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Cymbalta Withdrawal Symptoms

Cymbalta withdrawals can include:

  • Seizure 29
  • Suicidal thoughts 33
  • Akathisia 35
  • Dizziness, nausea, vomiting, headache 28
  • Paresthesia, electric-shock sensations, prickling skin sensations 28,30,31
  • Irritability 28
  • Nightmares 28
  • Anxiety 31
  • Panic attacks 33
  • Parkinsonism and other movement disorders 32
  • Withdrawal-induced mania 34
  • Sexual dysfunction 35
  • Brain fog, cognitive impairment, inability to concentrate 35
  • Muscle aches, tremors 35

Cymbalta Withdrawal Symptoms

Cymbalta withdrawal symptoms occur in the majority of users who try to quit and about half of those report their withdrawals as severe. Since these numbers are generally underestimated, a person may think their situation is unique when in fact it is more common than they’ve been led to believe.6

Antidepressants like Cymbalta, despite overwhelming evidence and patient testimonials, still get overlooked as being a source of many of the patient’s problems. In many cases, this can lead to misdiagnoses and missed opportunities for effective and meaningful treatment.

Do Your Symptoms Require Cymbalta?

getting off cymbalta
Cymbalta use can cause serious side effects and debilitating withdrawal characteristics for certain persons. Unfortunately, these are the exact patients that tend to get abandoned in their very real suffering.

Alternative to Meds Center helping patients with antidepressant withdrawal for over 15 years. We have published evidence regarding our success. Our founding staff and many of those who have been drawn to this work have had similar struggles. We are peers in this process. Feel free to reach out to us and get the kind of support you need to get through this.

Watch this video of a woman who gained her life back after coming off of antidepressants and benzodiazepines that she had been taking as prescribed. When she started the program, she thought her life was over. Unable to work, depressed, and barely able to walk. Little did she know, her life was coming to a new beginning. She left medication-free, hiking up to 1½ hours per day, and re-entered her professional counseling career. She is successful and happy to this day.

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Can Holistic Treatment Help With Cymbalta Withdrawal?

We have found certain methods can make the Cymbalta withdrawal process substantially more tolerable. We use a combination of inpatient tapering techniques, dietary modifications such as organic diet, counseling, and other daily support and encouragement from dedicated care managers, medical and nutritional lab testing, neurotransmitter rehabilitation protocols, IV therapies, and detoxification techniques to help alleviate a toxic body burden that may be contributing to neurochemical impairment.

Not only is it possible for the client to feel better very early in the process, but the person can relax and complete the withdrawal process limiting unnecessarily harsh Cymbalta withdrawal symptoms, worry, or strain. Our Cymbalta withdrawal program can help focus on the benefits of regaining mental health naturally.

We encourage you to view our articles that cover Cymbalta tapering methods, and alternatives to Cymbalta that truly address the withdrawal process and the shift to natural alternatives.

Is Cymbalta Addictive?

Addiction is not a term often used concerning SNRI medications, yet there has been considerable research concerning patients developing tolerance and dependence on SNRIs, and suffering withdrawals when the drug is discontinued. Fava et al in 2018 reviewed 22 double-blind randomized controlled trials, numerous open trials, and 23 case reports on various types of second-generation antidepressants like Cymbalta. After reviewing these trials and numerous other research they found that withdrawal symptoms occurred after any SNRI drug was discontinued.36  In contrast, the FDA label for Cymbalta offers one lean sentence on the subject, that recommends gradual discontinuation when possible, rather than abrupt cessation. No other guidelines are given. 2,5

Wilson et al in the research published in Therapeutic Advances in Pharmacology Journal 30 take a much stronger stance on the subject and in particular point to the extreme withdrawals of newer antidepressants such as Cymbalta, described as comparable to benzodiazepine withdrawals. In this review, the authors comment on various methods that have been proposed over time, such as reducing by some percentage per week or per month, converting to a liquid form for more precise tapering, switching to a drug with a longer half-life, and the NIH (who appear to have never seen the phenomena in any patients) that continues to discount the need to address withdrawals at all “because antidepressants are not habit-forming.” 30

For nearly 2 decades, the staff at Alternative to Meds Center have dedicated themselves to assisting others to free themselves from the unwanted burden of addiction and dependence on pharmaceutical drugs. With careful preparation, the use of lab testing, nutritional, psychosocial, and other support, our center has enjoyed a remarkable success rate for our clients eliminating original symptoms while also recovering from SNRI adverse effects and withdrawal phenomena.

