These are simple questions, mostly with short answers.
The key words, in combination with the name of the drug, should help you search online – or on this website – for more information.
(The ideal would be you click on a question and it rolls over to reveal the answer. The original was a click which took you to the answer lower down. This explains why questions and answers are not in the same order. The ones with (LINK) need to be linked to the key post.)
ADDICTIVE Is Cymbalta/duloxetine addictive?
AKATHISIA What is akathisia?
ALTERNATIVES What can I do instead of taking drugs?
ANGER Can I manage anger without drugs?
ANXIETY Can I manage anxiety without drugs?
BEADS What are the beads you keep talking about?
LISTEN TO YOUR BODY What do you mean, “Listen to your body”?
BRIDGING What is bridging?
CHEMICAL IMBALANCE Is there such a thing as a chemical imbalance?
CONFUSION Why is my brain so foggy?
COURT Can we take the makers of this drug to court?
CRYING Is crying a side effect of Cymbalta/duloxetine?
DANGERS How bad is Cymbalta/duloxetine?
DOCTORS Why do doctors keep prescribing Cymbalta/duloxetine?
DOSE What is the normal dose? What size capsules are available? Can you get Cymbalta/duloxetine as a liquid?
ELECTROLYTES I’ve been told electrolytes might help. What are they? Can I make my own?
EMOTIONS What does Cymbalta/duloxetine do to the emotions?
ENTERIC COATING What is the enteric coating?
EVERY OTHER DAY Can I taper by taking Cymbalta/duloxetine every other day or skipping several days?
EYES Does Cymbalta/duloxetine affect the eyes?
FAST TAPER What do you mean by a fast taper?
FATIGUE Can Cymbalta/duloxetine cause fatigue?
FIBROMYALGIA What is it? How can I treat this without drugs?
OUT of the SYSTEM How long does Cymbalta/duloxetine/duloxetine stay in the system?
HALF-LIFE What is it?
INCONTINENCE Are my water-works affected by Cymbalta/duloxetine?
INTERACTIONS Can I take SAM-e, Gabapentin, 5-HTP, Lyrica etc.at the same time?
ITCHING Does Cymbalta/duloxetine cause itching?
JOURNAL Why should you keep a journal?
LIVER Can Cymbalta/duloxetine affect the liver?
MAGNESIUM Which sort should I take?
MEMORY Does Cymbalta/duloxetine affect the memory?
MOUTH Can Cymbalta/duloxetine affect the mouth? Cause burning?
MUSCLES How can Cymbalta/duloxetine affect the muscles?
OPENING THE CAPSULES How can I open the capsules?
OTHER ANTI-DEPRESSANTS If Cymbalta/duloxetine didn’t work for my original problem, will other antidepressants?
PACKAGE INSERT Where can I find the Cymbalta/duloxetine package insert?
PAIN Does Cymbalta/duloxetine help pain or cause it?
PAWS What is PAWS?
PERCENTAGES for TAPERING Why 5%? Why do we occasionally mention 10%?
POLYPHARMACY What does polypharmacy mean?
RECOVERY How long will recovery take after an unsafe taper?
SEROTONIN SYNDROME What is it?
SEXUAL PROBLEMS Will Cymbalta/duloxetine affect my sex life?
SIDE EFFECTS Have you a full list, please? Can Cymbalta/duloxetine be causing problems with skin, breathing, pain, sleep? Can it increase depression, suicidality, anxiety, etc.?
SLEEP and DREAMS Does Cymbalta/duloxetine affect sleep and dreams?
STABILISE What do you mean, wait till I stabilise?
SWEATING Can Cymbalta/duloxetine cause sweating?
TEETH Can Cymbalta/duloxetine affect teeth?
TINNITUS Can Cymbalta/duloxetine cause Tinnitus?
WEIGHT Can Cymbalta/duloxetine cause weight issues?
