Preparing thoroughly for all doctor visits will help you achieve your desired results, such as securing prescription refills/repeats. Many patients are harmed by well-meaning providers that are not informed about how to taper safely off from antidepressants, including duloxetine. Most doctors do not understand that the drug works in a hyperbolic fashion. This means that the drug has the strongest effect at the very lowest doses.
Consider starting the conversation with your doctor like this:
“If I wanted to get off duloxetine, how would you recommend that I go about tapering off of it? I’ve heard it can be a difficult drug to come off. Have you read the latest evidenced based science about the need to slowly taper off of duloxetine?”
Ask questions about how they would recommend tapering off duloxetine to get a sense of their knowledge level about safe tapering. Keep in mind they may be supportive of a slow taper.. Once you understand their perspective on tapering you may or may not want to disclose your tapering goal. Your goal is to keep getting your prescription! Some doctors will pull your prescription or prescribe a dangerous rapid taper. Avoid this at all costs. Some doctors will want to switch (bridge) you to a different drug. Typically bridging to another drug does not prevent withdrawals.
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You ultimately are the driver of your own health care decisions! If your doctor recommends a fast taper it is best to tell them that you will think it over and for now want to stay on the drug at the full dose. This will allow you to secure your prescription and leave all options open.
Be aware that if you tell them that you are opening the capsules and counting/weighing beads they may discount your knowledge about tapering. Some members have had doctors cut them off from refills/repeats due to lack of knowledge about the necessity of a gradual taper. Sometimes the less said the better.
If the doctor suggests using a compounding pharmacy be aware it can be cost-prohibitive for most and difficult to find a knowledgeable compounding pharmacy.
If you feel comfortable printing off the following letter by Angie Peacock MSW and handing it to them, that might work to your advantage. The letter lists evidence-based resources for deprescribing and patient experiences of tapering and healing from psychiatric drugs.
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