Q. I have attempted to stop taking Paxil. The sickness and body reactions experienced after 3 days were horrible, however. I cannot afford to take that much time off work and I had no idea how long the effects would last. When I explained it to my doctor he said “Don’t worry, it’s ok for you to stay on the medication indefinetly.” HELP!


Q. I am frustrated by the lack of warning about what will happen when you try to discontinue Cymbalta. When I tried to stop, I only lasted 5 weeks after being sooo sick out of my mind. I was reduced to an emotional wreck.

It is WITHDRAWAL! I used to praise the working of this drug, until I was forced by financial difficulties and insurance confusion to have to end my medication.

In the ensuing horror of “discontinuation syndrome,” I almost lost my job and my mind.

Absolutely nobody warned me what could happen. I am back on Cymbalta, but I no longer feel the benefits of this drug relating to my depression. I wake up wishing I were dead and go to sleep praying that I don’t wake up. I live in utter fear that from month to month I won’t be able to come up with all the copays, deductibles, share of costs, denials and whatever other words relate to we-don’t-pay-anything health insurance.

I feel hooked and dependent on this drug.


A. We are outraged that drug companies, doctors and the FDA do not adequately warn patients about the possibility of withdrawal when they stop certain antidepressant medications. We have heard from many people that discontinuing drugs like citalopram (Celexa), desvenlafaxine (Pristiq), duloxetine (Cymbalta), escitalopram (Lexapro), paroxetine (Paxil), sertraline (Zoloft) and venlafaxine (Effexor) can cause some very unpleasant symptoms. They can include:

  • Brain “Zaps” (electric shock-like senstations in the brain)
  • Dizziness, light-headedness, vertigo, feeling faint
  • Headaches
  • Anxiety, irritability, hostility
  • Nausea, diarrhea, digestive upset
  • Tremor, hands shaking, nerve tingles, strange sensations
  • Fatigue, tiredness, lack of energy
  • Visual disturbances

Doctors sometimes call this “discontinuation syndrome.” That just doesn’t do this problem justice. And when the FDA or the drug company suggests that you should talk to your doctor they are just covering their derrieres. There are very few studies providing physicians clear guidelines about how to help patients discontinue antidepressant medications. As a result, many doctors are flying by the seat of their pants. They make up a “gradual withdrawal” program. It may work for some but not for others.

Here is an example of just such a home-made withdrawal program:

“As a counselor myself, I am appalled at the lack of info on Cymbalta withdrawal. I took it after the death of our infant son. It did help at first …but I also started gaining weight and become isolated and “numb.” I am a writer and photographer and I completely lost my ability to create. My migraines worsened.

“After decreasing my dose from 60 to 30 mg, I experienced severe night sweats, anxiety and feeling like my throat was closing up, nausea and extreme irritability. After educating myself on the best way to withdraw, I had to talk my doctor into this regimen. I weaned from 30 to 20 mg for two weeks. Then I added 10 mg of Prozac in the AM for two weeks along with Cymbalta. Then I started carefully pulling apart my capsules and pouring 1/3 out, 1/2 and then 2/3 out over the next 3 weeks all while still taking 10 mg Prozac. I then took just the Prozac for a week and then one more week of Prozac every other day.

“It’s been three weeks since I’ve taken any Cymbalta. No major withdrawals… some minor throat tightening and sweats. Definitely irritable but managing. My creativity is back, as is my passion for life. Good luck to all.”

Eden


We wish we could tell you that there was a sure-fire formula to phase off antidepressants so that there would be no symptoms. Each person is different and likely will require a tailored approach. A compounding pharmacist can create a series of lowered doses over a long period of time, but this will require assistance from a prescribing physician.

In the meantime, we welcome people to share their own stories. You can read more about different approaches here and here and here.

You can also learn more about withdrawal from antidepressants and nondrug approaches in our Guide to Dealing With Depression. We also have a section about mistakes doctors make when treating people with depression in our book, Top Screwups Doctors Make and How to Avoid Them. And we have lots of alternative approaches in our book, Best Choices From The People’s Pharmacy.

