What helps with Cymbalta withdrawal symptoms?
Slowly stopping Cymbalta treatment over 2 to 4 weeks is the best way to help avoid withdrawal symptoms like dizziness, nausea or headache. Talk with your doctor first if you want to stop treatment. It is best not to abruptly discontinue Cymbalta (duloxetine).
Cymbalta works in the brain to treat conditions like depression and anxiety. It works by increasing brain chemicals such as serotonin and norepinephrine. When you stop treatment, it can take several weeks for your body to adjust to being without the medicine. During this time, you may experience side effects that can be bothersome (see a list below). Dizziness has been shown to be most common withdrawal side effect with Cymbalta, occurring in over 12% of people.
Slowly discontinuing treatment may not prevent all withdrawal side effects. Contact your healthcare provider again if you are still experiencing withdrawal symptoms, even with a gradual taper as directed by your doctor. They may decide to stop it even more slowly.
How long does Cymbalta withdrawal last?
In studies, most withdrawal side effects (65%) resolved within 7 days of stopping treatment. Nearly all patients rated these side effects as mild-to-moderate in severity.
More patients using the highest 120 mg per day dose of Cymbalta (the maximum prescribed dose for depression or anxiety) reported side effects, but most people do not use a dose this high because it does not add any benefit.
What are the withdrawal symptoms with Cymbalta?
A large review of 6 studies evaluated withdrawal symptoms with duloxetine (Cymbalta) doses ranging from 40 to 120 mg per day for 8 to 9 weeks. The study included 870 patients with a diagnosis of depression, and Cymbalta compared to a placebo (an inactive capsule).
Researchers found that when the medicine was abruptly stopped, withdrawal symptoms occurred in 44% of duloxetine patients compared to 23% of those taking the placebo, a significant difference.
- dizziness (12.4%)
- nausea (5.9%)
- headache (5.3%)
- “pin-and-needles” or burning feeling on skin, called paresthesia (2.9%)
- vomiting (2.4%)
- irritability (2.4%)
- nightmares (2%).
Other withdrawal (discontinuation syndrome) symptoms reported by the manufacturer (in 1% of patients or greater) are: diarrhea, insomnia, anxiety, hyperhidrosis (excessive sweating), and fatigue.
In the period after Cymbalta was approved, the manufacturer has also had reports of confusion, lethargy, emotional lability, hypomania (mild overactive behavior), tinnitus (ringing or noises in the ears), and seizures.
One case report described a seizure occurring a 59 year old woman who abruptly stopped treatment. The author noted the seizure may have been aggravated by low electrolyte levels in the blood. If you have a history of seizures, be sure to tell your doctor before you start treatment.
Why is Cymbalta prescribed?
Cymbalta is a serotonin and norepinephrine reuptake inhibitor (SNRI) approved to treat:
- depression (major depressive disorder) in adults
- anxiety (generalized anxiety disorder) in adults and children 7 years of age and older
- nerve pain due to diabetes (diabetic peripheral neuropathic pain) in adults
- fibromyalgia pain in adults and children 13 years of age and older
- chronic muscle pain in adults
Medications and brands available in the serotonin-norepinephrine reuptake inhibitor (SNRI) class include:
- desvenlafaxine (Pristiq)
- duloxetine (Cymbalta, Drizalma Sprinkle, Irenka)
- levomilnacipran (Fetzima)
- milnacipran (Savella)
- venlafaxine (Effexor, Effexor XR)
What else can I do to help decrease withdrawal symptoms?
Be sure to talk to your doctor before you stop Cymbalta.
- In addition to a slow withdrawal, you and your doctor may also decide to change your treatment to another medicine.
- There are many options to choose from for the treatment of depression anxiety, or the other uses for this medicine.
You may also want to talk to a therapist (talk therapy) to help limit anxiety, mood disturbances or other problems when stopping treatment.
- Let your family and friends know that you are slowly stopping treatment over several weeks or longer so they are aware you may have side effects.
- Eat healthy, get plenty of sleep and exercise to keep your body strong, and talk to your doctor right away if your symptoms of depression return.
Learn More: Does Cymbalta cause weight gain?
This is not all the information you need to know about Cymbalta for safe and effective use and does not take the place of your doctor’s directions. Review the full Cymbalta information and discuss this information and any questions you have with your doctor or other health care provider.
- Perahia DG, Kajdasz DK, Desaiah D, et al. Symptoms following abrupt discontinuation of duloxetine treatment in patients with major depressive disorder. J Affect Disord. 2005 Dec;89(1-3):207-12. doi: 10.1016/j.jad.2005.09.003
- Labbate LA, Fava M, Rosenbaum JF, Arana GW. Drugs for the treatment of depression. In: Handbook of Psychiatric Drug Therapy, Sixth Edition, Lippincott Williams & Wilkins, Philadelphia 2010. page 54.
- Nelson C et al. Serotonin-norepinephrine reuptake inhibitors (SNRIs): Pharmacology, administration, and side effects. Up to Date. Accessed Jan. 21, 2021 at https://www.uptodate.com/contents/serotonin-norepinephrine-reuptake-inhibitors-snris-pharmacology-administration-and-side-effects
- Cymbalta (duloxetine) prescribing information. Sept. 2021. Eli Lilly. Indianapolis, IN. Accessed Jan 21, 2021 at https://pi.lilly.com/us/cymbalta-pi.pdf
- Qadir A, Haider N. Duloxetine withdrawal seizure. Psychiatry (Edgmont). 2006;3(9):10. PMID: 20975823
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