From the FDA Drug Label
A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the healthcare provider may continue decreasing the dose but at a more gradual rate [see DOSAGE AND ADMINISTRATION (2.8)].
The best way to taper off Cymbalta (duloxetine) is to gradually reduce the dose rather than stopping abruptly. This approach can help minimize discontinuation symptoms. If intolerable symptoms occur during the tapering process, it may be necessary to resume the previous dose and then continue to decrease the dose at a more gradual rate 1.
- Key considerations for tapering off Cymbalta include:
- Gradually reducing the dose
- Monitoring for discontinuation symptoms
- Resuming the previous dose if intolerable symptoms occur
- Continuing to decrease the dose at a more gradual rate
- Healthcare provider guidance is recommended to determine the best tapering schedule for individual patients.
From the Research
The best way to taper off Cymbalta (duloxetine) is through a gradual and hyperbolic reduction in dosage under medical supervision, reducing the dose by smaller amounts over a period of months, to minimize the risk of withdrawal symptoms. Patients should never stop Cymbalta abruptly due to the risk of withdrawal symptoms, which can be severe and distressing 2. A typical tapering schedule might involve reducing the dose by smaller amounts every 2-4 weeks, with more gradual steps for those on higher doses like 120mg or 90mg. The goal is to reduce the dose to very small amounts, much lower than the therapeutic minimum, before stopping completely, as suggested by the hyperbolic tapering method 3.
Some key points to consider during the tapering process include:
- Monitoring for withdrawal symptoms such as dizziness, nausea, headache, irritability, electric shock-like sensations, or mood changes
- Staying well-hydrated, getting regular exercise, and ensuring adequate sleep to help manage these symptoms
- Using the bead-counting method for the final stages, where capsules are opened and a portion of beads removed to create smaller doses, under medical guidance
- Tapering over a period of months, with reductions becoming smaller and smaller in size as the total dose decreases, to allow underlying adaptations time to resolve and possibly reduce the risk of relapse on discontinuation 3
It's essential to note that the tapering process may take several weeks to months, depending on the starting dose and individual sensitivity, and should be done under medical supervision to minimize the risk of withdrawal symptoms and ensure a safe and successful tapering process 4.