Please share your own story below. We hope someday to be able to offer people some clear guidelines to successful withdrawal from a variety of drugs, including acid-suppressing proton pump inhibitors (PPIs) like omeprazole (Prilosec), lansoprazole (Prevacid) and esomeprazole (Nexium). We would also like to know how people have successfully discontinued drugs like alprazolam or lorazepam. Maybe someday the FDA will require drug manufacturers to alert physicians and patients to withdrawal problems and successful strategies for discontinuing such drugs.

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  1. Grace W.
    Pennsylvania
    Reply

    After a stroke then a major car accident and two months later the sudden death of my son my body started screaming at me in pain. Migraines and body pain like I’d never experienced long term before. I was constantly depressed and often thought of suicide. I was sent to specialists after specialist and test after test to be told it could be fibromyalgia to top off everything else. I was put on Duloxetine along with other medications. After several years on duloxetine my new pharmacy had some problems getting it ordered and I was without it for 2 1/2 months. The withdrawals were horrendous. In the first few weeks I decided to wean myself from duloxetine since I couldn’t get it but little did I know how it would change my life. I had so many painstaking days but the worst was the crippling of my ability to walk as if my knees locked and I can’t bend them to walk as I did before. My legs hurt daily while on the medication but this surpassed the pain and crippled me. It’s been five months now and I feel better without the duloxetine but now have to deal with new and other painful problems. I’ve researched duloxetine and found out what I experienced was called duloxetine withdrawal syndrome.

  2. Carole
    MD
    Reply

    I can’t afford a $150 doctor’s appointment to refill a $4 Paxil prescription. Weaning myself off. Very horrible symptoms. Brain zaps, brain fog, sweating, shortness of breath, nausea, diarrhea, psoriasis on my elbows, leg pains, numbness in my feet, and anxiety while driving. I have a drink in the evening to take the edge off. I know this will end eventually. I try to keep busy outside which does help since I am retired. Also taking care of a husband with dementia. Good luck to those who have to work.

  3. Randy
    Amherst, NY 14336
    Reply

    I am scared for my sanity at he very thought of weaning myself off of Duloxetine. I am on 60 mg daily, and I am convinced that this drug is not the answer to my anxiety disorder. I will be speaking with my therapist this week and letting her know that I wish to titrate off this drug. I am going down the functional medicine path to a better lifestyle, better eating, and exercise to get myself off all meds.

    • John
      Washington, DC
      Reply

      I am in the midst of weaning off duloxetine. I bought a scale for gram weight and 1″ empty gelatin capsules online. Had been on 60 mg for about 5 years, and it really wasn’t working. I cut the dosage in half to 30 mg for one month. Then 15 mg for one month. Then a 15 mg capsule every other day for about 2 weeks. Now cold turkey. Still some withdrawal issues: Anger (however righteous) and crying – but feel like my emotions are returning to normal. Some dizziness and inability to focus. I also developed a meditation and yoga practice which, quite frankly, is helping much more than this dastardly drug. I can see the end in sight. And my sex drive is back. I feel 30 years younger in that regard. So, yoga three days a week and meditation every day. I’m doing 10 to 15 minutes of meditation. And if I feel out of sorts and depressed, I’ll sit and meditate for 10 minutes. My Dr. was no help. His response was, “you’ll be on this the rest of your life.” No thanks, Doc.

  4. Helene
    Warren, PA
    Reply

    I am trying to get off Cymbalta. I was told to reduce the dosage from 60 mg to 30 mg. It’s been 10 days since I started this reduced dosage, and I am experiencing severe insomnia. I am awake all night and all the next day. I get bad headaches and I’m very tired with no energy. I don’t know if this is normal or not since the PA didn’t tell me about side effects. After 2 weeks of taking 30 mg I’m supposed to discontinue taking Cymbalta and start taking Fazema. I hope that I can sleep then. My life is terrible now since I can’t sleep, and I’m too tired to drive or do much of anything. The reason I was taking the drug was to relieve nerve pain, and I’m not really sure if it did any good since I’m also taking Lyrica. When these anti-depressants are prescribed patients should be informed about the difficulties that occur with withdrawal.