WEIGHT of my DOSE How do I know how many milligrams of Cymbalta/duloxetine I am taking, once I start tapering?
WHEN SHOULD I TAKE CYMBALTA/DULOXETINE? Is it better in the morning? Or the evening? Twice a day?
WITHDRAWAL Are there withdrawal issues with Cymbalta/duloxetine?
Those were the questions …
… and now for the answers.
DANGERS
How bad is Cymbalta/duloxetine?
Very, seriously, dangerously bad. Read this linked document. It covers all aspects of the problems associated with Cymbalta/duloxetine withdrawal symptoms. It deals with the unreliability of the documentation provided by the manufacturer.
https://www.baumhedlundlaw.com/pdf/DrGlenmullenDeclarationSupportofCymbalta/duloxetineClassCert.pdf
WEIGHT
Does Cymbalta/duloxetine cause weight issues?
Yes, Cymbalta/duloxetine can affect weight – either loss or gain. However, weight gain is more common. Many people report that the weight put on while taking Cymbalta/duloxetine/Duloxetine comes off rather easily after they have tapered off.
ADDICTIVE
Is Cymbalta/duloxetine addictive?
In human terms of being able to stop taking it – Cymbalta/duloxetine is horrendously addictive. A safe taper to avoid side effects – we hope! – will take yuears
WITHDRAWAL
Are there withdrawal issues with Cymbalta/duloxetine? (LINK)
Yes! Withdrawal issues can last for months or years. Take no notice of so-called experts and doctors who say it is easy to come off Cymbalta/duloxetine. Even the drug insert warns that some people take a long time to reduce safely. (But they don’t tell you how to do that!)
EVERY OTHER DAY
Can I taper by taking Cymbalta/duloxetine every other day or skipping several days? (LINK)
No. This puts you into withdrawal after the very first day. It is extremely dangerous.
OTHER ANTI-DEPRESSANTS
If Cymbalta/duloxetine didn’t work for my original complaint, will other antidepressants help?
Unlikely. You might seem to improve for a while. Eventually, all these drugs cease to work and leave you with years of tapering and side effects. In any case, you will need to spend years tapering slowly off this drug and that is likely to put you off antidepressants for life.
ALTERNATIVES
What can I do instead of taking drugs? (LINK)
Find the root cause of your problem. (A functional/homeopathic/orthomolecular clinician may help.)
Use diet, appropriate supplements, lifestyle choices to manage the problem. Be aware that this drug may actually cause the thing it is supposed to cure.
SIDE EFFECTS LINK to SIDE EFFECTS
Can Cymbalta/duloxetine be causing problems with … (add your key word here!) skin, breathing, pain, sleep? Can it increase (add your key word here), etc.? (LINK)
Yes! To almost any side effects!
ENTERIC COATING
What is the enteric coating?
The beads are individually enterically coated to delay the release of the drug until it leaves the stomach and enters the upper intestine. (They are only ‘time-delayed’ inso far as the coating makes them survive into the intestine.)
INTERACTIONS
Can I take SAM-e, Gabapentin, 5-HTP, Lyrica etc. at the same time? (For example) (LINK)
No, they directly affect serotonin. They should not be taken while taking or tapering off Cymbalta/duloxetine. Additionally, they have their own side effects and withdrawal problems. CHW is opposed to all psychotropic drugs.
You should check ALL drugs and supplements for interactions. You could use this website: https://www.drugs.com/drug_interactions.html
CAPSULES
Must I use a capsule? (LINK)
Yes.
The drug must be taken in a gel capsule. We recommend you use the original capsule or a new one. This can be vegetarian.
The usual size is 0. Some people prefer 00 which is larger. The size makes no difference to the effect of the beads, but it may make it easier to fill them.
Capsules may be found online or in health food shops and some pharmacies.
