I (male, 28) took Duloxetine for 4 years, and tapered down to 7.5mg over 5 months. I stopped abruptly 3 months ago, and I've had a slew of symptoms since, fluctuating daily between bad and really bad. Symptoms include genital numbing, emotional blunting, dpdr, brain fog, mild nausea, and ear ringing. Emotional blunting and genital numbing have gotten much worse since stopping the drug, and got rapidly worse over the past week. I can't cry, and it feels like an anasthesia has been applied to my genitals. There's almost no pleasure left. I've also been feeling increasingly disconnected from myself, others, and the world around me.

A lot of these symptoms fall under the PSSD umbrella, and are getting worse every week. In contrast, dry mouth, gastrointestinal issues, and the general feeling of a fried nervous system have settled since emerging early on in withdrawal. Reinstatement feels dicey at this point, but I feel like I have to try it. I'm terrified of how much worse this numbing will get, and how long it will last. I did have mild genital numbing on the drug, but it worsened while tapering, and it's much worse now. My dosing was quite erratic while tapering, so if my symptoms are the result of a destabilized system, then reinstating has a chance to help me stabilize.

I would start at 0.15mg daily (I'll make sure to be consistent), then titrate up as needed. What do people think about the risk of reinstating after 3 months? On such a low dose, I think it'll go fine, but I'm afraid of making symptoms worse, or developing anhedonia. The way I see it, reinstatement has a decent chance to improve my symptoms, and a small chance to make them worse. Symptoms are already getting worse, so if it's gonna take multiple years for my body to restore native serotonin signalling, I may as well do that most of the way on a low dose and suffer less.

While tapering, my sexuality would actually get restored for a few hours after taking a dose. I see this as evidence that reinstatement is likely to improve symptoms. If a reinstatement goes well, and reduces emotional/sexual numbing, I can hold for a long time to let my body adjust before getting off the drug properly. Please tell me if you think I'd be making a big mistake. If people have relevant experiences or advice, I'd love to hear it.

Welcome to the forum!

 

This is a volunteer-run, community forum aimed at helping those who are tapering and/or experiencing difficulties with psychiatric medications and withdrawal syndrome. We are not medical professionals and cannot offer medical advice. We simply offer support and opinions which you could use as talking points with a medical provider knowledgeable in withdrawing off psychiatric medications.

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I'm so sorry to read about the tough time you've had recently you will find plenty of support here for sure.

13 minutes ago, bjossa said:

I (male, 28) took Duloxetine for 4 years, and tapered down to 7.5mg over 5 months. I stopped abruptly 3 months ago, and I've had a slew of symptoms since, fluctuating daily between bad and really bad. Symptoms include genital numbing, emotional blunting, dpdr, brain fog, mild nausea, and ear ringing. Emotional blunting and genital numbing have gotten much worse since stopping the drug, and got rapidly worse over the past week. I can't cry, and it feels like an anasthesia has been applied to my genitals. There's almost no pleasure left. I've also been feeling increasingly disconnected from myself, others, and the world around me.

As you no doubt now realise tapering an antidepressant needs to be done slowly over a long period of time with the later milligrams often needing to be slower than the first due to the hyperbolic relationship of dose to effect on the brain. Here is our tapering document. Tapering Information

 

Tapering too quickly can lead to withdrawal symtoms, many of which you have listed above. These symptoms can wax and wane in severity as the nervous system fights for homeostasis in a non linear pattern we refer to as waves and windows. The Windows and Waves Pattern of Stabilization

22 minutes ago, bjossa said:

A lot of these symptoms fall under the PSSD umbrella, and are getting worse every week. In contrast, dry mouth, gastrointestinal issues, and the general feeling of a fried nervous system have settled since emerging early on in withdrawal. Reinstatement feels dicey at this point, but I feel like I have to try it. I'm terrified of how much worse this numbing will get, and how long it will last. I did have mild genital numbing on the drug, but it worsened while tapering, and it's much worse now. My dosing was quite erratic while tapering, so if my symptoms are the result of a destabilized system, then reinstating has a chance to help me stabilize.

I would encourage you not to think about the PSSD question, I tend to try to think about these symptoms as WD symptoms rather than grouping them into a seperate category which I think only creates fear.

Sexual dysfunction is common whilst taking these drugs and is also a common WD symptom. I believe it is linked to the emotional anesthesia/numbing. Asides from Placebo I believe it is actually the main mechanism for their effectiveness, dialing your feelings down when life is hard can certainly be useful, unfortunately the risks of harm are far outweighed by any potential benefit in my opinon.

27 minutes ago, bjossa said:

I would start at 0.15mg daily (I'll make sure to be consistent), then titrate up as needed. What do people think about the risk of reinstating after 3 months? On such a low dose, I think it'll go fine, but I'm afraid of making symptoms worse, or developing anhedonia. The way I see it, reinstatement has a decent chance to improve my symptoms, and a small chance to make them worse. Symptoms are already getting worse, so if it's gonna take multiple years for my body to restore native serotonin signalling, I may as well do that most of the way on a low dose and suffer less.

RI can be very effective, it can make some people worse. There is no way to know for sure how you will do. I agree RI a low dose is the safe approach and can mitigate a bad reaction. Higher dose RI can be seen to kindle folk and should be avoided. Hypersensitivity and kindling

Here is our topic on RI Reinstating an Antidepressant

If you choose to try this I would try something very low, I assume you have picked 0.15mg as that is the average dose of one bead in your capsules? I would say you could try 0.5mg if you wanted to. It may be worth splitting the dose 12 hours apart due to its relatively short half life to help with potential interdose WD. (Duloxetine has a mean half life of 12 hours)

If you don't react severely initially I would then hold your dose for 7-10 days before assessing the RI and deciding on potential updoses from there.

39 minutes ago, bjossa said:

While tapering, my sexuality would actually get restored for a few hours after taking a dose. I see this as evidence that reinstatement is likely to improve symptoms. If a reinstatement goes well, and reduces emotional/sexual numbing, I can hold for a long time to let my body adjust before getting off the drug properly. Please tell me if you think I'd be making a big mistake. If people have relevant experiences or advice, I'd love to hear it.

Personally to me your thinking seems quite logical and I agree RI could help.

In the mean time this is what I would do if I were you:

 

-Stay Hydrated 

 

-Eat a good clean whole food diet, avoiding processed foods and sugars.

 

-Stay away from caffeine, alcohol and antihistamines and any other psychoactive substances.

 

Supplements are to be avoided initially, as they often irritate our nervous systems. Try to get your nutrition through food.

 

Down the line, you may wish to introduce Fish Oil and Magnesium. Those who can tolerate them have found them calming to the nervous system. Be careful try one at a time and start low and see how you get on should you choose to try them.

 

A daily walk is very important as much as you can manage, if you can manage it. Gets you your fresh air and Vitamin D does wonders for your mind!

 

You are very welcome here and I hope you find the site supportive.

Chippy

Welcome !

I would say reinstate if your symptoms are 8-10 out of 10. Reinstatement has it's own risks, and you would also need to taper that reinstatement dose at some point. If your symptoms are 5 out of 10 or below that, I would be inclined to not reinstate at this point after 3 months.

Symptoms are just symptoms, they don't mean death and they are only temporary, time and time again we see that people improve and heal overtime, Acceptance of symptoms are key while dealing with withdrawal, as well as energetically aiming to become better and improve, slowly over time, I believe in you ❣️