  5. Beth
    San Diego
    Reply

    I was put on 5mg of Paxil last month for what we thought was anxiety. I took it for six days, and decided to stop. It is now day 6 since I stopped it, and last night I woke up shaking and feeling extremely nervous, with a bad headache. Is this a side effect of withdrawal, or something else?

  6. louise
    Australia
    Reply

    I’m wanting my creativity, my sexual identity as a woman and my life back.
    60 mgs for 6 years, I’ve had enough. Weaning (ha!) from 60 mg daily to 60 mg every 2nd day, every third day, every fourth day . . . I trust I’m stronger

  7. Carol
    norwich,ct
    Reply

    I’ve been on Paxil and Trazadone for a few years and has helped me with my depression and anxiety. This past year I went off them due to no money for co-payment. It was fine for the first week then I had anxiety, moody, nauseous and felt weird, kind of out in space. I went a month before I got back on them. It was hell.

    Doctors should warn patients and ease them off gradually.

  8. Bonnie
    Reply

    I was on 20 mg of Paxil daily for 14 years. During that time I tried to wean off 3 times, but the withdrawal symptoms were so terrible, I just gave up and went back on it. Then I read that Paxil was offered in liquid form and this can be used for weaning slowly and I was all over it! (None of my doctors knew this info). I weaned .5 mg every 4 days — yes 160 days. Even at that slow rate of decrease, I spent 5 months in a perpetual state of slight dizziness, but I was able to push through it until the end. Paxil was perfect for me and addressed many of the issues I had been dealing with. Withdrawal made it a prison though. There’s no way to crack a 10mg pill into 20 pieces — the liquid is the only way to do it in small enough increments so the side effects do not overwhelm.

    • Katrina L W
      Illinois
      Reply

      I was on paxil for 3 years. Unfortunately i went to prison. After i got out i only had a 2 week supply of paxil and my insurance had been canceled while locked up so i had no way to pay for a doctor visit. December 2 2016 was my last dose of paxil. By the 5th i was feeling so sick i couldn’t sleep at all and eventually started hallucinating. I really thought i was going to die.

      By the beginning of February, I got into a free mental health clinic to get put back on it because the head zaps would not go away. I couldn’t handle it any more. It had been 2 months. I take 40mg a day. I want to try something else that will not cause head zaps if u don’t take it. Sincerely Katrina W.

  9. Heather
    charlotte nc
    Reply

    I had been on Paxil for a decade for treatment of severe PMDD. Well, I had a hysterectomy Oct 15th last year and the PMDD is gone. In conjunction with my psych and MD we decided it may be best to come off of the drug. It was tapered over the span of a month, and at the end, on the third day of NO PAXIL… I stayed to lose it BAD. Hallucinating visual and auditory, vomiting, diarrhea, sweating, trembling, insomnia, brain zaps, zapping in my gut, extreme confusion, crying constantly, neuro rage, I MUTILATED myself!!!

    Had a flat out grand mal seizure, ended up in the psych ward for three days, long enough to barely be able to come home. It lasted almost three weeks. It almost ruined my marriage. And that’s just what I experienced with withdrawal. A WHOLE OTHER chapter of what I experienced on it! This drug had nearly ruined my life. Want to add, I gained 70 pounds on this drug. I’m now completely detoxed from Paxil. I am a totally different person. The person I had forgotten I am.

  10. Lara
    The Hill Country
    Reply

    Discontinued Zoloft about a year ago because I was feeling numb, spacial and just plain awkward. Later I was prescribed paroxetine and needed testosterone meds. Talk about feeling better but the added testosterone made me more hyper-sexual as time went on. Personally, it bothered me. I was content to know that my testosterone level was okay after a year on it and thus the med was unnecessary. A few months later, I decided to weaned myself from paroxetine slowly because I was again feeling numb, spacial and awkward. I suffered mind buzz mainly and a little weeping during some movies but now as in now, I do not feel spacial, numb or awkward. I sense if I’m heading into a new life direction. Maybe my personality is adjusting or I am settling down into a new self. Maybe it is underlying anxiety about being off paroxetine. Not sure. Lara

  11. C.
    Kansas City
    Reply

    I’ve been on Cymbalta 90 mg and Seroquel 300 mg nightly for about three years now, for Bipolar II, and MDD, with voices. I have to say, I’ve never been this effective – the drugs have helped me significantly. However, the benefits come at a price. Weight gain, yes; brain zaps, yes; liver damage, yes; sweats, hot flashes, chills, yes; itching of scalp and back, yes. That’s a typical day for me, while being on it… Coming off is another story because I take it to address fibromyalgia, so I have to do something about the physical pain of my depression.

