Monday, March 19, 2012

Such A Slow Process of Detox

Coming off of Cymbalta is probably somewhat comparable to me having to adjust to having a spinal cord injury.  There are obvious differences, but the adjustment is the same - it's horrible.  Each day is different, and no two days are alike - much like the rocks in this picture I took while at the beach.  In the last month, there is only one day that I actually felt "normal."  It was such a respite that was refreshing.  They symptoms in the last post remain the same, though some have dissipated slightly.  As I continue to lower down in dosage, I've noticed that new symptoms bring on challenges of their own.  I'm thankful for the internet because I don't feel alone in this battle as I read of others' withdrawal struggles from Cymbalta.

Upon first diagnosis, I was embarrassed of the process.  I was embarrassed because I'm not someone who uses drugs let alone becomes "addicted" to them.  I felt like I had let myself down and wasn't meeting the expectations of God for my life.  I felt useless because I didn't have any energy to do anything - learn, grow, work, think, read, concentrate, speak, or maintain "kept," as they say in the South.  In fact, the blog I wrote took so long to write with accuracy, and I found myself getting frustrated because I couldn't stay focused.

I do better in one on one situations with people as I don't have to concentrate so hard, yet I still have severe anxiety when having to be somewhere at certain time (i.e. doctor appts) or upon meeting with a large group of people.  My speech is still a slight problem, though I'm probably more aware of it than others.  There's a fogginess to my brain and still an annoying buzzing in my ears.  The cramping in my legs is also unbearable upon dosage drops.  It is completely different than spasms as most people with spinal cord injuries understand.  My legs contract inward and do not want to go straight. It is practically physically impossible to move them while they are in this state - and it happens at least 30 times a day without notice.  This makes transferring extremely hard as moving from one object (bed, couch, car) to my wheelchair requires some straightening of the legs.  And they hurt so much.  I know I'm lowering dosage because the nerve pain has returned to my lower extremities and the lower back pain feels like a tight mess that doesn't want to let up.  *sigh*  I still am dizzy and go through periods of feeling like I see things that aren't really there.  Recently, I've started to hear things that aren't really there.  I have periods where I'm really cold, but for the most part I'm really hot.  Ups and downs, ups and downs.

One symptom that is really annoying is the lack of and/or tons of sleep.  It's either one or the other.  As I said, each day is different.  I never get a restful nights sleep.  I sleep two hours at a time at most before I wake up.  I've now resorted to just staying awake until I literally can't stay awake anymore - which usually ends up around sunrise.  Yes, I know.  You're probably gasping right now of how that is even possible.  Well, it is.  But there's an adverse effect to that of sleeping all day.  This frustrates me because I don't get much accomplished.  I'm thankful that my mom made two different dishes and put them in separate, individual containers in the freezer for me to eat each night.  Otherwise, food wouldn't be a part of my life right now.  I drink Gatorade constantly as I feel it keeps me hydrated.  I've recently gained an obsession with just wanting to flush all these toxins out of my body!  And just to keep it real - things that typically smell from your body, smell worse.  I'll just leave it at that.  I blame it on the toxins and although it grosses me out, it somewhat satisfies me that it's out of my body!

Below are pictures of the little balls of poison that are in each capsule.  (I do not intake them like this but keep them in capsule form until I have to manually remove balls after 20 mgs. because they don't come in smaller dosages than that dosage.)  The highest dosage I was on was 60 mgs capsules, seen here in the first picture.  I then lowered to 30 mgs capsules after a couple weeks.  This was a hard week as it was half of what I was taking originally.  My body definitely reacted poorly and I had all the side effects mentioned in the previous post, but I feel as if my body was still thinking it was going to get more of the medication soon.  At this point, I realized I had to separate "my body" and me into two different categories. My body was its own entity.

My "body" knew I wasn't fooling when I dropped down to 20 mgs capsules (pictured below).  I had to fight a lot to keep my mental stability stable as the cravings were bad.  I kept my thoughts focused on the future and knew that I'd make it through this struggle.  After all, I'm a fighter, a Taurus, and I'll beat this drug.  The doctor said that going from 20 mgs to 0 was going to be the worst.

I decided along with my doctor that after 20 mgs, I'd drop down by 5 mgs each week rather than 10mgs in order to lessen the side effects and allow my body an easier time to adjust.  Again, all of this has been done under the direction of my doctor.  I went down to 15 mgs and now down to 10 mgs (pictured below).  Can you believe how few balls there are, yet they still have such resounding effect over my entire body?  At this point, I have to manually remove balls from the capsules.  Counting balls, as some forums suggest of users who are also trying to withdraw from Cymbalta, would drive me insane and create even more anxiety in me!!  So, I've decided to eyeball it.  It's not that hard actually because I'm just splitting a 20 mgs capsule in half.

