We were taken to task recently by a reader who thought our answer to a question from someone having a terrible time with Cymbalta withdrawal indicated a lack of respect. None was intended.
Q. You blew it in your answer to a person who lost insurance and went off Cymbalta.
You suggested ways to manage depression without medication. Would you suggest someone “manage” diabetes without medication?
Maybe one can manage moodiness or the blues without medication, but not mental illness. Mental illness is a disease, not just a bad mood.
This person should try to go through her or his local health department to get the needed medication for a reduced cost.
A. Stopping antidepressants like duloxetine (Cymbalta) suddenly can be disastrous. The person who wrote us had seizures, brain zaps, nausea and emotional distress when she ran out of medicine because of a gap in insurance.
Your suggestion about checking with the health department is worthwhile, but this person might not have qualified because she had a job.
Advance Warning Must Be Given
People who are prescribed such medications need to be forewarned against discontinuing them abruptly and given guidance if they ever need to stop. Sometimes a longer-acting drug like fluoxetine can help with gradual withdrawal.
We certainly agree that mental illness is serious and deserves appropriate treatment. Sometimes, though, nondrug approaches can be helpful. They should be undertaken with medical supervision to make sure that they benefit rather than harm the individual.