    Recently my psych doc recommended I come down from 90 mg to 0 mg in a week. I was told to ‘expect breakdowns.’ We supplemented with a new drug called Fetzima which incidentally did nothing for my fibromyalgia pain. Nor did it address my anxiety/depression as I came off the Cymbalta. I went to the gym feeling OK, but left in tears as my anxiety started growing. I tried to cope by taking Klonopin, but instead, I bounced into mania and came home with a St. Bernard (no joke). My husband, a veteran with PTSD, didn’t respond well when I went manic, and I ended up in the ER with paranoia and anxiety attacks. Fortunately the ER doc knew what to do.

    The next day, I saw another psychiatrist who said I had done in a week what he would have suggested would take a month. Now I’m back on the same dosage as before, with the stipulation that if I try to go off of it again, I have go to into the hospital. This scares me. My doctors are not concerned that I am on a medication that takes hospitalization to discontinue, my liver is suffering, and I can’t lose weight. And the numbness is very awkward. To alleviate the sleepiness, I’m always using caffeine. I seem fine, I think, until I draw blood somewhere with my fingernails. I don’t even feel it until it’s done. Doesn’t go over well socially…

    Besides my liver, which has turned into pate, what worries me at this point is my sleep. Earlier this year, I started using a bi-pap machine, and a fitness tracker. Last night I got 5 1/2 hours of deep sleep, uninterrupted. Am I asleep or unconscious? Our medical system doesn’t pay attention to you until you’re too far gone, in my opinion. The only things that have really helped me is exercise and going off sugar, drinking water and focusing on decreasing inflammation, but I still have to take fat burners and Adipex to even hope to lose weight. It’s all I can do to just maintain because the sugar cravings are pretty intense.

    Sorry this is so long. I hope this helps someone in some way. I’ve learned lately that in order to change, you have to first deconstruct. And, a crossroads is a good place to be, because you have a choice. Good travels.

  12. sandra
    leeds
    Reply

    I thought I was doing the right thing coming off poroxatine, I reduced the medication for a few weeks and then stopped it all together, I have felt so ill, very tired nauseous, snappy distant dizzy, every days got worse and now I really don’t know what to do, I’m so stressed out it’s harder than it was 2 years ago when I started taking the medication it’s the worst thing I have ever done, and wish I never started on it.

    • Spotsy
      CO
      Reply

      This is the worse drug ever to get off of! I have noticed that even if you have to change “brands” of cymbalta you can get seriously ill withdrawl symptoms. I hate this drug. I don’t have the stamina to get off it as I have tried before and was so sick I barely wanted to go on. I tell everyone never to get on it. It is so seriously disabling.

  13. Dee
    TX
    Reply

    I was on alprazolem for 7 years and want to share how I easily came off of it with no withdrawal symptoms whatsoever due to my doctor’ recommendation because I was severely dependent on it, so much that when I ran out, after just 3 days of being off of it, I was in such severe nerve pain that I had to go to the ER. The reason I didn’t have 3 refills like I thought was that my Neuro who prescribed it for me retired in October but I had a very hard time getting a doctor to see me and be willing to continue to prescribe it. My pharmacy refilled 2 months of my refills in Nov & Dec. even though she retired in Oct., but when it came to Jan., they no longer honored it (with no prior warning) because by then my Neuro had been eliminated from the approved list of prescribing physicians because she was no longer in practice.

    To make a long story short, and having a hard time finding a doctor who was willing to subscribe it, I ended up having to get my primary doctor to refill it for me on day 3 and was so thankful for once I took just 1 .5mg pill, the extreme pain went away! I tapered alprazolem extremely slowly as stated below and though it took me 6 months, I had no withdrawal symptoms at all and have been off of Alprazolem now for 2 months and so far the only side effect I have right now is my anxiety and am trying to learn to control it by relaxing and prayer.