Planning Your Cymbalta Withdrawal

Please use the data here freely in coordination with your primary caregivers, to assist in your information-gathering phase, which is essential to successfully plan your Cymbalta withdrawal treatment. When given a residential level of support with experienced staffing, for most people it is possible to stop taking Cymbalta with a minimum of discomfort. For all of those who have come through our program, the consensus is that their recovery was worth the investment.

Concerns About Cymbalta Withdrawal

The concerns about Cymbalta withdrawal, and the drug in general, cover a wide range of topics, which we will aim to address below. We will discuss symptoms and side effects of trying to get off Cymbalta, plus the drug’s mechanism of action upon the brain and body, and interactions with other substances that one should be aware of. Also, the information below covers Cymbalta’s side effects, pregnancy-specific data, and more.

Any SNRI type of antidepressant can produce unexpected adverse effects. Sometimes, as in the case of Cymbalta, many of these AEs only came to light after the drug was placed on the market for consumers.7 Anyone considering taking such a drug is well advised to research the matter thoroughly so that the best-informed decisions can be made. Many feel as if the discontinuation syndrome associated with Cymbalta withdrawal has been understated by manufacturer Eli Lilly, which has resulted in many lawsuits.8 We find the challenges of this particular drug to be quite steep. Withdrawing from an SNRI like Cymbalta is thought to impact both serotonin and norepinephrine neurochemistry, as the drug classification itself suggests. There is more that is unknown than known about the neurochemical effects of SNRIs. Additionally, tapering generally involves opening the capsules and dividing up the beads, which can be frustrating at a minimum.

If you are currently taking Cymbalta or a similar SNRI medication, are suffering from Cymbalta addiction, dependence, or considering Cymbalta withdrawal, please remember the FDA warning against abruptly stopping Cymbalta.2,5 Stopping Cymbalta all at once is definitely a health risk — with one exception, in the case of Serotonin Syndrome, which is described in more detail in the Cymbalta Side Effects section of this article.

Cymbalta Withdrawal

At ATMC I was always supported. The staff was great at providing opportunities for me to work towards stability. What helped me here was always keeping a positive outlook and the constant encouragement and reminders to keep faith in myself.


What is Cymbalta (duloxetine) Used For?

The SNRI antidepressant Cymbalta (duloxetine) is most widely used to treat depression, anxiety disorders, and certain types of pain. Following is a timeline showing when the FDA approval for these uses came into effect:  Some of the uses of Cymbalta are “off-label” which are not all listed here. SNRIs in general have developed a very long list of these.

Please note that even in off-label use, Cymbalta withdrawal should never be abrupt.

  • In August of 2004, Cymbalta was approved for treating depression, and a month later the FDA added approval for treating diabetes-related peripheral neuropathy.9
  • In 2006, the drug gained approval to be prescribed for the treatment of GAD, or general anxiety disorder.9
  • In 2008, the FDA granted approval for prescribing Cymbalta in managing symptoms relating to Fibromyalgia, a medical condition that causes widespread pain throughout the entire body, rather than pain localized to a specific area or body part.9
  • In 2010, the FDA expanded its approval for Cymbalta to be prescribed in the treatment of CMP, or chronic musculoskeletal pain, for example, chronic back pain.9

An SNRI is sometimes prescribed for conditions that lay outside the above list, generally called “off-label” prescribing. Often, where a certain condition has not yet been successfully treated or managed with a particular medication, trials are done to explore other medications that may be of some help. When enough positive results have been documented, such off-label use can eventually become FDA-approved. Switching antidepressants should be done with care because of the Cymbalta withdrawal syndrome being activated.

Some off-label uses for Cymbalta (duloxetine) in the USA include:

  • Urinary incontinence in females, i.e., after pelvic surgery.3
  • Chemotherapy-induced neuropathy, i.e., after breast cancer treatment.10

Cymbalta Alternative Names and Slang

Duloxetine is the generic name for the brand or trade name Cymbalta. Other trade names include Yentreve, and the drug is sold in the EU as Xeristar and Ariclaim.