In awhile, I'll be able to drop down to 5 mgs., and then down to 0 and be completely off of it.  This period is probably the most I'm afraid of because I don't know how long my "body" will hold out before it realizes I'm not ever giving it another bit of this drug!  Right now, I feel it's used to going down and adjusting as needed.  But going to nothing?  It doesn't know what to do.  And I don't know how many days/weeks it will take before it starts to "revolt."  I'm sure I'll be okay.  It's just fear of the unknown.

I know I'm lucky compared to others who have been on the drug for longer than a month like myself.  There are some who have been on it for 2 years or more.  So, I'm thankful and extremely appreciative for those of you who have consistently prayed for me during this time.  Yet still, odd sleeping patterns, not leaving the house for days, stacks of clean laundry folded yet not put away, a sink full of dishes, and extreme exhaustion is getting old.  This is not like me.  Soon, though.

There are far to many yesterday's to count, but I keep pressing forward knowing this depressing "party" will be over with soon.  There is no physical way to undo what's been done.  So I start again each day knowing it's one step closer to the end.  I rest on what I know, not how I feel - even though there are days I'm not sure what I know.  And sadly, I don't know what the timing of "soon" will be in the end.  It could be a few more weeks, it could be another month.  However, I know there's an end in sight to where I'll be back to the hard working, determined, focused, joyful, and happy person I am.

(I write this blog as a way to help others know of my experience with this drug and to also document the process for myself.  Symptoms are different for everyone, though I urge you to contact your doctor if you are on Cymbalta or considering taking it.  Please educate yourself on all the symptoms, side effects, and withdrawal effects of this and all medications you take.)

Labels: , , ,

Thursday, March 8, 2012

Warning! Withdrawal Happening!

*** Others honesty in the past couple weeks has led me to be open and honest in this blog in hopes of helping someone out who may be dealing with the same thing. ***

Many of you have probably noticed I've been away from the computer, become withdrawn, and overall not had the happiest of days lately.  For about a month, I didn't know why I was becoming worse and worse by the day, but now I do.  It's because of a prescription drug, which I'd like to refer to more as "poison", called Cymbalta.

I grew up with my Dad having depression but could never understand it.  I used to think to myself, "Just be happy!" with a snarky attitude in my tone.  I never dealt with depression myself until after the car accident happened.  Depression is taboo in society that isn't often talked about but is definitely a real issue.  We've all seen the commercials on the television for various new drugs claiming to cure the "blues."  I always hear them say, "If your depression gets worse while on X medicine, call your physician immediately."  I used to think, "How can someone get worse on an antidepressant?"  Well, I'm living proof.

I had been taking another antidepressant for about two years due to situational depression, however starting February 1, 2012, the premium was going to be raised from the regular $20 copay I was paying to over $400 a month!  I cannot afford this so I was searching for another antidepressant knowing I couldn't just stop cold turkey on one.

Several friends had recommend Cymbalta to me because it would help with not only the depression side of things (which I had been managing really well with and was considering going off of the other drug but couldn't go cold turkey) but also the tingling nerve pain I have in my lower extremities on a constant, daily basis, and then the lower back pain from sitting all day (obviously).  I did do my research on the drug, but I only researched the drugs qualifiers and what it would do to help me, not the related symptoms or side effects it could cause.  

Towards the end of January, I started taking Cymbalta at 30 mgs. once a day for a week.  The second week, the doctor directed me to increase it to 60 mgs. once a day.  I did as she had suggested.  (Note:  This was not my regular primary care physician (PCP) but someone at an Urgent Care Clinic as I needed to be switched quickly and had yet to find a PCP where I recently moved to.)

I experienced a few symptoms on the first day I started and again on the day I increased the dosage, but it wasn't bad.  I noticed my nerve pain lessening and going from a constant 7 or 8 on a pain scale to around a steady 4 to 5.  This made me very happy!  Slowly, however, I noticed I was sleeping more than usual.  I just equated it to the fact I was working longer hours and working late into the night once I got home.  I started not eating and would wait until 5:30pm or so to eat a small meal or snack.  Progressively towards the end of February (4 weeks on Cymbalta), I was not amounting to much.  I was a step above simply existing.

