DISCLAIMER: THIS IS NOT MEDICAL ADVICE! We do not employ doctors or licensed medical professionals, so we do not provide medical advice. Nothing presented here is a substitute for the advice of a DOCTOR or other licensed health care provider. Never stop, start or add medications or supplements to your health or mental health care regime without first checking for interactions or other problems, and thoroughly researching the substance. Before you employ any information here, consult your health care professional. No information here is the result of valid clinical trials.

Tapering Off Multiple Drugs

There are three schools of thought on tapering multiple drugs:

Taper one drug at a time in order to see how decreases affect withdrawal symptoms.
Taper all at once - very slowly - your brain and body are already used to the combination of drugs. So this will cause the least amount of disruption to your brain. The problem with this method is that if one of the drugs is causing a problem, you won't know which one. Trying to figure out the different doses of all the drugs could be a challenge, too. (Antidepressant expert Ann Blake-Tracy recommends this method.)
The stair-step method: one drug is slow-tapered for a while, and then tapering that drug is stopped. Then tapering the next drug begins. By alternately tapering each drug, all drugs are slowly and deliberately discontinued.

We recommend you taper the most activating drug first

Normally, Cymbalta is the most activating, so you should taper that fully. Then you taper off the ones that are more sedating.
From Surviving Antidepressants: http://survivingantidepressants.org/topic/2207-taking-multiple-psych-drugs-which-drug-to-taper-first/
"If no one drug is clearly causing an adverse effect, discontinue the more activating drugs first."
Antidepressants and ADHD drugs (mostly amphetamine analogs) tend to be activating drugs. These cause jitteriness, anxiety, or sleeplessness.
Benzodiazepines, the "Z" drugs for sleep, anticonvulsants (such as Lamotrigine), Lyrica, Gabapentin (Neurontin), and antipsychotics tend to be regulating or sedating drugs. These cause drowsiness, sluggishness or dopiness.
The two types of drugs can be thought of as "accelerators" and "brakes."

Many people have a sedating drug -(a brake) added to an activating drug (an accelerator) to treat drug-induced anxiety or sleep problems.

In this case we suggest you taper the antidepressant or stimulant first, unless you are having clear adverse reactions to a particular drug. Otherwise, you will experience activation from the other drug as you decrease the "brake." The brake may make it easier to manage withdrawal symptoms.
The most common and significant antidepressant withdrawal symptoms are: nervous system activations (indicating a too-fast taper); hyper-alertness; sleeplessness; abnormal anxiety; agitation etc.
Withdrawal sleeplessness makes tapering much harder and recovery from post-withdrawal syndrome more difficult.
If you reduce the accelerator while taking a sedating drug, the sedating drug may help you manage the withdrawal better. You may plan to taper the sedating drug later.

BUT ... Don't add a "brake" to prepare for withdrawal

Do not increase your risk of neurological damage by increasing the number of different drugs you take. A new drug may interact with one you are already taking.
The sedating drugs will also need tapering and can create a withdrawal syndrome of their own.
Remember to check drug interaction at www.drugs.com/drug_interactions.html

CHW Recovery from Antidepressant Use

This file contains links to the most important files on RECOVERY. We highly recommend printing
out files for quick reference, and then highlighting the areas that are important to your needs.

CHW Serotonin Syndrome

In Cymbalta Hurts Worse, we spend an inordinate amount of time stressing the importance of a slow, slow taper to avoid Discontinuation Syndrome, but it is important to also mention Serotonin Syndrome. Sometimes people have such an immediate bad reaction to Cymbalta or other drugs their lives are in danger the drug must be stopped immediately.

CHW Testing

All Pharma drugs affect all organs and some can mask underlying root health problems. Mental health, autoimmunity and chronic pain symptoms may be caused by toxicities, sensitivities, deficiencies, infections, imbalances (hormone, thyroid, pituitary, adrenal), physical or emotional trauma, genetic factors, system overloads (mycotoxins), poor coping skills or leaky gut/poor gut health.

CHW Reinstatement Guidelines

There is only a 2 (possibly 3) week reinstatement window where it is (somewhat) safe to go back onto the drug to try to reverse the withdrawal, but only if other drugs have not been added and the person did not alternate days more than 2 (possibly 3) weeks. After that window passes, the person is left to deal with whatever comes their way. There is no known “cure” for protracted withdrawal once it settles in. It just takes time to resolve on its own.

CHW Fighting Insomnia

Fighting insomnia with a better sleep environment and routine
Two powerful weapons in the fight against insomnia are a quiet, comfortable bedroom and a relaxing bedtime routine. Both can make a big difference in improving the quality of your sleep.

CHW Finding Holistic, Functional & Integrative Practitioners

If your doctor is prescribing Cymbalta and other toxic psychotropics, you may be better served by finding a doctor that will try to help you find the cause of your condition rather than masking it.

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FOR INTERNATIONAL SUICIDE HOTLINES:

Please take the time to report your adverse symptoms from Cymbalta and Cymbalta withdrawal to the FDA. Call 1-800-332-1088

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