Care should be taken not to confuse Cymbalta or its generic name, duloxetine with “SALA” drugs, meaning drug names that sound alike or look alike. To avoid mistaking one drug for another, drug manufacturers often use specific colors, add markings, or use other distinctive features to help minimize this risk.

For example, the Institute for Safe Medication Practices 4 lists Symbyax as a drug that is often confused with Cymbalta (duloxetine). Symbyax is an SSRI drug that compounds two drugs:

  • An SSRI called fluoxetine, and
  • An antipsychotic drug called olanzapine

These similarities make Symbyax a drug that might be confused with Cymbalta, but are, in fact, much different from each other in how and when they would be prescribed, despite their similar-sounding names.

Cymbalta Side Effects

SynapsesIn addition to Cymbalta withdrawal symptoms, the drug does come with a number of side effects. Cymbalta (duloxetine) primarily targets the serotonin and norepinephrine neurotransmitters, and to a lesser extent, dopamine.11 Cymbalta has a blocking effect so that these naturally occurring neurotransmitters are restrained from following their normal pathway. Instead of being reabsorbed, they become suspended. The resulting build-up can result in a wide variety of effects such as mood-brightening or feelings of euphoria that speak to its popularity in the treatment of depression and pain relief.

These effects are temporary because after the neurotransmitters have been suspended or pooled, it is possible that the brain and nervous system adapt in ways that diminish the effect of the drug, called Cymbalta tachyphylaxis.12 Tachyphylaxis is a weakened pharmacological response to repeated doses of medication. Certain humanized rat and mice studies indicate that antidepressants like Cymbalta can actually diminish brain serotonin.13 The drug itself does not create new stores of these naturally produced chemicals, it only manipulates the ones that are there and likely affects the chemical states in the brain by what is called neuroplasticity.15

The result of drug-induced neuroplasticity is not completely understood but might explain why some people have to wait weeks to get an effect from Cymbalta.16 Initially perceived benefit can often be overshadowed by other troubling side effects that begin to appear after weeks or months.

In studies on pregnant women, SSRIs were found to have decreased efficacy due to the increased rate of drug metabolism during pregnancy, which has also left questions about safety for the child that need more definite answers.14 Cymbalta withdrawal symptoms may overlap some drug side effects. There are hundreds of reported Cymbalta side effects but here we will focus on the most common ones (1%-10% or higher) and a number of less common reactions that would signal a high health risk and potentially require swift medical intervention, should they occur.

Cymbalta Side Effects Include:

    • Suicidal behavior, suicidal ideation, especially in those under the age of 25 5
    • Seizures 5
    • Gastrointestinal hemorrhage, or other areas of internal bleeding 19
    • Pain in the upper right abdomen area 17
    • Blurred vision, dilated pupils 18
    • Back or neck pain, muscle spasms (dystonia) 20
    • Anorgasmia, premature ejaculation, decreased libido, erectile dysfunction 17
    • Skin reactions including Stevens-Johnson Syndrome (extremely serious reaction of the eyes, skin, and mucous membranes caused by certain medications, signaled by fever and flu-like symptoms, followed by discoloration and rash/eruptions/skin ulcers which can become septic, the skin then blisters and falls off, requires medical intervention done best in a burn unit or ICU, and is fatal in approximately 5 to 10% of cases.) 5
    • Pruritis (severe and unrelenting itchiness) 17
    • Hyperhidrosis (extreme, excessive sweating) 18
    • Spiking blood pressure 21
    • Heart palpitations 17
    • Fatigue 17
    • Vertigo 17
    • Decreased appetite 17
    • Weight loss 18
    • Weight gain (less common) 22
    • Worsened depression sup>23
    • Anxiety 18
    • Mood swings 24
    • Hyponatremia (abnormally low sodium level, can result in seizure, coma, spasms, mental confusion, muscle weakness, inability to speak clearly, vomiting, swelling of the body, etc.) 17
    • Insomnia, abnormal dreams, sleep disorders 5
    • Emotional blunting (reduction or total absence of normal emotional responses) 18
    • Mental confusion, inability to focus or think clearly 25
    • Panic attacks 26
    • Irritability, hostility, aggressive, impulsive behaviors 26
    • Akathisia (a relentless internal sensation of discomfort involving a compulsion to rock, pace, march, shift the feet, or otherwise stay in constant motion) 27
    • Mania or the lesser hypomania (an abnormally intense episode of racing thoughts, hyperactivity, euphoria, decreased need for sleep, disorganized behavior, elevated self-esteem, grandiosity, etc.) 5
    • Dizziness 17
    • Tremors 18
    • Vomiting 18
    • Darkened urine (may be a sign of liver or other organ dysfunction and should be medically assessed without delay.) 17
    • Abdominal pain 17
    • Unusual bruising or tenderness in the upper abdominal area may be a sign of internal bleeding and requires medical attention. 25
    • Serotonin Syndrome (a potentially life-threatening condition that occurs when too much serotonin is in the body which can result in seizure, coma, heart palpitations, and other symptoms and requires immediate medical intervention.) 5
    • Hepatotoxicity 5
    • Cymbalta Discontinuation Syndrome 5
    • Controlled Narrow-Angle Glaucoma 5

