This page lists many of the authoritative materials used to develop the Cymbalta Hurts Worse Gradual Taper™ Method.

STUDIES, PUBLICATIONS, PRESENTATIONS

Dr. Mark Horowitz, Clinical Research Fellow in Psychiatry

North East London NHS Foundation Trust (NELFT) video: https://www.youtube.com/watch?v=DnoyAcwO_OA
excellent article: [ignore the many “click me’s”] https://europeantimes.news/2024/05/users-of-antidepressants-may-suffer-due-to-doctors-not-knowing-new-research-and-guidelines/
book: The Maudsley Deprescribing Guidelines

The Maudsley® Deprescribing Guidelines is a comprehensive resource describing guidelines for safely reducing or stopping (deprescribing) antidepressants, benzodiazepines, gabapentinoids, and z-drugs for patients, including step-by-step guidance for all commonly used medications, covering common pitfalls, troubleshooting, supportive strategies, and more. Most formal guidance on psychiatric medication relates to starting or switching medications with minimal guidance on deprescribing medication. Most importantly, this book covers the critical subject of why and how to implement hyperbolic tapering in clinical practice.

Anders Sorenson, PhD, Danish clinical psychologist

He has undertaken extensive research which assesses the state of guidance on psychiatric drug withdrawal. He has also paid close attention to tapering methods with the aim of identifying approaches which might make withdrawal more tolerable for people. In addition to his research work, Anders utilizes psychotherapy in his private practice when helping people to come off the drugs.

PhD thesis: https://www.psykologanders.dk/wp-content/uploads/2022/10/PhD-thesis.pdf
website: https://www.madinamerica.com/2022/11/anders-sorensen-tackling-psychiatric-drug-withdrawal-research-practice/
video: https://www.youtube.com/watch?v=IOc8t1A7YSg
video: https://www.youtube.com/watch?v=or0MRaEdNBE
article: https://www.newsweek.com/how-kick-antidepressant-drugs-without-triggering-relapse-new-research-1745509
article: https://digitalcollection.zhaw.ch/bitstream/11475/26458/3/2022_Horowitz-etal_Estimating-risk-of-antidepressant-withdrawal.pdf
course: https://www.scientificfreedom.dk/2023/03/27/psychiatric-drug-withdrawal-first-course-in-denmark/

Dr. Peter Breggin

“In this book, Dr. Breggin systematically outlines how to safely withdraw a patient from psychiatric medication with rich case examples drawn with the detail and sensitivity to individual and situational differences that reveal not only his extensive clinical experience, but his clear, knowledgeable, and compassionate vision of a more humane form of treatment. In this volume, Dr. Peter Breggin has again demonstrated that he is a model of what psychiatry can and should be.” — Gerald Porter, Ph.D., Vice President for Academic Affairs, School of Professional Psychology, Forest Institute, Springfield, MO

“Peter Breggin has written a unique, brilliant, and comprehensive book that every mental health professional should read and “prescribe” to their patients and families! Dr. Breggin is a true pioneer in identifying the dangers of psychiatric drugs, being the first to warn us decades ago that treatment of the mentally ill would devolve to the shameful status it reveals today.” — Fred Ernst, Ph.D., Professor of Psychology, University of Texas – Pan American

book: https://breggin.com/article-detail/post_detail/a-guide-for-prescribers-therapists-patients-and-their-families

Wikipedia

DISCONTINUATION SYNDROME: … In 2012 The Institute for Safe Medical Practices (ISMP) published a report: “Duloxetine and Serious Withdrawal Symptoms”. The report highlights early clinical studies which found “abrupt discontinuation showed that withdrawal effects occurred in 40-50% of patients, that 10% of those were severe and approximately half were not resolved when side effects monitoring had ended after one or two weeks”.

Withdrawal symptoms listed in 48 case reports (in the first quarter of 2012) included anger, crying, dizziness and suicidal ideation.

The report concluded there was insufficient information and a lack of clear warnings about the effects of discontinuing duloxetine and that in many cases withdrawal symptoms may be “severe, persistent, or both”, adding “the prescribing information for physicians and pharmacists does not provide realistic schedules for tapering or a clear picture of the likely incidence of these reactions”.
https://en.wikipedia.org/wiki/Duloxetine

Eli Lilly Cymbalta documentation, highlighted

https://breggin.com/admin/fm/source/6905_breggin/antidepressant-drugs-resources/CYMBALTA2015-HIGHLIGHTED.pdf

Mad in America – Withdrawal Protocol Overview

“In short, the best tapering schedule is one that allows the person to withdraw while avoiding or minimizing withdrawal symptoms to a level where they can be tolerated and do not require major life adjustments. Since people have different tolerances, withdrawal is likely to need a person-centered, almost unique approach. Tapering speeds There is a wide disparity between tapering guidelines developed by professional organizations and the advice and practices that have originated within the “lived experience” community. The professional guidelines typically recommend much shorter tapers than recommended by those with lived experience, and protocols for lowering doses may vary greatly as well.”

https://www.madinamerica.com/withdrawal-protocols-antidepressants/

Protracted Withdrawal Syndrome (PAWS, P.A.W.S., PWS) article

“Conclusion: PWS or PAWS from antidepressants can be severe and long-lasting, and its manifestations clinically heterogeneous. Long-term antidepressant exposure may cause multiple body system impairments. Although both somatic and affective symptoms are frequent, they are mostly unrelated in terms of occurrence. Proper recognition and detection of PWS thus requires a comprehensive assessment of medication history, duration of the withdrawal syndrome, and its various somatic, affective, sleep, and cognitive symptoms.”

https://pdfs.semanticscholar.org/22b0/1b003a336f3d0beb7d303c1404eaf540fa8f.pdf

WEBSITES AND OTHER RESOURCES

International Institute for Psychiatric Drug Withdrawal

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.

https://iipdw.org/

Mad in America

From their “Withdrawal – Antidepressants” section

- Learn about research on antidepressants and withdrawal effects.
- Read blogs and listen to podcasts related to withdrawal from antidepressants.
- Access other resources related to withdrawal from antidepressants.

https://www.madinamerica.com/