Antidepressants are psychotropic drugs used mainly to treat depression. They improve mental mood, reduce or relieve melancholy, lethargy, apathy, anxiety and emotional tension, increase psychic activity, normalize sleep patterns and appetite in a depressed person. Currently, in practical medicine, a large number of antidepressants are used. They have different chemical structures, varying from each other in pharmacological and neurochemical profiles.
Antidepressants are not addictive. What patients call dependence is usually a withdrawal syndrome. If you take antidepressants for more than one week and then abruptly stop, in about 20-30% of cases, very unpleasant symptoms may occur, and if you start taking the medication again, they will disappear. The most common withdrawal symptoms are fatigue, headache, nausea but many other symptoms can also occur, from a runny nose to irritability. After a week or two, all this should go away. However, this is not an addiction: if you reduce the dose gradually over a period of weeks, you will be fine and there will be no urgent need to take the drug again. Heroin or alcohol instead are really addictive.
Cymbalta is an antidepressant, serotonin and noradrenaline reuptake inhibitor that weakly suppresses dopamine reuptake and has no significant affinity for histaminergic, dopaminergic, cholinergic and adrenergic receptors. The mechanism of action of duloxetine in the treatment of depression is to inhibit serotonin and noradrenaline reuptake, resulting in increased serotonergic and noradrenergic neurotransmission in the central nervous system. Cymbalta has a central mechanism of pain suppression, which is primarily manifested by an increase in the threshold of pain sensitivity in pain syndrome of neuropathic pain.
Cymbalta withdrawal occurs because most antidepressants affect certain receptors (nerve endings) that affect brain function. As long as these receptors are saturated with the substances in the medication, many chemical and biological processes in our body are blocked. As soon as a person stops taking Cymbalta these processes are released and the body can respond with a variety of negative reactions.
Avoiding withdrawal completely is almost unrealistic as the body gets too used to living on antidepressant stilts. The severity of withdrawal will depend on how long the Cymbalta has been taken and on the individual characteristics of the body. Abrupt withdrawal should be avoided. When duloxetine treatment is discontinued, the dose should be gradually reduced over one to two weeks to reduce the risk of withdrawal. Some practices lead to weaning off Cymbalta successfully. If significant Cymbalta withdrawal symptoms occur after dose reduction or after stopping treatment, a continuation of the previously prescribed dose may be considered. The physician may then continue to reduce the dose, but more gradually.
The most common Cymbalta withdrawal symptoms are dizziness, sensory disturbances (including paranesthesia), sleep disturbances (including insomnia, intense dreaming), agitation or anxiety, nausea and/or vomiting, tremor, headache, irritability, diarrhea, hyperhidrosis, vertigo.
Cymbalta weaning schedule: dose reduced by 50% for 3 days, reduced again by 50% for 3 days, complete cessation. If withdrawal symptoms occur, increase the dose, wait until withdrawal symptoms subside and continue the reduction.
It is best to reduce your dose during holidays, long weekends (e.g., New Year’s Eve) to have time to rest, get enough sleep and go for a walk in the fresh air. Because no matter how hard you try to brave the situation, it will not be easy to concentrate attention, to keep your thoughts fresh, to communicate normally, to keep your sanity. Even regular housework will be difficult to do. The best time for Cymbalta withdrawal is in late spring or summer. The hardest time to come off the medication is in autumn, especially late autumn.
For the first few days after you stop taking Cymbalta, try to get more rest and eat healthy foods: your diet is fresh fruit and vegetables. If you want something hot, make it a liquid or semi-liquid meal: soup, puree or mashed potatoes. It is also important to drink juices and water so that the Cymbalta withdrawal happens as soon as possible.
During the first week or two of the Cymbalta withdrawal periods, you may want to postpone all physical work and sports with heavy loads: Active exercise is not suitable but yoga and walking may be a good idea. Ask your doctor what vitamins and supplements you should take to help you through withdrawal. Fish oil, magnesium and various multivitamin complexes are usually the most helpful.
If you don’t live alone, tell your family (or at least one other person) how you feel, so that they can help you, talk to you, reassure you. It also makes sense, because irritability, nervousness can ruin the relationship with the person if he or she will not be aware that you have a reason for it.
Ask someone to look after you. The fact is that during Cymbalta withdrawal, people can do the most unexpected things. For example, some patients may commit suicide in the aftermath of treatment, driven by momentary despair. Have someone look after you when you are going through a difficult time.
A particular feature of Cymbalta is that the same symptoms can occur both during and after withdrawal of the drug. In order to prevent the development of withdrawal syndrome, special withdrawal schemes are used. They require the attention of both the patient and the doctor, but should not be neglected.
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