Cymbalta (duloxetine) is a prescription medication used to treat depression, anxiety, fibromyalgia, and diabetic neuropathy. It is what’s known as a serotonin and norepinephrine reuptake inhibitor (SNRI). SSNRIs have a powerful effect on the brain, working to increase the activity of neurotransmitters called serotonin and norepinephrine. When SNRIs are discontinued, some people experience withdrawal symptoms. This article discusses withdrawal from Cymbalta, including symptoms, how long it lasts, and how to cope.
What Is Cymbalta Withdrawal?
When you quit Cymbalta, it can take your brain some time to adjust to being without it. During this time, you may notice some dizziness and flu-like symptoms. Although these symptoms are typically mild, they can be alarming when they come as a surprise. Most people are not warned about the potential for withdrawal symptoms when they stop taking antidepressants. If your doctor did warn you, they might have used the term “antidepressant discontinuation syndrome,” which can be a bit misleading. A pooled analysis of six different placebo-controlled research studies found that 44.3% of people quitting duloxetine (Cymbalta) reported withdrawal-like symptoms, compared to 22.9% of people in the placebo group. The most commonly cited symptom was dizziness, followed by nausea and headache.
Signs & Symptoms of Cymbalta Withdrawal
When you stop taking Cymbalta, your brain has to adjust to lower levels of serotonin and norepinephrine. It can take days or weeks for your brain to settle into its new normal. During this time, you may experience several symptoms, including:
Anxiety Dizziness Irritability Nausea Nightmares Pins and needles Strange sensations like brain zaps Trouble sleeping Vomiting
Symptoms typically appear within two to four days of stopping your dose and last for a few weeks. While tapering—slowly decreasing—your dose is a common treatment strategy, some research suggests that even with this strategy, you still may experience some withdrawal symptoms. Compared to other SNRIs, like venlafaxine, Cymbalta withdrawal is relatively mild. If you have read elsewhere about an intense withdrawal syndrome from SNRIs, the authors were most likely referring to venlafaxine (Effexor). There is one report of a withdrawal seizure and one report of withdrawal symptoms coming and going over a period of ten months.
How to Taper Off Cymbalta
To help make it easier to come off Cymbalta, your doctor will likely recommend a taper lasting at least two weeks. Tapering a medication means working with your doctor to develop a plan to take progressively smaller doses of a drug over an extended period. It is unclear whether or not a slow Cymbalta taper will always prevent withdrawal symptoms, but it is generally considered the safest way to stop an antidepressant. An example of a tapering schedule for Cymbalta might be:
Starting dose: 90 mg1st dose reduction: 60 mg2nd dose reduction: 30 mg3rd dose reduction: 20 mg
After the third dose reduction, the individual would stop taking their medication and monitor their symptoms. While they may still experience some withdrawal symptoms, they will typically be milder and easier to manage with self-care strategies. Work with your doctor to develop a tapering schedule that fits your needs. Your doctor may want to switch you to a different antidepressant or provide medical support for your withdrawal symptoms.
Coping With Cymbalta Withdrawal
There are also self-care strategies and lifestyle modifications that may help you cope with withdrawal from Cymbalta. Other ways to ease the withdrawal experience include:
Working with a therapist. Talk therapy can help ease anxiety, soothe irritability, and even reduce physical discomfort.Seeking support from friends and family. Letting your loved ones know that you are experiencing withdrawal symptoms can help prevent conflict and reduce confusion.Practicing self-care. It is important to keep your body and brain in good shape by eating healthy and working out at least three times per week.Trying herbal remedies. If you are having trouble sleeping, try taking an OTC supplement like valerian root or melatonin at bedtime.Treating pain and nausea. You can treat headaches and stomachaches with OTC pain relivers and anti-nausea medications. Avoiding relapse. If you see signs that your depression or anxiety is coming back, talk to your doctor about alternative treatment options.
Cymbalta Withdrawal Warnings
Although quitting Cymbalta cold turkey is rarely dangerous, it is best to consult your doctor before attempting to do so. Tell your doctor why you are interested in quitting and ask about tapering options.
Long-Term Treatment
After Cymbalta, you may require ongoing treatment. The nature of that treatment will depend on a variety of factors, including the state of your mental health and your reasons for stopping the medication. Unlike other medications, like antibiotics, that work for almost everyone, antidepressants can be really hit-or-miss. A medication that your friend calls a lifesaver, might make you too dizzy to play with your kids or too foggy to work. Brain chemistry is an incredibly complex system involving not only neurotransmitters like serotonin, but also nerve cells, genes, and brain structures. If it were as easy as turning up the dial on one neurotransmitter and turning down the dial on another, depression would be much easier to treat. If you are quitting Cymbalta because you feel your depression has lifted, that’s fantastic. But it is important that you keep in touch with your psychiatrist or therapist to be sure that stopping the medication doesn’t cause a reemergence of your depression. Depression is a disease with a very high reoccurrence rate. About 50% of people who recover from one episode of depression will have more depressive episodes in their lifetime. If you have had more than one episode, there is about an 80% chance you will have another.
Consider Maintenance Therapy
If you have had one or more episodes of severe depression, you may be a good candidate for maintenance therapy. Typically, this means continuing with a therapeutic dose of antidepressants to reduce the risk of relapse. Other forms of maintenance therapy include psychotherapy. In the meantime, keep an eye out for symptoms that your depression is returning. Common symptoms include:
Experiencing outbursts of tearfulness, anger, or frustrationFeeling sad, empty, or hopelessFeeling anxious, agitated, or restlessFeeling tired all the timeFeeling worthless or guiltyFixating on perceived failures or faultsLosing interest, pleasure, or excitement for enjoyable activitiesMoving, speaking, or thinking slowlySleeping too much or too littleThoughts of death or suicide
Resources
If your doctor isn’t helping, consider finding a new psychiatrist, psychologist, or therapist in your area. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a searchable directory of qualified providers. You can also call them at 1-800-662-HELP (4357). If you have health insurance, you can also search the company’s list of local providers who accept your insurance.
A Word From Verywell
If you gave Cymbalta a good try, but you still don’t feel like yourself, don’t give up. There are other medications, doses, and combinations of medications that you can try. If you don’t think you need medication anymore, that’s great, but don’t neglect your mental health. For more mental health resources, see our National Helpline Database. A qualified therapist can help bolster the effects of antidepressants and help prevent a relapse. Just like medications, there is no once-size-fits-all therapist. Keeping trying until you find a combo that works for you. J Affect Disord. 2005 Dec;89(1-3):207-12.
