After many years operating a Group on Facebook that currently has over 20,000 members, the operators of this site have documented a way to slowly wean off of this drug.  We call it the SLOW TAPER Method.  Multiple methods exist.  This page documents the WEIGHT method using a small jeweler's scale.  

This site documents tapering recommendations of antidepressant experts like Ann Blake-Tracy, Dr. Kelly Brogan and Dr. Peter Breggin, who recommend a slow, steady, deliberate taper off psych drugs.  We recommend decreases of 10% or less, and generally a start from 5% seems to work best, from each prior dosage, holding for 14 days, allowing the brain and body time to adjust before stepping down.  

Many people report 2.5 - 5% decreases, holding 14 days, produce great initial results, and are holding or slowing the taper as needed. We believe a slow taper can greatly minimize withdrawal symptoms and reduce the risk of developing protracted (bad, long-lasting) withdrawal.  The key is to listen to YOUR body, and let it tell you what the best rate is for you.

We are part of a grassroots movement to raise awareness about the dangers of ALL serotonin-affecting drugs; the benefits of nutrition, gut health, diet and other healthy lifestyle choices; and the need to look for the underlying root causes of anxiety, depression, pain and chronic pain-causing illnesses. For many people, this is the first time they will be exposed to information that is contrary to what our society is being told by the pharmaceutical industry and conventional medicine. We hope everyone will open their minds, expand their thinking, and begin their own research, starting with our files located on this site.

For a detailed document from the Facebook Group "Cymbalta Hurts Worse" founder, CLICK HERE or paste this in your browser:

https://duloxetine.info/files/tapering-basics-document


Table of Contents

WEIGHING METHOD

EQUIPMENT
The SPREADSHEET
The SCALE
SMALL BOWL
CAPSULES
CALIBRATE the SCALE
BUILD the CAPSULE STAND
FOLD your POURING PLATE
WEIGHT AVERAGE PROCESS
DOING a BATCH


WEIGHING METHOD TUTORIAL


EQUIPMENT REQUIRED

  • Jewellery Scale from amazon.com for about $20
    • Comes with tweezers and small tray
    • Usually use two AAA or AA batteries, get spares!
  • Paper plate and scissors to make pouring tray for replacing beads in capsules
  • Silver foil for making capsule stander-upper so you can pour into it
  • WEIGHING spreadsheet from Files section here
  • Very small bowl to hold beads before weighing
  • Possibly some #1 empty capsules from amazon.com
  • Your existing prescription of Cymbalta capsules


THE SPREADSHEET

The weight spreadsheet is located in the FILES section of this site:

https://duloxetine.info/files/weight-spreadsheet

Now, let's open the spreadsheet.  If you have a PC with software, use your spreadsheet program. 

If you don't have a spreadsheet program, use the SHEET app from Google Apps.  

If you do not have a Google account, we strongly recommend you get one.  Their apps are free and very useful.  Also, their email is THE most secure of any free email available.

Fill in the light green cells on the sheet.

This will be your Google account info required for using their FREE tools.

Once you have the sheet where you can run it, get the rest of this gear together, then do the WEIGHT AVERAGE PROCESS to get your sheet completed. 


THE SCALE

Get a scale.  They are called "jewellery scales" usually.  The little "g" after the number means GRAMS.  Typical small scales can weigh 20g, 50g, or 100g.  We suggest the 20g models, as they are more accurate with small weights like we will be doing.

I tested three scales, from about $7 to $21.  The two cheaper scales, from the left that claim "Professional", would not respond to small milligram changes at very low weights.  They are NOT recommended.  

My favorite scale says "SmartWeigh GEM20".  It was accurate down to just a few beads.  This appears to the least expensive one that is adequate for our purposes.

This goes by MANY different names on a site like Amazon.  It sells for $18-$30.  ALL scales that LOOK like this one are very likely to be exactly the same, just sold by different people.  Looks are everything.  Find the lowest priced one you can.

These are some current links (07/2019) to the scale on Amazon.  We find them by searching for "GEM20" without the quotes.

This is the link to the one for $18.99
https://www.amazon.com/Precision-Portable-Milligram-Reloading-Weighing/dp/B00OA5YLAQ/ref=sr_1_2

Things change on Amazon, so you may just have to search for "GEM20" or "GEM 20".


SMALL BOWL

We use a small bowl that I found in the kitchen.  Anything similar will work.  This is the easiest step of the process!  


CAPSULES

You may NOT need capsules.  When we were doing 60mg doses, we re-used the existing capsules, as they are Size 1 and easy to handle.  So if you are on 60mg you likely will not need capsules, though they can be handy if you break some when opening.

We are now on a 20mg capsule from the pharmacy, and they are tiny, so we use the Size 1.  On Amazon, search for "empty medicine capsules".

I like the size 1.

Capsules are basically all the same.  Get the cheapest.


CALIBRATE THE SCALE

Turn on the scale.  Make sure the table is solid and does not jiggle.  We are weighing THOUSANDTHS of a gram, so the scale is very sensitive.  Let the scale warm up a bit.

Hold the Power button until it says CAL. 

It now says CAL, so let off the button. 

