Cymbalta (Duloxetine): Uses, Side Effects, Dosage

Cymbalta (duloxetine) is a medication used to treat anxiety, major depressive disorder, and chronic pain related to certain health conditions. Cymbalta is in a class of drugs called SNRIs — selective serotonin and norepinephrine reuptake inhibitors — which work by altering the levels of serotonin and norepinephrine in the brain.  

While Cymbalta is very effective in managing some mental and physical health conditions, like any medication, it also comes with potential side effects, adverse effects, and warnings. Before you take Cymbalta, you should talk to your doctor, healthcare provider, or a medical professional so you understand what to expect. 

Explore what Cymbalta is used for, its approved and off-label uses, the pros and cons, and any possible side effects or additional considerations you should know if you’re considering using this SNRI as part of your therapy plan. 

What is Cymbalta?

Cymbalta is an effective antidepressant that treats mental health conditions like anxiety and depression and treats physical conditions like nerve and bone pain in people with fibromyalgia, diabetic peripheral neuropathic pain, and chronic musculoskeletal pain. 

How does Cymbalta work?

By blocking the reuptake of serotonin and norepinephrine in the brain, Cymbalta boosts levels to alleviate depression symptoms and control pain. Cymbalta used for depression, generalized anxiety disorder, and pain is generally effective for most people.  

How does Cymbalta make you feel?

This drug can enhance mood, reduce tension, and lessen physical indications connected with some health conditions and chronic musculoskeletal pain. Altering the amounts of serotonin and norepinephrine in the brain helps with symptoms, as these neurotransmitters are essential for regulating mood. 

Common Cymbalta side effects may include nausea, dry mouth, insomnia, constipation, dizziness, and fatigue. However, with proper use under a doctor’s or medical professional’s supervision, side effects and adverse effects often resolve, and Cymbalta can improve overall mental health and well-being over time. 

Cymbalta Uses 

Cymbalta is used for several mental health conditions and to treat pain related to diabetic neuropathy and fibromyalgia. 

Major depressive disorder (MDD) in adults

Using Cymbalta for depression can help manage symptoms in adults. Changing the levels of serotonin and norepinephrine in the brain helps regulate mood. Studies have shown that Cymbalta is effective for treating depression when compared to a placebo.

Generalized anxiety disorder (GAD) in children 7 and older

Cymbalta for anxiety is approved in people 7 and older. Research indicates that Cymbalta can help with restlessness, difficulty focusing, irritability, and muscle strain connected to generalized anxiety disorder.

“Cymbalta has been prescribed for many conditions, such as depression, fibromyalgia, diabetic neuropathy, and anxiety. This medication can cast a wide net when addressing all types of conditions.”

– Talkspace therapist Dr. Karmen Smith LCSW D DIV

Pros & Cons of Cymbalta

“Cymbalta and other medications like it have been known to cause an increase in suicidal risk amount teens and young adults. Taking this information into account, it may not be the best option for this age group.”

– Talkspace therapist Dr. Karmen Smith LCSW D DIV

Side Effects of Cymbalta

Common side effects of Cymbalta (duloxetine) include:

• Nausea
• Dry mouth
• Constipation
• Fatigue
• Loss of appetite
• Increased sweating
• Drowsiness
• Sexual dysfunction

Taking Cymbalta excessively or for an extended duration can cause severe adverse reactions. The potential risks of long-term or high-dose usage include disorientation, irritability, hepatic impairment, fits, changes in blood pressure, Cymbalta weight gain, and suicidal ideations.

“Cymbalta can have some common side effects which your doctor should advise you of such as drowsiness, nausea, constipation, loss of appetite, dry mouth, increased sweating.”

– Talkspace therapist Dr. Karmen Smith LCSW D DIV

Cymbalta Dosage

Cymbalta comes as delayed-release capsules in multiple strengths. Your condition, symptoms, and other factors determine the dosage you should take. The hypothetical dosage below should not be broadly applied for everyone. Please talk to a doctor before taking any medication to determine the right dosage for you.

