduction is kind of much, even WITH the addition of another med (Prozac).  That's pretty severe.

I would suggest slowly and gradually tapering down the Cymbalta, while at the same time slowly and gradually tapering UP on the Prozac.  Exactly what your doc suggested, but MUCH slower and more gradual.  These meds affect different chemicals in the brain, and to do it too fast may end up causing some crazy symptoms.   I wouldn't recommend doing this change over any faster than about 1- 2 months (2 would be better).  The current plan is WAY WAY too fast IMO.  If you DO end up with more severe symptoms from a discontinuation syndrome, they will be much worse if you've come off so quickly...and it will be too late to do much about it.

No matter what you decide, let us know how you're doing!

[ticked]

I didnt have any issues coming off of Wellbutrin, Celexa or Zoloft. This is the only one that caused this. It is maddening. Please talk to your doctor about what to expect and if there is anything you can use for nausea and insomnia. Good luck. Let me know how it goes.

[jkw86]

Thank you for the heads up! And since i won't actually be completely weaning off it, by itself, i am weaning off it while increasing the prozac. I plan to stay on the prozac for a bit. So i'm hoping it makes it easier? I just preferably want to be on a SSRI instead of a SNRI. I once was weaned from Effexor while going onto zoloft and didn't have any issues...i have never taken Prozac before either...

[ticked]

I am telling you right now coming off this drug is unreal. There is NO easy way to come off this medication and if you have a hard time with withdrawal symptoms this is going to hit you like a ton of bricks. I really need to be upfront with you as I am still going through withdrawals over 10 days later and I was only on this med for 5 months. Before that I was on Wellbutrin for 6 yrs.

I was on 30mg my body couldnt take the 60mg so I came back down after a couple of days. The first day coming off was fine but after that HOLY Crap. The vertigo is unbelievable. I haven't got the brain zaps I guess I am one of the lucky ones. The nausea and vomiting has subsided for the last 3 days but it helps when I keep eating which has made me gain 5 lbs in a week. . I have sudden bouts of low blood pressure as well causing me to have anxiety. So I regular check my blood pressure to make sure it is not dropping too much. Gravol has been my best friend I will take it and go to sleep it off for a bit, however I work full time and this has affected my job. I did hear that some people have taken 10mg of prozac to help wean off the cymbalta so I tried that with Wellbutrin. No way I finally just cut them both off. 2 weeks ago I tried to come off this as well and I went back on because of the terrifying suicidal thoughts and anger I was having.

I can't express this to you enough, this is going to be hard and from what I have heard it could take like 3 months for the withdrawal symptoms to completely leave. If I would have known this I would never have went on it in the first place. I have never ever experienced something so terrifying in all my life and that is why I need to give you the heads up.

Some people use omega fish oil to help, For me its been gravol, sleep, gatorade and crackers. Some people have tapered off by opening the capsules and removing half and buying those gel capsules to fill the balance that you are taking out to use the next time since the lowest dose I have heard of is 20mg but I know in Canada we dont have that and 30mg is the lowest.

the thing with Cymbalta is it worked really well with my anxiety but was causing a lot of other bad symptoms that is the reason I came off it.

I don't want to scare you but I really wished someone told me this before I came off if it.