In addition to depression, doctors can prescribe Cymbalta to treat anxiety that lasts for at least six months, pain from diabetic nerve damage, fibromyalgia, and long-term muscle or bone pain.
Cymbalta is in a class of medications called serotonin-norepinephrine reuptake inhibitors (SNRIs).
It works by increasing the levels of the neurotransmitters serotonin and norepinephrine, which help regulate mood and may block pain signals traveling through the brain.
The Food and Drug Administration (FDA) approved duloxetine in 2004 under the brand name Cymbalta for the Lilly drug company.
In 2013, the FDA announced that it had approved generic versions of duloxetine for several drug companies.
Cymbalta could also help ease pain associated with osteoarthritis, according to a study published in the International Journal of Clinical Practice in 2012.
The researchers noted that use of Cymbalta could result in fewer side effects than the drugs traditionally used for the condition, such as non-steroidal anti-inflammatory drugs, or NSAIDs, which can lead to gastrointestinal bleeding, and opioids like morphine, which often lead to constipation.
They concluded that doctors may consider adding antidepressants, such as Cymbalta to the treatment regimens for patients with osteoarthritis.
Cymbalta Suicide Warnings
The FDA requires that Cymbalta carry a black-box warning about the risk of suicide among people who use the antidepressant.Cymbalta may increase the risk for suicidal thoughts or behaviors if you are 24 years old or younger. Doctors usually do not prescribe Cymbalta for anyone younger than 18.
The risk is greatest when first starting treatment or increasing the dose of Cymbalta.
Your depression may get worse before it gets better when you start taking Cymbalta. Let your doctor know if you have:
- Thoughts of suicide
- Symptoms of aggression
- Irritability
- Panic attacks
- Extreme worry
- Restlessness
- Acting without thinking
- Abnormal excitement
You should also let friends and family members know about these symptoms.
If you have any thoughts of suicide or if a friend or family member thinks you are acting strange, call your doctor right away.
Cymbalta Withdrawal
Take Cymbalta as directed by your doctor. Don't stop taking Cymbalta on your own, because suddenly stopping can cause severe withdrawal symptoms.Symptoms of Cymbalta withdrawal may include:
- Nausea and vomiting
- Anxiety
- Dizziness
- Headache
- Tingling and numbness
- Insomnia
- Sweating
- Nightmares
Cymbalta and Weight Gain
Researchers have found that Cymbalta (like many antidepressants) can cause fluctuations in weight among people taking the drug.A 2011 study, published in the International Journal of Clinical Practice, found that weight loss was reported among some Cymbalta users at the start of their Cymbalta therapy. This may be explained by a loss of appetite, a common side effect of the drug.
Some long-term users of Cymbalta, however, reported weight gain up to 16 percent over their initial weight (especially people who were taking Cymbalta for low-back pain or fibromyalgia).
These findings, the study authors wrote, were consistent with earlier studies that had focused on weight changes among people taking Cymbalta for depression.
Other Cymbalta Warnings
You should also know that you cannot take Cymbalta if you have a condition called uncontrolled narrow-angle glaucoma.Cymbalta can worsen glaucoma symptoms. Tell your doctor if you have any eye conditions.
Cymbalta may cause liver damage. You may not be able to take Cymbalta if you have liver disease or if you abuse alcohol. Alcohol may increase some serious side effects of Cymbalta.
Cymbalta may make you feel drowsy until you know how the drug will affect you, do not drive or operate machinery.
Cymbalta may cause high blood pressure, dizziness or lightheadedness, especially when you get up too quickly after sitting or lying down.
Cymbalta has many side effects and can interfere with many medications and can cause problems.
Always tell your doctor if you have allergies to any medications, including antidepressants. You will need to discuss all the risks and benefits of Cymbalta with your doctor.
Let your doctor know if you are taking a type of drug called a monoamine oxidase inhibitor (MAOI). Brand names for MAOIs include Marplan, Nardil, Eldepryl, Emsam, Zelapar, and Parnate.
