What is Cymbalta?
Cymbalta is a prescription medication taken to treat depression, anxiety, and some forms of pain.
It contains the active ingredient duloxetine, which is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI) antidepressant. This means it increases levels of serotonin and norepinephrine in your brain, helping to restore their natural balance.
Cymbalta can improve your mood and thinking, increase energy levels, reduce feelings of anxiety, help you sleep, and fight pain caused by certain medical conditions.
What is Cymbalta used for?
Cymbalta is taken to help manage the following conditions:
- Major depressive disorder (MDD), usually just called depression
- Generalized anxiety disorder, often just called anxiety
- Fibromyalgia – chronic widespread pain and a heightened sensitivity to pressure
- Chronic musculoskeletal pain – long-lasting pain in the bones, joints, muscles, and nerves
- Diabetic peripheral neuropathic pain – numbness and pain caused by nerve damage resulting from diabetes
Cymbalta treats these conditions by having a range of effects on your body. The most notable of these is increasing levels of serotonin and norepinephrine in your brain.
Serotonin is a neurotransmitter; a messenger molecule that allows signals to travel between neurons in your brain. It regulates your brain function and plays a role in thinking and understanding, learning, memory, and reward pathways, amongst others.
Norepinephrine is another neurotransmitter and is also a natural hormone. It makes you feel awake, increases arousal and alertness, focuses your attention, and aids with forming and retrieving memories.
Serotonin and norepinephrine are produced continuously in your brain. Any excess serotonin and norepinephrine that isn’t used up is quickly reabsorbed by the neurons that produced it. Cymbalta slows down the rate of reabsorption though. This causes a build-up in levels of serotonin and norepinephrine in your brain.
The medication has the following uses:
Cymbalta for depression
It used to be thought that depression was caused by low levels of neurotransmitters like serotonin. Whilst research has illustrated that depression is more complicated than this, increasing serotonin and norepinephrine levels have been shown to help with depression.
Cymbalta may also help ease the symptoms of depression by reducing inflammation. It’s thought that depression, at least in part, can be caused by continuous, low levels of inflammation in your body. Cymbalta reduces inflammation by limiting the activity of molecules called cytokines that your immune system releases to trigger an inflammatory response.
Cymbalta for anxiety
The causes of anxiety aren’t clearly understood. It’s thought to involve changes in levels of serotonin and norepinephrine though, or a reduced sensitivity to them. Research has shown that medications that increase serotonin and norepinephrine concentrations, like Cymbalta, can be effective at relieving the symptoms of anxiety disorders.
Cymbalta for pain
Both serotonin and norepinephrine are involved in the perception of pain. Medications that increase serotonin and norepinephrine levels, including Cymbalta, have been shown to reduce pain.
Cymbalta may also help reduce pain by slowing the passage of sodium into your cells (it is also a sodium channel blocker). This can reduce the speed at which signals pass through cells and lower cell excitability, thought to reduce the perception of pain and to slow the passage of pain signals through the body. You can take Cymbalta for nerve pain, fibromyalgia, and musculoskeletal pain.
Before taking Cymbalta – What you need to know
Cymbalta isn’t suitable for everyone. You shouldn’t take Cymbalta if you:
- Are allergic to the active ingredient duloxetine
- Are allergic to any of the other ingredients in Cymbalta
- Have liver disease
- Have a severe kidney disease
- Have an eye condition called uncontrolled narrow-angle glaucoma
You should talk to your doctor before taking Cymbalta if you:
- Have previously had thoughts about harming yourself or committing suicide
- Have previously experienced a negative reaction to other SRNI antidepressants or SSRI antidepressants
- Have kidney disease
- Have ever had fits or seizures
- Have ever experienced mania
- Have bipolar disorder
- Have any eye problems, including any kinds of glaucoma
- Have any bleeding disorders
- Are at risk of having low sodium levels, for instance, if you’re taking diuretics
- Are intolerant to some sugars
- Are under 25 years of age
- Are pregnant or trying to become pregnant
- Are breastfeeding or plan to breastfeed
You should contact your doctor immediately if you feel any of the following:
- A worsening of your depression or anxiety
- An increase in thoughts of self-harm or suicide
- Restlessness and hyperactivity
- Panic attacks
Cymbalta black box warning
The FDA requires that Cymbalta carries a black box warning about the risk of antidepressants and suicide. Research has shown antidepressants can increase suicidal thoughts and the risk of suicidal behavior in children and young adults (under 24).
If you take Cymbalta, and you’re under 24, you should be watchful for this and your parents or caregivers should be aware of it. Your physician should also monitor you for suicidal thoughts and behaviors. If you have any thoughts about suicide, tell a friend or family member right away, and call your physician.
Research hasn’t found an increase in the risk of suicidal thoughts and behaviors in people over 24 who take antidepressants. Depression, and other mental health disorders, put you at a greater risk of suicide though. You should be aware of this and make loved ones aware of it too.
Other Cymbalta warnings
Cymbalta can cause side effects, like drowsiness and dizziness, that can make driving, using machinery, or performing other hazardous tasks more dangerous. Make sure you avoid doing these activities whilst taking Cymbalta until you’re confident you know how it affects you.
How to take Cymbalta
Cymbalta comes as an oral capsule or a delayed-release oral capsule. Both types of capsules are available in 20 mg, 30 mg, and 60 mg strengths.
You must swallow Cymbalta tablets whole. They can be taken with water and with or without food.
The medical professional who prescribes Cymbalta to you will decide on which version of the tablet to take and the dose. The following are typical Cymbalta dosages for each condition:
- Depression – 40 mg per day (two 20 mg tablets) to 60 mg per day (either one 60 mg tablet or two 30 mg tablets).