BUT in an emergency: A small, old, scientific study has shown that beads without a capsule can be taken in applesauce: https://www.ncbi.nlm.nih.gov/pubmed/18691989
PACKAGE INSERT
Where can I find the patient package insert?
https://pi.lilly.com/us/cymbalta-pi.pdf
https://medlibrary.org/lib/rx/meds/duloxetine/
SWEATING LINK to SIDE EFFECTS
Can Cymbalta/duloxetine cause sweating?
Yes. Sometimes great floods during the night!
RECOVERY
How long will recovery take after an unsafe taper?
Everyone is unique – we have no idea. Some really rare people have had no withdrawal issues. It is very common to spend years in withdrawal.
OUT of the SYSTEM
How long does Cymbalta/duloxetine stay in the system?
Tapering is not about getting the drug out of the system. The very first dose starts to restructure the brain. The effects stay for a very, very long time. Tapering is about letting your brain readjust, to recover.
WEIGHT of my DOSE
How do I know how many milligrams of Cymbalta/duloxetine I am taking, once I start tapering?
If you are not good at math, ask someone to help.
Or, try adapting this, by putting your own figures in and doing the sum.
I started with a 30mg dose, and my average number of beads in 3 capsules was 178 beads. I’m now on 28 beads. Multiply 30 x 28 and divide by 178. Answer = 4.7 mg
If you enter this formula in a spreadsheet you can keep a record of your progress.
EYES
Does Cymbalta/duloxetine affect the eyes? LINK to SIDE EFFECTS
Yes. Eli Lilly has documented these side effects / adverse events:
diplopia (blurred vision)
glaucoma (disease)
keroconjunctivitis sicca (dryness of the conjunctiva & cornea; too few tears produced, or tears evaporate too quickly)
macular degeneration (loss of central vision)
maculopathy (loss of acuity)
mydriasis (dilated pupils)
photopsia (visual distortions)
photosensitivity (sensitivity to light)
retinal detachment (loss of vision where retinal layer detaches)
blurred vision
visual disturbances
COUNTING and WEIGHING WORRIES
What can I do if I am seriously worried about making the correct doses, either by counting or weighing?
Read the How to taper post carefully. Take your time and make notes. LINK
ANGER
Can I manage anger without drugs? LINK to SIDE EFFECTS
Yes, diet will help. Sugar, dairy and processed foods are bad foods for brain health.
Try magnesium glycinate at night 400-800mg. Motherwort tea is said to work wonders.
Keep your Omega-3 levels high. You can find vegetarian omega-3 if you are vegetarian.
Sleep as much as you can while your brain is healing. Eat brain-healthy foods to support your healing.
Take Vitamin D and vitamin C
ELECTROLYTES
I’ve been told electrolytes might help. What are they? Can I make my own?
What they are and what they do:
https://www.medicalnewstoday.com/articles/153188?fbclid=IwAR34yXtccihsSljToyoF42kAkd4546EsPt4KgVBy6t2qDgsEPwX3iAXsaVM
Here are some healthy, homemade electrolyte drinks. (Avoid Gatorade and similar drinks.)
https://www.wellandgood.com/…/better-than-gatorade-diy…/
https://www.fivehearthome.com/homemade-all-natural…/
CHEMICAL IMBALANCE
Is there such a thing as a chemical imbalance in your brain?
Recent research (Link) shows there is NO evidence whatsoever of this. Millions of people have been sold this lie.
FAST TAPER
What do you mean by a fast taper? LINK
Depending on circumstances, the best taper % is 5% at most, holding for 14 days at least. Anything faster than this is a fast taper. Exceptional circumstances are: pregnancy, serotonin syndrome, being on Cymbalta/duloxetine only a very short time.
MAGNESIUM LINK
Which sort should I take?
For sleep: 400-800mg evenings.
AKATHISIA
What is akathisia? LINK
This is only caused by medication! “A neurological complication characterized by strong, uncontrollable feelings of abject terror, inner restlessness, and a physical inability to remain still” and the rest of the definition. Hell on Earth.