The later days consisted of sleeping 18 hours, not eating, not caring about anything or doing much other than the essentials.  I knew something was wrong.  I was not myself.  I wasn't the go-getter, hard worker, happy, laughing, take on a challenge Alyson that I am.  I was severely depressed and extremely worn out.  I needed help, but I didn't know who to go to!  I am new to the area and don't know any doctors.  I remember looking online at the doctors on my insurance and calling for an appointment, but they were either not taking new patients, on maternity leave, or not seeing patients until like April 2075.  Talk about making someone who's severely depressed even more depressed!  It was like calling 911 and them not having any ambulances available!  I needed help now!  I finally lost it at work (which ended up being my last day of work) crying uncontrollably about how frustrated I was with what was happening to me.  Who was I?  What's happening to me?

As a final resort (after not going to work the previous day because what little I had eaten I was starting to throw up), I went to the Emergency Room.  For some reason, I had a feeling it was the Cymbalta that may be causing all of these symptoms.  I also thought that my thyroid might be imbalanced (I'm hypothyroid).  

Bingo!  I was correct about both.  I was experiencing the "if your depression gets worse, contact your physician" warning and all the side effects of the drug.  On top of that (due to my own negligence for skipping my previously scheduled blood draw for January), my thyroid numbers had almost doubled!

I am fortunate in that I was only on Cymbalta for 5 weeks when I discovered it was the cause to my literal withdrawal from society and myself. I am now in the process of detoxing from the drug which my doctor said is equivalent to coming off of a narcotic like heroin.  It is one of the worst medications to come off of and can take several months to be completely off of this drug and back to feeling like yourself again.  He said the withdrawal symptoms would be horrible - and he is not lying.  After hearing of the lengthy titration that has to happen to get off of this "poison", I began researching the withdrawal symptoms.  I finally felt like I wasn't alone in this battle!  So many people are having or have had the same exact experience that I have had and are also experiencing the same withdrawal symptoms!

I currently started my second week of detox on an outpatient program regime yesterday.  Last week was bad.  Here's what I've experienced so far:
  • vertigo/dizziness - the room spins constantly
  • nausea
  • motion sickness (when in my wheelchair and moving)
  • horrible headaches
  • blurred vision
  • hallucinations
  • extreme fatigue
  • hot and cold flashes
  • clammy skin
  • sweating profusely out of the blue
  • sore muscles
  • cramped legs - makes transferring in/out of my wheelchair extremely difficult
  • impaired motor skills
  • slurred speech (I sound drunk sometimes and it's so embarrassing!)
  • stuttering (again, extremely embarrassing)
  • constant buzzing in my ears
  • high anxiety
  • extremely emotional - from anger to crying
  • loss of focus/attention
  • irritability
  • dry mouth
The majority of these are constant.  All day long.  Not to mention I have to factor in all the responsibilities I have with being paralyzed!!  Thankfully my doctor has taken me off work for the next several weeks and then we'll reassess at that time.  It's hard to do it all - deal with the withdrawal symptoms and the paralysis aspect and then to add work onto it?  I was floundering.  I still feel like I am.  Right now, however, I'm laying low and away from people for the most part.  I don't trust myself with the emotional swings, and the speech impairments are just plain embarrassing.  I get anxious if I have somewhere I have a certain time I'm supposed to be somewhere.  I'm also unable to multi-task as most women are experts at.  I can only concentrate on one thing at a time.  I take a lot of naps throughout the day as my body just can't stay awake.  It's a chemical imbalance that's going on and nothing I have control over.  These are just a few examples.

The hardest part about all of this is obviously the withdrawal symptoms, but also the fact that it's a chemical imbalance in my brain that I cannot control.  I am not me right now, and I'm not in control of the timing of when I'll be me again.  But, I do have comfort knowing there will be an end to these symptoms based on others' experience.  It just takes time.  

I write all of this out to warn people about the severe effects of this drug and the extreme withdrawals that come from trying to get off of it.  I also have learned and now encourage others to research all medications thoroughly before starting it.  Look for the pros, the cons, and the withdrawal symptoms.  Make sure it's right for you and don't always rely on a doctor to know what these new drugs do.  

Please pray for me as I continue my titration off of Cymbalta over the next several weeks and that the side effects would be minimal.  Also, please feel free to share this story with anyone you know who is going through depression or is on or considering taking Cymbalta.  There hasn't been enough research on the drug for it to be recommended to people, and I'm honestly not sure how it got approved by the FDA.

Depression hurts.  Cymbalta hurts worse.

(This has been my experience with this drug.  It may work for you, however educate yourself on the withdrawal symptoms.  Also, please recognize that this and all medications have side effects and need to be monitored by you and your physician closely - especially new medications.)

Labels: , ,