Symptoms following abrupt discontinuation of duloxetine treatment in patients with major depressive disorder




ABSTRACT

BACKGROUND: Discontinuation symptoms are common following antidepressant treatment. This report characterizes symptoms following duloxetine discontinuation. METHODS: Data were obtained from 9 clinical trials assessing the efficacy and safety of duloxetine in the treatment of major depressive disorder (MDD).

RESULTS: In a pooled analysis of 6 short-term treatment trials, in which treatment was stopped abruptly, discontinuation-emergent adverse events (DEAEs) were reported by 44.3% and 22.9% of duloxetine- and placebo-treated patients, respectively (p<0.05). Among duloxetine-treated patients reporting at least 1 DEAE, the mean number of symptoms was 2.4. DEAEs reported significantly more frequently on abrupt discontinuation of duloxetine compared with placebo were dizziness (12.4%), nausea (5.9%), headache (5.3%), paresthesia (2.9%), vomiting (2.4%), irritability (2.4%), and nightmares (2.0%). Dizziness was also the most frequently reported DEAE in the analyses of 3 long-term duloxetine studies. Across the short- and long-term data sets, 45.1% of DEAEs had resolved in the duloxetine-treated populations by the end of the respective studies, and the majority of these (65.0%) resolved within 7 days. Most patients rated the severity of their symptoms as mild or moderate. A higher proportion of patients reporting DEAEs were seen with 120 mg/day duloxetine compared with lower doses. For doses between 40 and 120 mg/day duloxetine the proportion of patients reporting at least one DEAE differed significantly from placebo. Extended treatment with duloxetine beyond 8-9 weeks did not appear to be associated with an increased incidence or severity of DEAEs.

CONCLUSIONS: Abrupt discontinuation of duloxetine is associated with a DEAE profile similar to that seen with other selective serotonin reuptake inhibitor (SSRI) and selective serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressants. It is recommended that, whenever possible, clinicians gradually reduce the dose no less than 2 weeks before discontinuation of duloxetine treatment.

LIMITATIONS: The main limitation is the use of spontaneously reported DEAEs.


SOURCE:-
Perahia DG, Kajdasz DK, Desaiah D, Haddad PM.
Lilly Research Centre, EMC Building, Erl Wood Manor,
Sunninghill Road, Windlesham, Surrey, GU20 6PH, UK;
The Gordon Hospital, London SW1, UK.
J Affect Disord. 2005 Dec;89(1-3):207-12.



You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

How Long Cymbalta Takes to Clear out of Your System: Two to four days to get clean.
SOURCE:- crazymeds.org All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to other's won't necessarily happen to you. Nobody on this site is a doctor, therapist, or a pharmacist.
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I mean no disrespect here, but for me, this drug was pure hell to get out of my system. I am still having problems that started when I started taking this med. For some though it's a miracle drug. I'm happy for these folks but for me-it's put me on a downward spiral that is apparently not going to end any time soon.

Cheryl

Agreed

Unexplained bleeding after withdrawal from Cymbalta?

I just wondered if anyone else experienced this after taking Cymbalta...I am 51 year old (post-menopausal, I thought!) woman, who has had no periods for a year and a half. Now, one week after stopping Cymbalta, I had swollen tender breasts, and about 3-4 weeks after stopping Cymbalta, I have started a period. I am trying to see if this has happened to anyone else on here, or is it just a coincidence, and something else is going on in my system? Thanks.

I had this about a year after I thought I was through menopause. One time, mind you, but when you think it's over, it really seems strange. It's been a couple of years ago. I was ON cymbalta when this happened, and am STILL on it and having hot flushes two or three times a day. If I have to go through that again, I'll never get off it, lol!

Jackie

I have been without medical insurance since May because I had to leave my job to go out of state to take care of parents with health issues. I was running low on Cymbalta and for about a week I was taking it every other day and then went about 3 days without after I exausted my supply. I experienced increased dizzyness , increased iritability , and crazy, crazy dreams at night. I finally went to a family practice doctor, paid the office visit and they gave me some samples of the med. Cymbalta is an expensive drug.

Hi, my name is jennie and I have been on cymbalta for a couple of months now. I have talked to my doc about getting off of it..I am currently on 60mg a day. Two days ago I started my tapering. He has told me to take one 60mg every other day for two weeks and then one evry 3 days for two weeks, then to stop completly. After reading many of these stories I am terrified. today is my 3rd day; so I took one 60mg this morning. There have been times that I have forgotten to take my pill and I have noticed alot of the side effects. I want to be completely off of this but I kno3w that I am gonna need the support fro others to make it thru all of it.

I didn't think this was the symptom of Cymbalta, but maybe it is. Because of my ed I haven't had periods for a while and I got some "sort of" periods when I stopped taking Cymbalta for few days. Don't know if that's the reason, I just hoped that my periods would start again

I have been on Cymbalta 120mg for four years now. I attempted this year to quite cold turkey. It was not that bad because I am on two more drugs that might be balancing the lack of Cymbalta in my system. There is one crazy side effect I have when not taking Cymbalta, I can hear a swishing sound when my eyes move. It is really irritating and does not stop. Even while you sleep. I have found out through extensive research that it has to do with the serotonin level in the brain. I did not know that Cymbalta affected levels that much. Anyway, I had to go back on it and now everything is ok. I am still depressed but not as bad when I stopped taking Cymbalta.

I took Cymbalta for 3 days and on the third day passed out after having heavy heart palpatations through the night. The doctor said it had nothing to do with it but I think she was just covering her butt, which means it never went on my record or reported to the makers. I've never experienced anything like it before or since and was not on any other medications.

