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. 

Much of the material presented here is the result of a decade of refining the Gradual Taper™ method of Cymbalta/duloxetine cessation while operating the Facebook group Cymbalta Hurts Worse (CHW) with over 39,000 members and hundreds of thousands of posts. 

The Gradual Taper methodology employing hyperbolic/exponential/proportionate dosage reductions is is based on the work of noted professionals as listed on our Authorities page and the result of the documented experiences of many CHW members over a decade as they attempted to minimize the horrific effects of discontinuing Cymbalta/duloxetine.

Tens of thousands of people have followed the Gradual Taper protocol we explain and have stopped the drug with minimal side effects. 

We are not acting as doctors or medical professionals, but we employ the research of renowned scientists and researchers including the following:

• Mark A. Horowitz, MD, PhD is a psychiatrist and researcher in London, who has a PhD from the Institute of Psychiatry at King’s College London on the action of antidepressants. When he tried to come off these drugs himself he was given a short, sharp education in the pain of withdrawal and the lack of knowledge in the medical field about this topic.  Since then he has tried to bring more awareness to the topic of safe deprescribing of psychotropic drugs through his academic work, including an article published in The Lancet Psychiatry journal on how to safely taper antidepressants and in JAMA Psychiatry on how to taper antipsychotics. He has also worked with the Royal College of Psychiatrists in the UK to publish their guidance on how to safely stop antidepressants. He has a deprescribing clinic in the NHS that helps patients from around the country come off psychiatric medications.
• Anders Sørensen, PhD is a Danish clinical psychologist with a PhD in psychiatric drug withdrawal. His private practice in Denmark specializes in helping people come off psychiatric drugs through gradual, hyperbolic tapering and psychotherapy, and on helping people avoid starting psychiatric drugs via psychotherapy. His practice always aims at making sense of emotional suffering and “symptoms” and at helping people regulate their difficult emotions, thoughts, and traumas via their own mind (as far as is possible), not via drugs. He has also undertaken research which assesses the state of guidance on psychiatric drug withdrawal.
• Adele Framer is the founder of SurvivingAntidepressants.org. She resides on the West Coast of the US and is retired from information architecture and user experience design for software. She went off 10mg paroxetine in 2004 and it took 11 years to recover from the withdrawal syndrome. She has studied psychiatric drug withdrawal syndrome since 2004 and founded the website SurvivingAntidepressants.org in March 2011.SurvivingAntidepressants.org was designed to collect case histories. It has more than 12,000 registrations and receives more than 300,000 page views per month. It has 6,000 naturalistic longitudinal case histories by patients. It provides more than 60 tapering topics (“Tips for tapering [drug]”) and explanations of titration methods (e.g. gradual 10% per month hyperbolic tapering method self-guided by patient). The site content is widely shared on Facebook and other websites.
• The Withdrawal Project is an information resource designed to help people empower themselves to make more meaningfully informed choices — aligned with their personal desires and needs — regarding taking, reducing, and coming off psychiatric drugs. TWP’s website includes a free, comprehensive, self-directed Companion Guide to Psychiatric Drug Withdrawal aimed at helping people learn and make decisions about the most risk-minimizing ways to prepare for responsibly tapering off antidepressants, benzodiazepines, stimulants, antipsychotics, mood stabilizers, Z-drugs and other psychiatric drugs, along with coping techniques for dealing with common withdrawal symptoms.
• The International Institute for Psychiatric Drug Withdrawal (IIPDW) has the following aims:
  • Support research and practice-based knowledge that will facilitate safe reduction of and withdrawal from psychiatric drugs.
  • Contribute to evidence-based practices for reduction of and withdrawal from psychiatric drugs, and facilitate their inclusion in general practice guidelines.
  • Support the human right to informed choice with regard to psychiatric drugs.
  • Promote practices that help families, friends, and practitioners support safe reduction of and withdrawal from psychiatric drugs, and take into account relational and social aspects essential to this process.

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. 

Graph and percentage list from Anders Sorenson, PhD: https://www.nature.com/articles/s41380-021-01285-w

A “small” dose of 20mg achieves approximately 70% of the effect, while tripling the dose to 60mg only increases the effect to approximately 80%. 

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 doses of 90mg and 120mg do not make sense.

Gradual Taper

Because of this, we recommend that a reverse hyperbolic tapering be performed, reducing the dose a set percentage from the most recent dose every two weeks or more.  Generally, the maximum percentage drop we can 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 $25) to create the doses by weighing the microbeads found inside the capsules

Weighing Page: https://healthwithoutantidepressants.com/weighing/

COUNTING

Creating the doses by counting the microbeads found inside the capsules

Counting Page: https://healthwithoutantidepressants.com/counting/

The online calculators and downloadable spreadsheets, your choice, are available at

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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