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Tapering off Cymbalta (Duloxetine) with Zoloft (Sertraline)

Zoloft /Effexor combo pooped out Nov 2020. Dr. had  me increase Zoloft - not tolerated. Next he had me taper off the combo and onto Cymbalta 60mg in May. Gave it 11 weeks but it caused anxiety, panic and fatigue. Dr. Tol me to increase dose from 60mg to 80mg. This made everythibg worse. I then was told to resume 60mg and I asked Dr. to help me discontinue Cymbalta. He instructed me to start taking Zoloft 50mg and reduce Cymbalta from 60 to 40 then 20 over 2 weeks then stop the Cymbalta. I was not comfortable with such a fast taper after all I read online about withdrawals but Dr. said Zoloft would kick in right away and I should be fine. I decided to count beads and reduce more gradually. I am down to 30 beads fir the past week and I feel miserable. Depression, fatigue, anxiety, headaches, poor appetite and dizziness.

I tapered down today to 23 beads today, and in one week increments have prepared doses as follows:
15 beads, 10, 8, 6, 4, 2. Seven weeks more left of taper. I am still taking the Zoloft 50mg and .05mg Ativan only as needed (scared of getting addicted to benzos). Once I am off Cynbalta I plan to taper off Zoloft and try holistic approach to my depression and anxiety.

My question is, does my taper make sense or does anyone have advice/experience with successful taper using Zoloft? I don’t trust my Dr. fir advice at this point. He told me Cymbalta was EASY to discontinue but for me it has been hellish.