You can report this to the company if you look on the drug insert. They do have a number you can call.

Jackie

I wonder if Eli-Lilly really cares? After all, "... discontinuation syndrome/effects"? Didn't that used to be "Withdrawal Symptoms?

I don't know if it's helpful for many folks, but after the paroxetine withdrawal debacle, Big Pharma's really spinning stuff ...

I'm not trying to defend Eli Lily or any other pharma comany, but really, I'm growing quite tired of the bashing because of the withdrawal side effects. This is common knowledge now and its not just cymbalta that has bad withdrawal effects. Search the web and you will find withdrawal horror stories for every AD out there. You have two choices:

1) You can take the medication and hope it works for you and worry about the withdrawal side effects when it comes time to cross that bridge. The withdrawal IS NOT going to kill you and there are ways to lessen the effects if you have a competent doctor. If you arent seeing a psychiatrist, shame on you.

2)You can take nothing and ty to deal with your mental illness drug free because you are worried about something that might/might not happen to you. Good luck.

This post has been edited by maintainin: May 1 2008, 06:53 PM

I have only taken one dose of cymbalta and it was a 20 mg dose. However, I really disliked the drug. It made my insomnia much worse and caused me much more anxiety. I told my doctor and he said to just stop taking it.
I've read so much about the "withdrawal" and I know that I only had one dose, but are there any side effects I should be aware of now that I have decided to discontinue the use? I had asked my doctor but he seemed generally unconcerned.

anyone have any thoughts? It would be much appreciated!!

I have to say I have been on it for 6 months now and I HATE HATE HATE the side effect of this stuff.. it is harsh and i feel that , in my case, it all depends what part of my cycle I am in ... I know it must sound far fetched to the male readers.. and pms is something that we have to deal with already.. but I think it makes it SOOO much worse for me .... it even makes me have double the periods some months..

try telling this to my doctor and she just tells me that it is for my own good to stay on them and deak with all that comes my way..

yeah NO

I have also recently started seeing a new ahrink that has never given her patients these meds and wonders why my doctor did HMMMMM

so after telling my shrink I wanted to get off these pills .. and waiting too long for my sext seeion I have teken myself offf them...

yeah smart idea I know.. and HOLY are my ears ringing... or soemthing of the sort.. I feel like I am in the middle of some gigantic hummmmmmmmming computer or something.. anyone else have similar???

My husband has just recently stopped his Cymbalta. I am very concerned about him, he seems to zone out all of a sudden almost like in a daze. I am worried because he drives for a living and affraid this might happen while driving has anyone else had similar effects? Would love help.

six months on 30mg (not much), not effective, but I was kinda stoned every single morning..headache, nausea, fatigue.
What's the point then ? get a supposed medication and feel worse in your body which aggravates your 'background' ?
So, i opted for stopping it cold turkey two days ago...also talked to my buddie shrink, says if your system can stand it,
it's ok. otherwise try the 48 hrs/ pill dosage for 15 days..and then, finito
So far, i feel much better than before...D*** medications and their side effects

did you stop taking the drug? if so are you on anything else now?

Agree! I had been on Cymbalta for 8 months mostly for GAD and mild depression...last year was horrible, brother passing, breast cancer scare, laid off from job & almost lost my house...dr put me on Cymbalta 30mg as I was worried about everything to the point where I froze! The last couple of months I could tell I really didn't need it any longer as the side effects kicked in ... excessive sweating, unable to sleep well and my competitiveness was not the usual...the boss & I both wanted it back! NOT EVERYONE HAS MAJOR WITHDRAWAL SYMPTOMS!!!!!! So if you are scared about going off this drug after reading all the posts...remember everyone is different. I had some mild lightheadness and achiness, but that was it. Now 9 yrs ago I was on Effexor for 9 months after my mother passed away & I did have major withdrawal coming off that...brain zaps & all. My dr was very interested in hearing about those! JUST REMEMBER EVERYONE IS DIFFERENT IN EACH DRUG...YOU MAY NOT HAVE MAJOR WITHDRAWAL!

I do love Cymbalta, it has worked wonders for me. Unfortunately, it is crazy expensive and I can no longer afford to take it.

Very stupidly, I quit cold turkey, I VERY MUCH DO NOT RECOMMEND DOING THIS! It has been 1 week since I last took it and I am still feeling nauseated, had some vomiting, diahrrea, and dizziness. Has anyone else gone through this??? How long will I be feeling this way?

Hi

Unfortunately a lot of people are familiar with this. Doctors should really make sure they emphasise the dangers of this when they prescribe the meds.

How long it lasts just depends on the person. For some people, it can just be a few weeks but for others it can be a long old road. If you have a look around the cymbalta forum, you should be able to find some other people's experiences of this.
If you take Benadryl it can help with the nausea and dizziness - although if you're on any other meds, check for interactions with your pharmacist first. The vomiting should wear off quickly but if it doesn't, go straight to your doc. Actually I would go to your doc anyway, sometimes they can prescribe a single dose of prozac to help with withdrawal I think, although that may not be accurate.

Hope you find something cheaper that works. xx

Hi Aureliecleo

I went through exactly what you are going through-HANG IN THERE. The worst of the syptoms lasted about 2 weeks. I am in day 44 of no meds-and I still experience some brain zapping, headaches and nausea. Perhaps if you journalized, you will see the progress through your symptoms. Force yourself to eat properly and focus on positive things-or spend some time in nature. ARE THERE OTHERS OUT THERE GOING THROUGH (OR WENT THROUGH) CYMBALTA WITHDRAWALS?