Cymbalta Taper w/ Tianeptine Titrate?

[virtualboy]

I currently take 90 mg of Cymbalta for major depression, panic, anxiety, OCD... in theory, at least. I am interested in starting tianeptine instead, but I know that duloxetine (Cymbalta) withdrawals are awful, from first-hand experience. So what I'm wondering is this: should I titrate tianeptine while I taper duloxetine? Is it necessary to titrate? I don't know if I should be worried about serotonin syndrome. Will the tianeptine abate the duloxetine withdrawal? Just wondering how to make this transition as painless as possible. Any insight/experience will be appreciated.

~virtualboy~

 

[ConanTheAccountant]

Hi - My sister is 15 years on Cymbalta, and trying to taper off, do you have any suggestions?

 

[plumbus-nine]

Tianeptine isn't a serotonin reuptake inhibitor or releaser, in past it has been declared a serotonin reuptake enhancer while in the meantime it has been found to work on the opioid system and the enhancement label has been dropped but it means that there is no danger for serotonin syndrom. It should be safe to start while you're still in cymbalta taper, and tianeptine afaik doesn't need to be titrated, it's so well tolerated that it's (ab)used in much, much higher dosages than 3x 12.5mg. But tianeptine also won't help against cymbalta withdrawal.

About cymbalta, never been on that one but it's similar to venlafaxine and this causes horrendous withdrawal, even when tapered. I've been on it for many years and couldn't bring up the energy to go through withdrawal. What helps a great deal is to switch to fluoxetine and taper that one because of its week-long half life instead of less than one day. So fluoxetine (Prozac) has kind of a taper built-in. I still got withdrawal after a week or so and have resumed venlafaxine 37.5mg for now but my target is to get off any antidepressants for good.