BEADS
What are the beads you keep talking about? LINK
The Cymbalta/duloxetine capsules contain either tiny, tiny beads or just a few chunks. They are also called ‘pellets’.
You can only use the beads for tapering. A 30mg capsule may have 180 – 200 beads in it. The numbers vary.
LISTEN TO YOUR BODY
What do you mean, “Listen to your body.”?
Keep a detailed journal of all the side effects. Observe carefully what happens to you and how you feel. Then you can spot slight changes which tell you to slow the taper.
BRIDGING
What is bridging? LINK
Doctors often add another drug, especially when tapering patients off Cymbalta/duloxetine. This often has a dangerous interaction and does not help the withdrawals.
CONFUSION
Why is my brain so foggy? LINK to SIDE EFFECTS
This is a common side effect of Cymbalta/duloxetine.
COURT
Why can’t we take the makers of this drug to court?
You can try – it has been done. It was not worth it. They are Big Pharma and have money and power. Concentrate on your recovery. LINK
POLYPHARMACY
What does polypharmacy mean?
Officially, it means taking 5 or more drugs at the same time. Some people would just say “taking multiple drugs”.
FATIGUE LINK to SIDE EFFECTS
Can Cymbalta/duloxetine cause fatigue?
Yes. This is a common effect of Cymbalta/duloxetine, especially after a dangerous taper.
MUSCLES LINK to SIDE EFFECTS
How can Cymbalta/duloxetine affect the muscles?
It can cause tiny tears in the muscles which can cause all levels of pain. It can cause pain in other ways too.
EMOTIONS LINK to SIDE EFFECTS
What does Cymbalta/duloxetine do to the emotions?
When taking Cymbalta/duloxetine, it may numb your feelings, take away your emotions. During and after tapering, emotions may be more extreme than usual as they come back.
LIVER LINK to SIDE EFFECTS
Can Cymbalta/duloxetine affect the liver?
Yes, especially when interacting with other drugs.
DOSE
What is the normal dose?
There is no normal dose. Even the makers tell us there is no evidence that more than 60 mg produces better results. But many people are on 60 mg or 30 or 90. And some are on 120 or even higher! Fewer are on 20 mg. 30mg is referred to as a “low” dose. When you are tapering, you may discover that even one mg can be too much for you.
CAPSULES
What size capsules are available? LINK
Capsules come in 30 mg and 60 mg. Some countries have 20 mg.
LIQUID
Can you get Cymbalta/duloxetine as a liquid?
No. Cymbalta/duloxetine has to be taken in a capsule so it can reach the upper intestine. Recent (2023) reports suggest there may be liquid versions available. We would not recommend them.
PAIN
Does Cymbalta/duloxetine help pain or cause it?
Both. The longer you take it, the more likely you are to suffer from pain.
PERCENTAGE FOR TAPERING LINK
Why 5%? Why do we ever even mention 10%?
Depending on circumstances, experience has shown that the best taper % is 5% at most, holding for 14 days at least. Anything faster than this is a fast taper. 10% may be appropriate: in pregnancy; if you have serotonin syndrome; if you have been on Cymbalta/duloxetine only a very short time.
CRYING and SOBBING LINK to SIDE EFFECTS
Is crying and sobbing a side effect of Cymbalta/duloxetine?
Yes, these are common side effects of Cymbalta/duloxetine. Great howls of anguish. And also a withdrawal symptom, long after a slow taper.
SIDE EFFECTS LINK to SIDE EFFECTS POST
Can Cymbalta/duloxetine be causing problems with skin, breathing, pain, sleep? Can it increase depression, suicidality, anxiety, etc.?
Yes. All of these and many, many more. Don’t just assume it IS caused by Cymbalta/duloxetine. Get other possibilities checked out. If all else is fine – probably it is Cymbalta/duloxetine.
ITCHING LINK to SIDE EFFECTS
Does Cymbalta/duloxetine cause itching?
