Cymbalta: What Is Duloxetine and How Does It Work for Treating Mental Health?

Author:

Jemma Strain

B.S. Psychology

Editor:

Emma Loker

B.S

If you’re dealing with a mental health issue or chronic pain that’s affecting your ability to live a full, meaningful life, finding the right solution for your problem might feel hopeless.

If this is the case for you, you’re not alone. Many people struggle with similar issues, but this doesn’t mean that your condition is any less difficult to cope with. It takes strength to seek support, even if this help sometimes involves medication such as antidepressants.

Duloxetine, also known as “Cymbalta,” is a type of antidepressant that is often used to successfully treat both mental health conditions and chronic pain. Yet, this doesn’t mean that duloxetine is suitable for everyone with these issues.

Mission Connection can talk to you or a loved one about duloxetine’s effects and how they may fit your needs. This article can also provide guidance, as it covers:

What duloxetine is
How long it takes for duloxetine to work
Potential Cymbalta side effects and risks
If it’s possible to stop taking duloxetine abruptly
How to taper off Cymbalta safely
Frequently asked questions about duloxetine
Where to find professional support for medication guidance and treatment

What Is Duloxetine?

Duloxetine (Cymbalta) is a type of antidepressant that is Food and Drug Administration (FDA) approved for the treatment of major depressive disorder. It’s also commonly prescribed for conditions like generalized anxiety disorder (GAD) and chronic pain, such as fibromyalgia and musculoskeletal pain. It was first created in 1993 and introduced to the American market in 2004.¹

Duloxetine belongs to a group of second-generation antidepressants called “serotonin norepinephrine reuptake inhibitors” or SNRIs for short. SNRIs work similarly for treating depression as older antidepressants, such as tricyclics, but they pose the risk of fewer side effects. This makes them better tolerated by a wider range of people.

The reason why SNRIs work for treating mental health conditions comes down to how they can restore a chemical imbalance in the brain. While the role of chemical imbalances in depression and anxiety is debated, people with these conditions have been shown to have less availability of certain neurotransmitters: serotonin and norepinephrine. These chemicals are primarily responsible for mood, energy, arousal, and attention.²

SNRIs target both of these chemicals, increasing their availability in the brain. What this means is that the medication inhibits the reabsorption of serotonin and norepinephrine, improving their ability to carry messages from nerve cell to nerve cell. As a result, people with mental health conditions often feel more alert, focused, motivated, and positive. Additionally, SNRIs can relieve the symptoms of chronic pain.³

SNRIs might sound like the solution to all your mental and physical health problems, but the same SNRI can affect two people differently. Plus, it may be more effective for certain conditions over others, which we’ll touch on next.

What Conditions Does Duloxetine Treat?

As mentioned, Cymbalta for anxiety and depression is FDA approved, as is a range of chronic pain-related conditions. Duloxetine is often also prescribed off-label for other conditions, which means it can be given for problems that it’s not officially approved for. These off-label conditions include duloxetine for nerve pain relating to chemotherapy and urinary incontinence caused by stress.¹

A mental health provider can discuss off-label duloxetine for your symptoms if they believe it could provide relief. The following information discusses common conditions for which duloxetine is prescribed.

Duloxetine for Depression

Depression is marked by feelings of persistent sadness and hopelessness that can continue for months or even years. Duloxetine has been shown through studies to improve the symptoms of depression for many people. However, recent evidence suggests that it may not be as suitable for more severe symptoms of depression as other SNRIs.⁴

Cymbalta for Anxiety

Anxiety disorders can create generalized and social worries that affect day-to-day functioning and quality of life. Research shows that duloxetine works to reduce worries in both the short and long term, so it may be an effective option for many people with anxiety.⁵

Duloxetine for Chronic Pain

Chronic pain is long-standing pain that extends beyond a typical recovery period or goes hand in hand with an ongoing physical health condition, such as arthritis or fibromyalgia. Duloxetine has demonstrated its ability to reduce the symptoms of chronic pain. For instance, Cymbalta for fibromyalgia can work by treating both physical symptoms and mental health consequences of pain. However, the duloxetine dosage may need to be relatively high to see consistent benefits.⁶

How Long Does Duloxetine Take to Work?

Everyone’s physicality is different, as are their reasons for taking duloxetine, so there’s no black and white answer to how long it takes duloxetine to work. Some people might see benefits in as little as one to two weeks. However, others might not see the full effects of duloxetine for up to eight weeks. As a side note, duloxetine generally starts to work to relieve physical pain by two weeks.⁷

It may be disheartening to hear that duloxetine could take up to two months to work for mental health symptoms, but even small improvements in symptoms can make a big difference. For this reason, we highlight signs Cymbalta is working below to help you recognize its effects.

Signs Cymbalta Is Working:

Better sleep
Boost in energy
Increased appetite
Reduced physical pain
Improved mood
Increased interest in activities
Feeling more like yourself

The latter three symptoms may take the longest to appear, but the early signs can give you a sense of encouragement that the more significant changes will happen. If you don’t see any of these symptoms as you continue through the adjustment period, speak to your provider. They may be able to offer reassurance or adjust your dose if needed.

Cymbalta Side Effects

Duloxetine, as with other medications, can cause side effects. Not everyone will experience side effects, yet other people might go through a few of them. The good news is that the more common duloxetine side effects should ease as someone adjusts to the medication. However, if they persist or become too uncomfortable to cope with, it’s important to communicate this with your provider. They may discuss adjusting your dose or switching to another medication.

Common Cymbalta Side Effects:⁸

Stomach pains
Loss of appetite
Diarrhoea
Fatigue
Drowsiness
Perspiration
Dry mouth
Racing heart
Headaches
Constipation
Sexual dysfunction

These are not the only side effects of duloxetine. There are less common, but considerably more severe, risks that are important to be aware of. Duloxetine’s information leaflet will contain the following information, but it’s also good to be aware of it prior to starting treatment.