• For adults with depression: Adults start with 20 – 30 mg twice daily. Your doctor may increase your dose up to 60 mg per day after a week if needed. For those with severe liver issues, the highest dosage suggested is 30 mg a day.
  • Maintenance: Either 30 mg 2 times a day or 60 mg once per day
  • Max dose: 120 mg daily

• For adults with generalized anxiety disorder: Initial dose is 60 mg once per day
  • Maintenance: 60 – 120 mg per day
  • Max dose: 120 mg per day

• For geriatric adults with generalized anxiety disorder: 30 mg once a day for 2 weeks
  • Maintenance: 60 mg per day
  • Max dose: 120 mg per day

• For adults to treat pain (neuropathic and chronic): Start with 30 – 60 mg once each day
  • Maintenance: 60 mg per day

• For pediatric — 7 years and older — generalized anxiety disorder: 30 mg one time per day for a minimum of 2 weeks
  • Maintenance: 30 – 60 mg per day
  • Max dose: 120 mg daily

How to take Cymbalta

Cymbalta dosage should be carefully monitored by a healthcare professional or healthcare provider to ensure the best results. When deciding on your dosage, your doctor will consider things like age and prior medical history. Taking more than the suggested dose will not increase efficacy but can worsen side effects. 

Take Cymbalta exactly how your doctor prescribes it — do not chew, crush, or break it open unless directed to do so. You can take Cymbalta with or without food. 

Additional Considerations

Before taking Cymbalta, you want to know about potential interactions with other drugs, medical conditions, and supplements. Some medical conditions can affect how your body reacts to Cymbalta. For example, you should monitor your blood pressure closely when taking Cymbalta. 

Interactions

To prevent potential drug interactions, informing your doctor of all medications you currently take is essential. This includes prescription and nonprescription drugs and supplements, vitamins, or herbal remedies. 

Ask your doctor about taking any of the following with Cymbalta:

• Ibuprofen or Advil
• Aspirin
• Motrin
• Aleve
• Naproxen
• Vitamins
• Herbal supplements

Drug interactions may occur with the following medications:

• Bromopride
• Furazolidone
• Linezolid
• Moclobemide
• Safinamide
• Viloxazine
  

*Note this list is not exhaustive — check with your doctor about any medication combinations if you’re taking Cymbalta.

Warnings

There are several potentially severe warnings to be aware of if you take Cymbalta. 

• Suicidal thoughts: The most serious warning is an increased risk of suicidal thoughts, especially in people under 24. If you’re experiencing thoughts of suicide, get medical attention right away. 

• Risk of bleeding: Other warnings include an increased risk of bleeding due to the anticoagulant effect of taking certain types of antidepressants like duloxetine.

• Serotonin syndrome: Though rare, serotonin syndrome is a potential risk for those who take Cymbalta. Symptoms include confusion, agitation, and fever, among others. 

• Withdrawal: Some studies show up to 44% of people experience Cymbalta withdrawal symptoms when they stop taking antidepressants. Dizziness and nausea may occur if you suddenly stop taking Cymbalta without tapering off slowly. Always follow your doctor’s instructions carefully when discontinuing use.

• Liver damage & high blood pressure: High doses of Cymbalta have been linked to liver damage in some research. The drug also may increase blood pressure. 

Cymbalta Alternatives

While it’s an effective treatment option for many, there are cases where different medications might be superior to Cymbalta. Some similar medications include:

• Other SNRIs like Effexor or Pristiq
• SSRIs like Prozac and Zoloft
• Norepinephrine-dopamine reuptake inhibitors like Wellbutrin
• Monoamine oxidase inhibitors like Marplan
• Atypical antipsychotics, including Abilify 
  

Your doctor will decide if another drug might be a better alternative to Cymbalta based on your condition and symptoms. 

Online Cymbalta Prescription Through Talkspace Psychiatry

Cymbalta helps manage symptoms of depression, anxiety, diabetic neuropathy, fibromyalgia, and chronic pain. A licensed psychiatrist is available through Talkspace to discuss symptoms and recommend treatment options, including prescriptions for Cymbalta online if necessary.

With Talkspace, a licensed online psychiatrist will evaluate your condition, symptoms, and medical background before giving any medication or advising lifestyle alterations that may help diminish signs of anxiety or depression. 

Reach out to Talkspace today if you want to discuss Cymbalta for anxiety, depression, or any other condition.