This is an astonishing list of possible Cymbalta side effects to consider. Considering our success rates at transitioning people off of Cymbalta and managing symptoms effectively without these side effects, we feel that safer lifestyle interventions, as opposed to invasive medications, should be one of the first-lines of treatment for the majority of patients, certainly not the last.

Inpatient Clinic for Cymbalta Withdrawal

Because of the potentially overwhelming difficulties of coming off a drug like Cymbalta (duloxetine), it can be wise to choose treatment of a mild nature, to ensure a safe and comfortable withdrawal experience. Cymbalta addiction or dependency can be overcome. Residential treatment is often the best choice to significantly reduce any discomforts that otherwise may make Cymbalta withdrawal near to impossible to accomplish without step-by-step help.

inpatient care for cymbalta withdrawalInitial lab tests can be utilized in order to get a snapshot of existing neurochemical anomalies and deficits, as well as possible nutritional deficiencies and extant toxic body burden. Then, each of these areas can be addressed using a combination of protocols that work to safely and gently restore nutritive values, remove toxins, and stabilize a person’s neurochemistry.

By supporting natural rebalancing of neurochemistry, not only is it possible for the client to feel better very early in the process, but an array of adjunctive therapies allow the person to relax and complete the withdrawal process without unnecessarily harsh adverse effects, worry, or strain. When a client is ready for exercise, Equine-assisted therapy, or personal counseling, these and other opportunities on our services overview page can provide an enriched therapeutic experience.

We invite you to call us At Alternative to Meds Center for any information you would like for you or your loved one’s recovery. We are specialists in providing safer, gentler ways to overcome dependency and achieve successful and comfortable Cymbalta withdrawal.

1. Hoog SL, Cheng Y, Elpers J, Dowsett SA “Duloxetine and Pregnancy Outcomes: Safety Surveillance Findings” NCBI [INTERNET] 2013 Feb 28 [cited 2020 Jul 25]

2. FDA label Cymbalta (duloxetine delayed-release capsules) [cited 2020 Oct 6]

3. Schlenker B, Gratzke C, Reich O, Schorsch I, Seitz M, Stief CG “Preliminary Results on the Off-Label Use of Duloxetine for the Treatment of Stress Incontinence After Radical Prostatectomy or Cystectomy” PubMed [INTERNET] 2006 Jun [cited 2020 Jul 25]

4. “List of Confused Drug Names” Institute for Safe Medication Practices, 2019 Feb 28 [cited 2020 Jul 25]

5. FDA Label Cymbalta [cited 2020 Sep 22]

6. James Davies, John Read, A systematic review into the incidence, severity, and duration of antidepressant withdrawal effects: Are guidelines evidence-based? Addictive Behaviors Volume 97, 2019, Pages 111-121, ISSN 0306-4603. [cited 2021 Feb 15]

7. U.S. Department of Health and Human Services FDA Access Data Drug Safety-related Labeling Changes (SrLC) CYMBALTA (NDA-021427) (DULOXETINE HYDROCHLORIDE) [cited 2021 Feb 15]

8. Drug-Injury Website Drug Injury Watch Some Patients Who Stopped Taking Cymbalta Have Suffered From Extended And Severe Withdrawal Reactions Without Warning by attorney Tom Lamb October 27, 2014. [cited 2021 Feb 15]