Yes. This is a common side effect. It can drive you crazy.
MEMORY LINK to SIDE EFFECTS
Does Cymbalta/duloxetine affect the memory?
Yes. This is a common side effect. Omega-3 capsules should help.
JOURNAL LINK
Why should you keep a journal?
Keep a detailed record of all the tapering details – date, %, number of beads – and all the side effects experienced. Then you can learn to “Listen to your body.” and make changes to your taper if you need to. (Link)
DOCTORS
Why do doctors keep prescribing Cymbalta/duloxetine?
Money. Arrogance. Ignorance. Poor training. Lack of time. Lack of interest.
It’s not important – your recovery isn’t worth the wasted energy thinking about it. If you try to educate them, they may cause problems for you.
MOUTH LINK to SIDE EFFECTS
Can Cymbalta/duloxetine affect the mouth? Cause burning?
Yes. This is a common side effect.
OPENING the capsules LINK
How can I open the capsules?
A gentle twist may work, then you can reuse the capsule. Some people twist and cannot reuse it. Some use a knife.
SEROTONIN SYNDROME LINK
What is it?
It is such a bad reaction to Cymbalta/duloxetine or other drugs that the life is in danger. The body has reached its limit of serotonin, probably by being prescribed two or more varieties of the same type of drug. The drug must be stopped immediately, regardless of the damage that may cause.
SEXUAL PROBLEMS LINK to SIDE EFFECTS
Will Cymbalta/duloxetine affect my sex life?
Very likely. It may affect your libido, your ability to manage a relationship, the sex act itself.
TEETH LINK to SIDE EFFECTS
Can Cymbalta/duloxetine affect teeth?
Yes. This is a common effect of Cymbalta/duloxetine. They may crumble.
WHEN SHOULD I TAKE CYMBALTA/DULOXETINE?
Is it better in the morning? Or the evening? Twice a day?
It probably depends on you. If you need to switch, change slowly by an hour at a time, spread over a few days.
STABILISE LINK
What do you mean, wait till I stabilise?
If you are suffering withdrawal symptoms, stop tapering and keep the same dose until you feel everything is “right” again. Then hold for 3 more weeks.
If you have reinstated, keep the same dose until you feel everything is “right” again. Then hold for 3 more weeks.
Some people never feel completely stable. Sometimes it’s just recognising when things are “as good as they can get”.
FIBROMYALGIA LINK to SIDE EFFECTS
What is it?
It is a long-term condition that causes pain all over the body. Various possible causes. One cause is certainly the use of Cymbalta/duloxetine.
How can I treat FM without drugs?
You can work hard on nutrition, appropriate supplements and lifestyle changes.
HALF-LIFE
What is it?
The short, unscientific version: how long it takes half the dose to be out of the body. Cymbalta/duloxetine has a short half-life of 12 hours. This means you can soon start having withdrawals if your next dose is late.
INCONTINENCE LINK to SIDE EFFECTS
Are my water-works affected by Cymbalta/duloxetine?
Yes. Difficulty in starting, frequency, difficulty in stopping: they can all be a problem.
PAWS LINK
What is PAWS?
Protracted Acute Withdrawal Syndrome – significant withdrawal symptoms, usually after an unsafe taper or cold turkey. This can be debilitating, even life-threatening and last months or even years.
ANXIETY LINK
Can I manage anxiety without drugs?
You can work hard on nutrition, appropriate supplements and lifestyle changes. Remember: the patient package insert mentions that this drug may actually cause anxiety.
TINNITUS LINK to SIDE EFFECTS
Can Cymbalta/duloxetine cause Tinnitus?
Yes. This is a common problem.
SLEEP and DREAMS LINK to SIDE EFFECTS
Does Cymbalta/duloxetine affect sleep and dreams?
Yes. Sleep can be impossible OR we can’t wake up! Dreams commonly disappear while taking Cymbalta/duloxetine and reappear – often violently – during the taper or after it.
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