Q. I have narcolepsy with cataplexy. Cataplexy is sudden loss of muscle tone brought on by strong emotion, such as fear, anger or excitement. In my case, it is triggered by laughter. I can go a long time without an attack and then have several in a single week.
For several years I have been taking Cymbalta to control the cataplexy. When I have tried to stop, I started having frequent attacks, collapsing on the floor.
Is there a way to discontinue Cymbalta without side effects? All my pharmacist says is that it is a difficult drug to stop taking.
A. To avoid unpleasant withdrawal symptoms when stopping Cymbalta (duloxetine), it is necessary to reduce the dose extremely gradually. Some people open the capsules and remove a tiny bit of the medication to reduce the dose slowly enough.
A doctor might be able to substitute a low dose of a long-acting SSRI antidepressant such as fluoxetine to ease withdrawal, but extreme care is required. Combining these two antidepressants could trigger a dangerous interaction called serotonin syndrome.