Sorry if this is somewhere already and I missed it and/or not allowed. My symptoms are bad today.

I am on the final stretch of my cymbalta taper. I felt great dropping one bead per week from about 12-3mg. I am currently stuck at 7 beads (.175mg per bead) and have been having significant issues since i hit 10 beads.

Since my symptoms are alleviated most days later in the day and almost always between 12-4 even on my worst days I am fairly certain I am dealing with cyclical withdrawal as i take my pill at 7 am.

I began splitting my dose 4/3 a few days ago by moving the latter dose back an hour each day. I am still getting really debilitating waves pretty much every other day/every few days. I am wondering if it is just better to stop the transition and move the latter dose all the way to thr 12 hr mark immediately so i dont have any more changes and can truly hold for a good while.

Its been hard to make the call because I dont find too many stories about peoples experience transitioning. I feel like its a total shot in the dark and my system is clearly so destabilized it feels like a life of death gamble either way.

Just looking for info about what others have experienced in this capacity so i have better expectations i suppose — how did you do it, did it work or no, how quickly did you adjust, what advice might you give etc. Thanks.

Hey @Jazzjunkie84

If it were me I would continue to move it slowly 1 hour per day, as your nervous system is so sensitive I think it will appreciate the more gradual transition, I understand you want to get the spread set sooner rather than later of course. Dr Horowitz often suggests splitting doses when you run into trouble and actually slows the transition down when people are in bother to 1/2 hour per day. So perhaps keep up that 1 hour process as a compromise.

Once you get to 12 hours apart it might not be an instant fix as your body will need time to settle and probably do a little healing too. So a good hold at that dose and shedule will be needed for a while for things calm down for you I suspect.

@Chippy thanks. For better or worse I did go ahead and switch only because I really need a nice long month of NO changes and was concerned the cyclical withdrawal was torching my system. I dont know if it was the right call but I suppose I will know soon enough.

I am concerned about my sleep. Originally I switched to morning dosing because taking it at night made me lose my ability to feel sleepy. I expect some weirdness the first two weeks but I am wondering if splitting it in a slightly uneven way (say 7 am and 3 pm) might be enough to have the peak of the drug over by sleep time but still bump my plasma levels enough to where i am not quite in withdrawal overnight. Such a stupid thing to be stuck with :/

27 minutes ago, Jazzjunkie84 said:

I am wondering if splitting it in a slightly uneven way (say 7 am and 3 pm) might be enough

I've wondered about this myself....if I decide to split paroxetine, taking it at night is activating for me. I don't think it could hurt trying....it should be less disruptive than interpose withdrawal. Let us know how it goes. ❤️🙏

6 minutes ago, LostinCanada said:

I've wondered about this myself....if I decide to split paroxetine, taking it at night is activating for me. I don't think it could hurt trying....it should be less disruptive than interpose withdrawal. Let us know how it goes. ❤️🙏

Another idea MIGHT be for a 7 am half, take the other half late like midnight? Hypothetically the 6 hour peak will happen around wakeup time …? But that still leaves a window of withdrawal. So annoying and complicated. Im hoping I will build enough sleep drive to deal with the evening dose. Ill post updates. Hopefully others who have done this will join in the convo…

1 minute ago, Jazzjunkie84 said:

Another idea MIGHT be for a 7 am half, take the other half late like midnight? Hypothetically the 6 hour peak will happen around wakeup time …? But that still leaves a window of withdrawal. So annoying and complicated. Im hoping I will build enough sleep drive to deal with the evening dose. Ill post updates. Hopefully others who have done this will join in the convo…

To me, 7am and 3pm sound more feasible for stability.... I've even thought of just doing a 3-4 hour spread since paroxetine has a 21 hour half life. Cymbalta has that 12 hour average but 8-17 is possible.... when do you start feeling the interpose WD?

There might be some insights here:

https://www.survivingantidepressants.org/forums/topic/23110-dose-splitting-for-interdose-withdrawal-from-short-half-life-drugs/?do=findComment&comment=493718

17 minutes ago, LostinCanada said:

There might be some insights here:

https://www.survivingantidepressants.org/forums/topic/23110-dose-splitting-for-interdose-withdrawal-from-short-half-life-drugs/?do=findComment&comment=493718

I had read through this and sadly felt like i was just as in the dark after! Seems like such a tossed bag.

My typical pattern is i usually feel like my old self and completely normal right after a drop for a few days. I have learned the hard way not to enjoy or trust this and just rest preemptively. :/ When withdrawal hits - usually ramping up day 2-5 peaking after that, I will typically feel like toxic hangover garbage when i wake up and my body starts feeling “normal” (still tired and foggy) by noon. I sometimes maintain that until bed or sometimes start to feel “excited adrenaline” that turns into akathisia by bedtime.

I will also say the activating/sedating aspect seems very tricky to pin down. Supposedly at the dose of duloxetine i am on - 1.2mg - it should essentially not even touch the norep transporters and basically just be an ssri. That being said, lots of cymbalta hurts worse mods swear its most norep interactive at the low doses. I dont really know what to think.

17 hours ago, Jazzjunkie84 said:

I am concerned about my sleep. Originally I switched to morning dosing because taking it at night made me lose my ability to feel sleepy. I expect some weirdness the first two weeks but I am wondering if splitting it in a slightly uneven way (say 7 am and 3 pm) might be enough to have the peak of the drug over by sleep time but still bump my plasma levels enough to where i am not quite in withdrawal overnight. Such a stupid thing to be stuck with :/

I think you can be creative with times for sure. If you note the dose effects your sleep then 7am and 3pm sounds good.

16 hours ago, Jazzjunkie84 said:

I will typically feel like toxic hangover garbage when i wake up and my body starts feeling “normal” (still tired and foggy) by noon. I sometimes maintain that until bed or sometimes start to feel “excited adrenaline” that turns into akathisia by bedtime.

Sorry to read. I think all you can do is hold your split times now and see if it helps, I think splitting is useful, my only concern is I see a lot that folk use it as a lever to pull to try to make things better (I think we are all looking for fixes), however I worry the changes make things worse sometimes. I have seen this quite a bit. So I would try to be as delbreate as you can, and then stick to your guns on the timings. The body likes consistency.