I need advice ASAP as I am starting a new job tomorrow and really scared of functioning in this sickened state. Thank you fir any advice!!!!
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Avatar universal
Yrs ago I tried SSRI Celexa. Did not seem helpful after mths. Dr put me on Cymbalta which worked very well. Felt great, thought positively, didn't stress much, slept great, etc. But it's added muscle relaxant caused bladder and prostate control issues when having more then few drinks. So got off it. Should have reduced or gave up thinking need for social and pc gaming drinking. It's mostly about not stressing about what you can't improve. Counting what thankful for past, present, future, plus problems not had, have and not likely to have. Stay organized. Use budget planning app like MSmoney to know what you can afford and stay within workable income and expenses. Except working at what job you can as necessary so don't stress about it. ;-) Seems you should maybe try stronger faster acting relaxant SNRI. Work at the methods mentioned and plan to reach time you decide you don't need the meds, or drinks, etc. Best wishes. ;-)
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Ya, I'm wondering if a healthier choice would have been to stop drinking. That can cause a lot of issues for those struggling with any sort of mental health issues in my opinion. PC gaming is a good distraction for a lot. As long as you get your other stuff done too. Are you still taking celexa or did you wean off of that? Was cymbalta hard to come off of?I think exercise can be like medicine in itself.
Not drinking for sure better. Stopped Cymbalta fully abruptly. Hard coming off it. Depression and over thinking, PTSD + very strong Social Anxieties took over, (the drinking was to offset strong social anxities since High School)(it's like i never felt able to be interesting or funny like the people in commedies whcih likely gave me illogical view of how i should be like that which i was far from)been strong since. Celexa for few yrs maybe helped  wee bit. Had to stop it fully when retired no more ins coverage.
Avatar universal
Doctors don't agree on this, so you have to form your own opinion.  First, I hope you're using a psychiatrist, because general docs don't do this as often and aren't as familiar with the meds.  I have seen different views on this by different psychiatrists.  There are books on the subject.  Most psychiatrists and virtually all general docs are pretty clueless about it.  I've been on a lot of different meds and because of my health plan early on I had a lot of different psychiatrists, and I can't say any of them agreed with one another on much.  But I had a horrific experience with one med, and that led me to do a lot of research on my own because my psychiatrist was a quack and it was a very bad time to have a quack for a doc.  I think you have a doc who doesn't understand the meds he's using.  First, most antidepressants don't start working right away.  The average person takes 4-6 weeks for a med to start to have a beneficial effect, while the side effects you don't want start right away because a lot of them are caused by the body trying to reject the med.  All meds attempt to get the body to act in a way that is counter to how evolution made us, and often that's not a bad thing, but it does mean the body doesn't want them in our bodies and fights them.  Once they start to work, the side effects tend to become more acceptable because they're working and that makes us feel better.  My own view is this:  if you're on a med and want to stop taking it, do that and complete the process successfully before starting another med.  None of these meds works exactly the same; if they did, even those in the same category, they would be ineligible for a patent and would be sued to stop making the drug by the company that made the first drug, so no two drugs work exactly the same way.  It's very odd to be taking Zoloft and Effexor, as both affect serotonin and that can lead to serotonin syndrome, but sometimes when nothing else works docs try things they wouldn't usually do.  So first, the Zoloft isn't likely to kick in right away except for side effects as it takes longer for most people than 2 weeks for that to happen, but that doesn't mean it never does.  The drug some docs use to handle a rough taper is Prozac.  This is when you're suffering a bad withdrawal from a drug affecting serotonin, and the hope is if they can get the Prozac to work it's easier than most other serotonin affecting drugs to stop taking because it lasts a lot longer in the body and therefore has a self-taper along with the one the doc gives you, so if the doc can get the body hooked on the Prozac instead of the drug you're having a problem with, the problem hopefully goes away and then they can more easily get you off the Prozac.  Zoloft, on the other hand, leaves the body pretty quickly and has a lot of withdrawal problems, though not nearly as many as Effexor and not as many as Cymbalta,  The SNRI category is one of the worst.  Also, the anxiety increase might have been caused by the Cymbalta, as it targets norepinephrine as well as serotonin, and the former is a stimulant.  Effexor is like this as well but uses a different mechanism and is better tolerated by some with anxiety problems but it's hell to stop taking.  Sometimes, though, you gotta do what you gotta do.  So if it were me, I'd taper off the Cymbalta and not add the Zoloft.  One drug problem is enough at one time, and there's another problem which is, if your'e basically on two drugs at the same time, you have the withdrawal problem going and the start-up side effect problem of the new drug going on at the same time.  Two problems instead of one.  Still another problem is, you have no idea and neither does your doc if the Zoloft is going to work for you even if it worked for you before.  The second time around isn't the same for many people, so there's no guarantee it's going to do anything for you at all and so no guarantee it will help with the Cymbalta problem.  So why bother?  A taper should last as long as is necessary for the person being treated, not one a doc uses for everyone because we're not all the same.  It should last as long as it needs to.  I'm also concerned that you were having problems with a drug and instead of lowering the dosage to where the problem stopped and tapering you up slowly, which is also recommended, the doc increased the dosage, which was pretty much guaranteed to just make the problem it caused worse.  If I were you, I'd find a better psychiatrist.  If you started the Zoloft very recently, you can probably taper off of it without problem pretty easily.  Then you can focus on the taper off the Cymbalta until withdrawal symptoms are done with and move on from there.  Of course, it's you and not me, but you're going to have to decide because again, psychiatrists don't have a consensus on how to do this.  Every one of them is a medical practice independent of anyone else.  Peace.
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Thank you for your reply!

Yes my Dr. is a psychiatrist but I’ve already determined he is totally incompetent for numerous reasons. I should have demanded Prozac instead of Zoloft for the taper due to its long half life. I knew that ….but I figured he knew better- was he thinking because I tolerated Zoloft before it would be a better choice? I used Prozac to taper off Effexor years ago with no problem.

Well now I have to decide if I should taper off Zoloft quicker than the Cymbalta. I started a new job today so I am literally between insurance coverages. I need sound advice.

How long have you been on the Zoloft?  Because if it's not very long, it hasn't really become normal for your brain to be on it yet and in which case it shouldn't be that hard to taper off of it.  The longer you're on a med, the harder it is to stop taking it because your brain has become so used to functioning the way the drug makes it function and this is different that the way the brain functions without medication.  
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