    Here’s how I slowly tapered off of it and I was extremely dependent on it for 7 years ending up taking a max of .5mg twice a day. By tapering my morning dosage down first really seemed to help not interfere with not being able to go to sleep since I suffer from insomnia, one of the many symptoms of Fibromyalgia. I am proof that if you go by this schedule, and stick to it religiously, you will be able to stop it as well without the horrible side effects!

    First month: reduced dosage from .5mg twice daily to .25mg in AM and .5mg in PM.
    Second month: reduced morning dosage to .25mg and continued same PM dosage.
    Third month: reduced morning dosage to .125mg and continued same PM dosage.
    Fourth month: stopped morning dosage completely; same evening dosage.
    Fifth month: reduced evening dosage down to .25mg.
    Sixth month: reduced evening dosage down to .125mg.
    Seventh month: stopped evening dosage and completely off of med.

  14. J. Marie
    Reply

    Adding a post-script: yes, my depression has included many major depressive bouts over the years, and ending up in a fetal position on more than one occasion, suicidal thoughts, falling into that deep dark hole, etc…………
    I’m not going to allow the “cure” kill me….. so many of you may want to consider combining allopathic with licensed naturopathic physicians. You will learn so much about how all aspects of your body, balancing out minerals, etc. impacts your mental health.
    Thank you.

  15. J. Marie
    MA
    Reply

    My questions are how long do withdrawal symptoms last on average, has anyone else had the allergic skin reaction?

    I have been dealing with severe rash on face and neck which have been progressively worse over last 2 years-most recently occasional hives thrown into the mix. I’ve had it with anti-depressants! My primary care doctor and “shrink” are clueless regarding how all my symptoms are intertwined with my overall medical history! It took a friend of mine (not a doctor of any kind) doing some kinesiology muscle testing, to point out the connection of the rashes and the meds.

    My psycho-pharmacologist never stressed many of the interactions and especially potential liver damage for the “cocktail” I’ve been on for the last several years. I’ve been on one or more SSRI’s almost 30 years! While they have been extremely helpful over the years – the toxicity to my entire body has not been worth it, now that I am dealing with physical symptoms that are intolerable (but, you have to grin and bear it) at times!

    I’ve always either reduced or changed to a new anti-depressant gradually under the guidance of my psycho-pharmacologist (M.D.)…..When I emailed him explaining my rashes, hives, etc. in an email recently and requested his guidance for gradual reduction, he told me to contact my PCP, because he is on vacation for a few weeks.

    Sooooo, that’s it, I’ve had enough! I’m taking responsibility for my own my mental and physical health. My depression has been a life-long, and a common familial issue for many reasons.

    I’ve decided to let my Naturopathic physician (who is also an M.D.-but does not practice allopathic medicine) guide me through this. I stopped Cymbalta (generic version) on Tuesday of this week – continuing on my Wellbutrin (generic) and the addition of Standard Process brand St. John’s Wort.

    I am so happy to have found this site.

  16. Angela
    Palo Alto Ca.
    Reply

    I’ve been on Cymbalta for the past 6 years for depression. My new insurance would not pay for my meds without a prior auth. I’ve been waiting for a month for my Dr. to handle the paperwork. I’ve been so sick. Headaches, sweating thoughts of killing myself, hostility,crying, not sleeping, feeling of everyone around me is gonna die, can’t think clearly, the runs, chest hurting, wheezing, and so much more !!!!! I finally got my thoughts right for me to look up rx discount today. I’ll be getting my meds tomorrow. Thank God!!!!!!!!!!

  17. Joanne
    Newmarket On
    Reply

    I came off cymbolta last tuesday of Nov. Oh My God! I don’t mind pain but this is sick.
    The nausea, runs, stomach pain. Headache. Well at least I don’t have thoughts of suicide. One min. cold the next hot feverish. Some times light hurts my eyes. Gas, burping, farting.

    Moment of wanting to just break down and cry for no reason at all. Chills. I am having a bad moment now I just want to go to bed and stay there until it all passes and God I hope this passes soon. Shortness of breath. Please tell me it will end soon. Joanne L.

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