Use this drug with caution if you have certain medical conditions. Tell your doctor about any history of these conditions:
- Liver problems
- Eye problems
- Frequent use of alcohol
- Heart problems
- High blood pressure
- Seizures
- Drug abuse
- Bipolar disorder
- Kidney disease
- Abnormal bleeding
- Family history of suicide
Pregnancy and Cymbalta
Cymbalta might harm a developing fetus.If you are pregnant or may be pregnant, you should discuss with your doctor the relative risks of taking Cymbalta while pregnant.
Cymbalta is known to pass into breast milk, and it's therefore recommended that you talk with your doctor before breastfeeding while taking Cymbalta.
Cymbalta Side Effects
- Nausea
- Dry mouth
- Sleepiness
- Fatigue
- Constipation
- Loss of appetite
- Sweating
- Headache
- Muscle ache
- Diarrhea
- Vomiting
- Heartburn
- Stomachache
- Loss of interest in sex
- Increased urination
- Dizziness
- Weakness
- Tremor
- Unusual bruising or bleeding
- Loss of appetite
- Abdominal pain
- Yellowing of the eyes or skin (jaundice)
- Dark-colored urine
- Fever with sweating, confusion, racing heart, and muscle stiffness
- Extreme weakness
- Swelling of the face, lips, or tongue
- Swelling in other parts of the body
- Trouble breathing or swallowing
- A blistering or peeling rash
- Chest pain
- Difficulty breathing
- Worsening depression
- Panic attack
Cymbalta Interactions
It's very important to let your doctor know about all drugs you are taking, including illegal drugs and any over-the-counter herbs or supplements.
Types of drugs that are known to interact with Cymbalta include:
- MAOIs, such as isocarboxazid (Marplan), linezolid (Zyvox), and phenelzine (Nardil)
- Blood thinners, such as warfarin (Coumadin, Jantoven)
- Other antidepressants, including amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), and certain selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac, Sarafem)
- Over-the-counter pain medications, including aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve)
- Drugs used to treat mental illness, including lithium (Eskalith, Lithobid)
- Diuretics (water pills)
- Heart and blood pressure medications, including amiodarone (Cordarone) and flecainide (Tambocor)
- Prescription pain medications, including fentanyl (Abstral, Actiq, Fentora, Onsolis)
- Medications used to treat heartburn, such as cimetidine (Tagamet), lansoprazole (Prevacid), and omeprazole (Prilosec)
- Some antibiotics, including ciprofloxacin (Cipro) and enoxacin (Penetrex)
- Medications used to treat migraines, including such as almotriptan (Axert), eletriptan (Relpax), and frovatriptan (Frova)
- St. John's wort
Other Cymbalta Interactions
Cymbalta may make you feel drowsy and may affect your judgment. Until you know how Cymbalta will affect you, you should not drive or operate machinery.Drinking alcohol may increase some serious side effects of Cymbalta.
Cymbalta may cause high blood pressure. It can also cause dizziness or lightheadedness, especially when you get up too quickly after sitting or lying down.
Cymbalta Dosage
Typical Dose of Cymbalta
Cymbalta comes in delayed-release capsules, which you may have to take once a day or twice a day.Swallow capsules whole with a glass of water. Do not open or crush the capsules.
You can take Cymbalta with or without food.
It may take four weeks or longer to feel the benefits of taking Cymbalta. A typical dose of Cymbalta for depression is 40 to 60 milligrams (mg) a day.
A typical dose for diabetic nerve pain, anxiety, fibromyalgia, or muscle/bone pain is 60 mg a day.
Cymbalta Overdose
It is possible to overdose on Cymbalta. Symptoms of a Cymbalta overdose may include:- Sleepiness
- Coma
- Seizures
- Dizziness
- Rapid heartbeat
- High or low blood pressure
- Vomiting.
- Fever with sweating
- Confusion
- Racing heart
- Muscle stiffness
Missed Dose of Cymbalta
Take Cymbalta exactly as directed by your doctor. Do not stop taking Cymbalta on your own.Stopping suddenly can cause Cymbalta withdrawal symptoms that include:
- Nausea
- Vomiting
- Anxiety
- Dizziness
- Headache
- Tingling and numbness
- Difficulty sleeping
- Sweating
- Nightmares
If it's almost time for your next dose, skip the missed dose. Do not double your dose to make up for a missed dose.
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