Cymbalta Risks:

Low blood sodium levels: Leading to confusion, memory and concentration issues, and physical weakness
Angle closure glaucoma: Characterized by eye pain, blurred vision, headaches, and a “ring” around light sources
Liver damage: Seen through dark urine, itchy skin, fatigue, and jaundice. For this reason, duloxetine may not be prescribed for people with liver issues.
Seizures: Which can look like spasms or convulsions, and can feel like tingling in the extremities, as well as loss of hearing or taste
Serotonin syndrome: Leading to rapid heart rate, agitation, confusion, delirium, vomiting, tremors, perspiration, fever, and seizures

If you notice any of these signs in yourself or someone else, it’s important to seek immediate help. Issues such as serotonin syndrome can be life-threatening, so if you think there’s a medical emergency, call 911 or visit your local emergency department

Can I Stop Taking Duloxetine Abruptly?

There are many reasons why someone might want to stop taking duloxetine. For instance, the side effects might outweigh the benefits. Alternatively, someone might feel ready to come off medication for their symptoms altogether. However, the answer to the question “Can I stop taking duloxetine suddenly?” is, effectively, “no.”

Research shows that stopping Cymbalta suddenly can lead to discontinuation syndrome or Cymbalta withdrawal symptoms. Not everyone will experience these symptoms, but they can be highly uncomfortable and last for a long time.⁹

Cymbalta Withdrawal Symptoms:

Return of mental health issues
Stomach upset, such as nausea, vomiting, and diarrhoea
Headaches
Fatigue
Irritability
Sleep disturbances
Brain “zaps”
Sensory issues, such as a prickling or burning sensation
Perspiration

These withdrawal symptoms don’t always come on immediately. Cymbalta has a half-life of 12 hours, so some people might see withdrawal symptoms after it starts to wear off. Yet others may not see symptoms until days later. It depends on your dosage and how long you’ve been on the medication. If you notice any of these symptoms, it’s a good idea to contact your provider for guidance.

How to Taper Off Cymbalta

If you’re wondering how to stop taking Cymbalta safely, the answer is “slowly and under professional guidance.” It’s best to taper off duloxetine, meaning that its dosage should be reduced bit by bit over time. For instance, a provider may lower the dose for a period of a couple of weeks and monitor emotional and physical reactions before reducing the dosage further.

Mission Connection can help you or someone you care about create a safe tapering plan that protects your continued recovery.

Frequently Asked Questions About Duloxetine

While the goal of this article is to give you the full picture about duloxetine – how it works, its benefits, side effects, and risks – there may still be some concerns on your mind. To help as much as possible, we provide some answers to FAQs about duloxetine below.

Can Cymbalta Cause Fatigue?

Everyone experiences the side effects of Cymbalta differently, but there is a risk of increased fatigue in treatment – especially during the early stages. If fatigue persists past the adjustment period or interferes too much with your life, discuss your concerns with your provider. They may talk to you about adjusting your dosage or switching you to a medication that is less likely to cause fatigue.

Is There a Link Between Cymbalta and Weight Changes?

The short answer regarding Cymbalta and weight changes is: yes, it can create weight changes. While many people report appetite and weight loss early in treatment, longer-term treatment could result in weight gain. However, studies show that weight gain from duloxetine is minimal. A provider can discuss nutrition and lifestyle changes to help you manage any duloxetine weight gain.

Does Cymbalta Work in Older Adults?

Cymbalta in older adults has been shown to work for improving mental health, autonomy in treatment, pain symptoms, and overall quality of life.¹⁰ However, it should be noted that duloxetine has not been shown to improve physical health or functioning. Additionally, while duloxetine is generally well-tolerated by older adults, they may be more susceptible to its side effects and risks. Therefore, regular monitoring by a healthcare provider is essential.

Are There Any Cymbalta Sexual Side Effects?

Cymbalta sexual side effects are an unfortunate downside for some people. Not everyone will encounter these issues, but some may experience a loss of sexual desire and difficulties with orgasm or ejaculation. However, these effects are often temporary and ease after the initial adjustment period. Plus, duloxetine may be linked to fewer sexual side effects in comparison to other antidepressants, such as escitalopram.¹¹ If sexual dysfunction is a concern for you or a loved one, a provider can discuss supplementing treatment with a medication that could ease this side effect.

Are There Any Cymbalta Drug Interactions?

Cymbalta can interact with a wide range of medications. Therefore, it’s always best to check with your provider to discuss anything you already take and before adding any new substances to your intake. For instance, taking duloxetine with other drugs can increase the risk of serotonin syndrome and other risky side effects. As the interactions can be extensive, it’s best to be open with your provider throughout treatment.¹²

Mission Connection: Guiding You Through Treatment

No two people experience mental health issues in the same way. For this reason, everybody can respond to medications differently. Choosing the right medication for your symptoms and needs can feel like finding a needle in a haystack, but it doesn’t have to. With the right questions, support, and guidance, the best solutions for you can become clear.

Mission Connection can look beyond outward symptoms to the issues behind them, targeting mental health through a holistic approach. If medication becomes part of the picture for you, it’s because it’s the right fit for your needs.

Medication works best alongside therapy for providing long-term recovery. For this reason, our team can discuss therapy options that can resonate with your symptoms and schedule. Whether this involves residential, outpatient, or telehealth services, our team can help.

If you’re ready to talk about Mission Connection’s treatment options or just have more questions to ask about medication, our team is here to help. Contact us via phone call today or fill out our confidential contact form.

References

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