Wait a little bit, and it will display 10.000. 

That is the weight it is requesting being placed on it.  Put one of the two weights on the scale.

In a few seconds, it will recognize that and request the second weight to be put on for a total of 20g. Place the second weight on with the first and wait.

In a few seconds, it will show "PASS".  If not, read your instructions and try again. 

Most scales that can measure milligrams display the weight in GRAMS with 4 digits, 0.000. Often sold as .001 scales.  Set your scale to GRAMS!


BUILD the CAPSULE STAND

I use a piece of aluminum foil to hold the capsule bottom upright so I can pour into it.

Take a complete empty capsule and form the foil around it.  This may take a few times to get it to stand up.

Just work the foil as best you can to get something similar.  My first one was a crumpled mess, and it worked for a year. 


FOLD YOUR POURING PLATE 

First thought to putting the beads back in the empty capsule is usually a funnel.  Tried it and did not work for me.  So I folded a paper plate and have used it for a long while very happily. 

Start with a paper plate.  Use a cheap one, the "grease resistant" work best.  Too thick is hard to work with.

Cut off the crinkled part:

Fold it in half, and press down the fold with something hard.

Draw something like this shape on it while folded:

Cut it out.  Does not have to be perfect, at all.

Unfold it and pinch in the center part on the top of the "heart":

Pull it together, fold at the center, and press it down to make this backstop for the beads.  This prevents them from rolling off the back! 

Should look something like this.  Does not have to be exact.

Now, cut off the very tip of the point, while folded.  This allows the beads to roll into the cap. 

Should look about like this: 

Congratulation, you have all the required tools. 


WEIGHT AVERAGE PROCESS 

Turn on your scale and place the tray provided with the scale on the scale and hit TARE.  Should show 0.000g.

First, we need to get the average weight of a capsule of your current prescription by weighing the total contents of three capsules.  We will then divide by three to get the average for one cap.

Note that the WEIGHT milligrams has NOTHING to do with the DOSAGE milligrams.  Two different things!  We will only be dealing with the WEIGHT milligrams as we weigh.

Clear a working area on a hard, stable, table.  Assemble all the gear from above.  Take the clean small bowl and pour the contents of three capsules into it.

Pour them into the tray on the scale and note the weight.

Divide the weight by 3 and put that result in the cell D5 in the spreadsheet:

Note that only the light green cells can be filled in.

Select your taper rate, we suggest 5% is a good place to start.  DO NOT think you can push this process.  Starting too high only leads to wasted time in the end.

Select your taper period, and we suggest 14 days.

Once you have a spreadsheet complete, print the first page or two and get ready to load.


DOING A BATCH

Note that WE are doing 20mg capsules that are tiny.  If you are doing 30 or 60mg capsules, they will be larger.  When we did 60mg, we re-used the capsules from the prescription.  We did not need the empty caps, except in the beginning when I cracked a capsule or two twisting them apart.  Once you get the hang of it, you won't have an issue popping them open.

We already ran a few sheets, so this is typical of what you might see if you are starting a taper from 20mg.  You numbers will vary!

Our target today is 0.100g, which is 83% of the original dose.  I squeeze the caps with my fingernails to get a grip and then twist to break the seal.  You can see the indent.  On a 60mg cap, it is not so deep.

Once the cap is twised open, pour all of the contents into the little bowl. 

This is the result of two weeks' doses.  ALL of the contents of the caps is in the bowl. 

Now, setup an empty capsule bottom in the holder. 

I open all of them first, so they are ready.  The scale will timeout if you take too long, so I get everything ready up front.

The whole setup looks like this to get started. 

Then, I use the tweezers in my right hand to push beads into the tray on the scale.  I had to operate the camera, so my right hand is busy... 

If I go over just a few thousandths (like 0.103 when I want 0.100), I will pick a few beads out with the tweezers.  If I am too far over, I will pour some back in the bowl. 

This is the goal, 0.100 of weight.  Remember, this weight HAS NOTHING TO DO WITH THE DOSE.  While the weight and the dose are both measured in milligrams (mg), there is way less dose per weight.  This 0.100mg weight (one hundred milligrams) only has ~0.017mg of actual medicine dosage.  Then I pour the beads into the pouring plate, held level or tilted back a bit.  They sit nicely there...

See!

Now, I pour the beads into the capsule, holding my finger over the top of the cap against the paper to prevent them from running over.  Only had one hand here, so I could take a picture. 

The glorious result: 

Place the top on the capsule and fell it click into place.

Voila!  One finished cap. 

This is the leftover beads from two weeks of doses. 

 

 


OTHER METHODS

Counting the beads you consume is another approach that is used.  Since this requires counting literally hundreds of beads that are tiny and have static, many find it very challenging.  Also, some compounding pharmacies will provide the counting service, though some are limited to the unacceptable conversion to a liquid.  A "ruler" method exists, where you line up the little beads and measure them.  Having tried this, I question the accuracy.  Bottom line, for this writer, the weight method makes the most sense.

Post you comments on the Facebook Group Cymbalta Hurts Worse

https://www.facebook.com/groups/Cymbaltahurtsworse/

 

Best of luck in your SLOW TAPER!