- Anxiety – 60 mg per day (one 60 mg tablet)
- Fibromyalgia – 60 mg per day (one 60 mg tablet)
- Chronic musculoskeletal pain – 60 mg per day (one 60 mg tablet)
- Diabetic peripheral neuropathic pain -– 60 mg per day (one 60 mg tablet)
Your doctor may decide to start you on a lower Cymbalta dose to let you adjust to the medication and to see how you react to it. For instance, you may take 30 mg daily for a week before moving up to 60 mg.
Always take your Cymbalta as directed.
If you take too much, you risk a Cymbalta overdose. Talk to your physician or call an ambulance immediately if you do take too much and tell them how much you’ve taken.
If you forget to take your medication, take it again as soon as you remember. However, if it’s close to the time you’d take your next dose, skip it and wait for your next dose. Never take more Cymbalta to make up for a missed dose.
Cymbalta and alcohol
You should avoid drinking alcohol when taking Cymbalta. Alcohol can make some side effects of Cymbalta worse, like dizziness and drowsiness. Alcohol and Cymbalta could also interact to make any possible liver damage worse or aggravate pre-existing liver disease.
How long does it take for Cymbalta to work?
This varies by person. It depends on a range of factors, like your condition, your health, how you react to the medication, and the dose you take. You may see effects in one to two weeks after you start taking Cymbalta. These include improvements to your energy levels, sleep, and appetite.
You may also see improvements in depression after six to eight weeks. Remember, these timelines are only average guides. You may respond faster, or it may take longer for Cymbalta to work for you.
Cymbalta side effects
When you take Cymbalta there is a chance you may experience some side effects, with the most common including:
- Dry mouth
- Abdominal pain
- Decreased appetite
- Drowsiness and sleepiness (somnolence)
- Excessive sweating (hyperhidrosis)
Cymbalta can also cause more serious side effects, although this is rarer. They can include:
- An increase in suicidal thoughts and behavior
- Other changes in behavior and thinking
- Serious allergic reactions
- Liver failure
Cymbalta side effects in men
Research has shown that Cymbalta can cause some side effects in men that can disrupt your sex life. These include a reduction in sex drive, problems getting or keeping an erection (erectile dysfunction), and difficulties achieving orgasm. Most men don’t get these side effects, but you should talk to your physician if you’re worried about them.
Cymbalta side effects in women
The same research that showed Cymbalta can have sexual side effects in men didn’t find any in women.
Cymbalta can cause abnormal vaginal bleeding, however, and it can affect your periods, making them lighter or heavier, irregular, prolonged, or cause you to miss them.
Cymbalta and pregnancy
Cymbalta can affect an unborn baby and it can be present in breast milk. Talk to your physician if you are pregnant or trying to get pregnant, are breastfeeding or plan to breastfeed.
Some people who’ve stopped taking Cymbalta have reported withdrawal side effects (called Cymbalta Discontinuation Syndrome). Cymbalta withdrawal symptoms are more likely and can be felt more strongly when people suddenly stop taking it. These withdrawal side effects can include:
- Nausea and vomiting
- Brain zaps – a feeling like a mild electric shock in the brain
Talk to your physician if you’d like to stop taking Cymbalta. They may recommend you reduce your dose gradually to withdrawal from Cymbalta slowly, lowering your likelihood of getting withdrawal symptoms.
Cymbalta drug interactions
If you take Cymbalta and you also use other medications, the drugs may interact with other medications, which can change how they work and can increase the likelihood and severity of some side effects. Those thought to interact with Cymbalta include:
- Other medications that can increase serotonin levels (SSRI and SNRI antidepressants tramadol, tryptophan, or St John’s Wort)
- Monoamine oxidase inhibitors (MAOIs), used as antidepressants and antibiotics
- Medicines that cause sleepiness (strong painkillers, benzodiazepines, antipsychotics, phenobarbital, and antihistamines)
- Medicines which thin your blood or prevent it from clotting (anticoagulants or antiplatelet agents)
Is Cymbalta an SSRI?
No, Cymbalta is not an SSRI, it’s an SNRI.
SSRIs (selective serotonin reuptake inhibitors) are medications that increase levels of available serotonin in the brain. Cymbalta does do this, but it also increases available norepinephrine. This means it’s classed as an SNRI (Serotonin-norepinephrine reuptake inhibitor) medication.
How does Cymbalta make you feel?
Different people respond to drugs in different ways. Cymbalta can improve your mood and thoughts, can give you more energy and more motivation can dampen feelings of worry and anxiety, and can reduce pain.
It can also have some negative side effects though. Specifically, it can make you feel sick, give you headaches, cause you to feel tired, drowsy, and dizzy. Cymbalta is an effective medication and its benefits outweigh any side effects for most people who take it.
Does Cymbalta cause weight gain?
Cymbalta can cause changes in weight. Some people lose weight when they take it, probably because it can reduce your appetite. Others gain weight, but both losses and gains are usually minimal. In some clinical trials, people lost weight when they first started taking Cymbalta, but in longer trials, some gained weight, although this was only around 3lbs (1.4 kg).
How much does Cymbalta cost?
Without insurance, the cost of Cymbalta varies depending on the number of tablets you buy, the strength of the tablets, and the retailer. As a guide, costs are likely to be around $300 to $340 for a 30 pack of 25 mg strength tablets.
With Prescription Care you may be able to get Cymbalta for a flat fee of $49 per month. See how we can help you access affordable Cymbalta medication.