THIS SITE DOES NOT PROVIDE MEDICAL ADVICE. We do not employ doctors or other certified health professionals. Never start, stop, or change the dosage of any prescribed medication without consultation with your medical professional.
This website documents the Gradual Taper Method of discontinuing Cymbalta/duloxetine.
The Gradual Taper methodology using hyperbolic dosage reductions is based on the work of professionals listed on our AUTHORITIES PAGE. We have refined our documentation based on the documented experiences of the Facebook group Cymbalta Hurts Worse (CHW) 45,000+ members over more than a decade as they worked to minimize the horrific effects of discontinuing Cymbalta/duloxetine.
Tens of thousands of people have followed the Gradual Taper protocol presented on this site and have stopped the drug with minimal side effects.
What is “Hyperbolic”?
Cymbalta/duloxetine has a hyperbolic effect on the brain, meaning that small doses have greater effect than higher ones. The effect is not linear. This is different from most drugs you are familiar with, where the effect increases directly, proportionally, with the dosage.
Graph and percentage list from Anders Sorenson, PhD:
https://www.nature.com/articles/s41380-021-01285-w
If the chart was for a “typical” drug, the line in the graph above would be straight from bottom left to top right, not curved.
For Cymbalta/duloxetine, a “small” dose of 20mg achieves approximately 70% of the effect, while tripling the dose to 60mg only increases the effect to approximately 80%.
APPROXIMATE EFFECT
5mg ~44% effect
20mg ~74% effect
40mg ~81% effect
60mg ~85% effect
Obviously, it only takes a little to make a big difference. The same 10mg dose increase from 10mg to 20mg causes a 15% increase in effectiveness, while going from 50mg to 60mg only has an increase of 2%! This is also why high doses of 90mg and 120mg do not make sense and are not recommended by Eli Lilly.
Gradual Taper
Because of this, we recommend that a reverse hyperbolic tapering be performed, reducing the dose a small, set percentage from the most recent dose every two weeks or more. Generally, the maximum percentage drop we recommend for Cymbalta/duloxetine is 5%. This hyperbolic pattern of tapering takes into account the increased reaction of the brain to changes at small doses.
Some uninformed physicians prescribe a rapid discontinuation by large drops in dosage and/or skipping days. We have literally hundreds of thousands of posts in the Facebook group Cymbalta Hurts Worse that detail the horrific effects of this misguided approach. We provide the tools to use one of two methods to perform a Gradual Taper:
WEIGHING
This employs a small scale (costing approximately USD $30) to create the doses by weighing the microbeads found inside the capsules. This is especially valuable at the start of the taper as the beads number in the hundreds. At some point at a very small dose, you will transition to counting the fewer beads when the scale is no longer able to be precise.
Weighing Page: https://healthwithoutantidepressants.com/weighing/
COUNTING
Creating the doses by counting the microbeads found inside the capsules
Counting Page: https://healthwithoutantidepressants.com/counting/
CALCULATING
The online calculators and downloadable spreadsheets are available at
Calculators: https://healthwithoutantidepressants.com/calculators/
In addition, we present material to provide guidance in being healthy and managing any issues without using antidepressants.
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