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Cymbalta Withdrawal: Symptoms, Timeline, and Treatment

 

Cymbalta is a popular FDA-approved antidepressant medication that is classified as a serotonin and norepinephrine reuptake inhibitor (SNRI). It is also known by its generic brand name duloxetine. Like other SNRIs, Cymbalta treats depression, suicidal thoughts and behaviors, chronic musculoskeletal pain, and anxiety disorders by preventing the reuptake of serotonin and norepinephrine in the brain, boosting the levels of the neurotransmitters. 

Common side effects of Cymbalta and duloxetine include dry mouth, stomach pain, and decreased appetite. Due to the changes in brain chemistry that occur when using Cymbalta, the drug is associated with withdrawal symptoms if the dose of the medication is stopped or reduced quickly. 

More than half of people who take antidepressants like Cymbalta can experience withdrawal symptoms after discontinuing their medication.

Who is likely to experience symptoms of Cymbalta withdrawal?

It is common for patients who use medications like Cymbalta and duloxetine to experience withdrawal symptoms when they stop using the drug or reduce their dose. While doctors once believed that withdrawal from SNRIs did not cause severe symptoms, it is now commonly understood that antidepressants can cause severe withdrawal symptoms. 

Patients who have been taking Cymbalta for at least four weeks are the most likely to experience withdrawal symptoms associated with the medication, as four weeks is about the amount of time it takes Cymbalta to produce maximum effects. Patients who have been taking Cymbalta for at least four weeks should gradually reduce their dose of the medication under the guidance of a healthcare professional if they choose to stop taking the drug.

What are the symptoms of Cymbalta withdrawal?

Cymbalta and other serotonin-norepinephrine reuptake inhibitors (SNRIs) like it all cause similar withdrawal symptoms as a result of the way that they influence the activity of neurotransmitters in the brain. Symptoms associated with Cymbalta and SNRI withdrawal include:

  • Dizziness
  • Diarrhea
  • Vomiting
  • Nightmares
  • Strange sensations, such as brain zaps or electric shock sensations
  • Paresthesia
  • Irritability
  • Nausea
  • Nerve pain
  • Headache
  • Hyperhidrosis
  • Pins and needles
  • Tremors
  • Anxiety and agitation
  • Sexual dysfunction
  • Insomnia, sleepiness, or fatigue

Compared to withdrawal from other antidepressants, withdrawal from Cymbalta is considered relatively mild. The most serious symptoms associated with Cymbalta are withdrawal seizures, which have occurred very rarely.

What is the timeline for Cymbalta withdrawal?

Each patient will experience Cymbalta withdrawal differently due to variances in the dose, length of time for treatment, and medical history. 

Patients who have been taking Cymbalta for at least four weeks and who want to stop using the medication will need to seek the supervision of a medical professional in order to establish a plan for lowering their dose of the drug over time. Most people start to experience Cymbalta withdrawal symptoms within about two to four days of discontinuing the drug or reducing their dose. 

Symptoms of Cymbalta withdrawal are typically experienced for about one week after they begin, with 65 percent of participants in one study stating that their substances went away in one week. Most participants in the study classified their symptoms as either mild or moderate, with severe symptoms being relatively rare. 

Gradually reducing your dose of Cymbalta over a period of several months, a strategy called tapering, can help reduce your chances of experiencing withdrawal side effects and help prevent the symptoms you do experience from being severe. Tapering is generally the best strategy for patients who desire to stop using Cymbalta for one reason or another.

What treatment is available for Cymbalta withdrawal?

While Cymbalta can cause uncomfortable withdrawal symptoms, it is not usually associated with addiction or dependence. Therefore, most people don’t need to attend inpatient treatment for Cymbalta withdrawal and will not require additional medication. 

Most patients are able to successfully taper their dose of the medication down under a doctor’s supervision, thereby minimizing their risk of experiencing Cymbalta withdrawal. If you are planning to stop using Cymbalta, surrounding yourself with a supportive group of family, friends, or an online community can help if you experience withdrawal symptoms.

Summary

Cymbalta is associated with similar withdrawal symptoms compared to other drugs in its class, but these symptoms are comparatively mild. Cymbalta should not be used in conjunction with other SNRI or SSRI prescriptions like paroxetine (Paxil) or fluoxetine (Prozac) unless specifically directed by a doctor, as the drug interaction could lead to selective serotonin syndrome (serotonin toxicity), which can be potentially fatal.

Your doctor can help minimize the symptoms of Cymbalta discontinuation syndrome through tapering. Detox medications are not typically needed to reduce the adverse effects of Cymbalta withdrawal. Patients who are planning to discontinue use of Cymbalta or reduce their dosage of the drug should only do so under the supervision of their healthcare provider.

Sources:

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30032-X/fulltext 

https://www.sciencedirect.com/science/article/pii/S0306460318308347?via%3Dihub 

https://pubmed.ncbi.nlm.nih.gov/16266753/ 

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