9. Cymbalta FDA Approval History [cited 2021 Feb 15]

10. Wickham R. Review of a study of duloxetine for painful chemotherapy-induced peripheral neuropathy.J Adv Pract Oncol. 2013;4(5):361-368. [cited 2021 Feb 15]

11. StatPearls [Internet] Duloxetine Jaberpreet S. Dhaliwal; Benjamin C. Spurling; Mohammed Molla. Last Update: June 19, 2020. [cited 2021 Feb 15]

12. Targum SD. Identification and treatment of antidepressant tachyphylaxis.Innov Clin Neurosci. 2014;11(3-4):24-28. [cited 2021 Feb 15]

13. Siesser WB, Sachs BD, Ramsey AJ, et al. Chronic SSRI treatment exacerbates serotonin deficiency in humanized Tph2 mutant mice.ACS Chem Neurosci. 2013;4(1):84-88. doi:10.1021/cn300127h. [cited 2021 Feb 15]

14. Ornoy A, Koren G. SSRIs and SNRIs (SRI) in Pregnancy: Effects on the Course of Pregnancy and the Offspring: How Far Are We from Having All the Answers? Int J Mol Sci. 2019 May 14;20(10):2370. doi: 10.3390/ijms20102370. PMID: 31091646; PMCID: PMC6567187. [cited 2021 April 17]

15. Andrade C, Rao NS. How antidepressant drugs act: A primer on neuroplasticity as the eventual mediator of antidepressant efficacy. Indian J Psychiatry. 2010;52(4):378-386. doi:10.4103/0019-5545.74318. [cited 2021 Feb 15]

16. Health Grades How long does it take for Cymbalta to work? Sarah Lewis, PharmD Last Updated: February 12, 2020. [cited 2021 Feb 15]

17. RxList CYMBALTA Generic Name: duloxetine hcl Medical Editor: John P. Cunha, DO, FACOEP Last reviewed on RxList: 10/19/2020. [cited 2021 Feb 15]

18. FDA Access Data CYMBALTA® (duloxetine hydrochloride) Delayed-release Capsules. [cited 2021 Feb 15]

19. Perahia DG, Bangs ME, Zhang Q, et al. The risk of bleeding with duloxetine treatment in patients who use nonsteroidal anti-inflammatory drugs (NSAIDs): analysis of placebo-controlled trials and post-marketing adverse event reports. Drug Healthc Patient Saf. 2013;5:211-219. Published 2013 Nov 25. doi:10.2147/DHPS.S45445. [cited 2021 Feb 15]

20. Karakaş Uğurlu G, Onen S, Bayındırlı D, Cayköylü A. Acute dystonia after using single dose duloxetine: case report.Psychiatry Investig. 2013;10(1):95-97. doi:10.4306/pi.2013.10.1.95. [cited 2021 Feb 15]

21. Mermi O, Atmaca M. Duloksetin Kullanımına Bağlı Hipertansiyon: Bir Olgu Sunumu [Duloxetine-Induced Hypertension: A Case Report]. Turk Psikiyatri Derg. 2016 Spring;27(1):67-9. Turkish. PMID: 27369688. [cited 2021 Feb 15]

22. Wise TN, Perahia DG, Pangallo BA, Losin WG, Wiltse CG. Effects of the antidepressant duloxetine on body weight: analyses of 10 clinical studies.Prim Care Companion J Clin Psychiatry. 2006;8(5):269-278. doi:10.4088/pcc.v08n0503. [cited 2021 Feb 15]

23. Sansone RA, Sansone LA. Duloxetine-related acute dysphoria.Psychiatry (Edgmont). 2007;4(11):65-68. [cited 2021 Feb 15]

24. Cymbalta Side Effects: Cause For Concern? Medically reviewed by Carmen Fookes, BPharm. Last updated on April 6, 2020. [cited 2021 Feb 15]

25. WebMD Cymbalta Side Effects by Likelihood and Severity [cited 2021 Feb 15]

26. Sabljić V, Rakun R, Ružić K, Grahovac T. Duloxetine-related panic attacks. Psychiatr Danub. 2011 Mar;23(1):114-6. PMID: 21448113. [cited 2021 Feb 15]

27. MIMS Learning Duloxetine may cause akathisia 4 September 2006. [cited 2021 Feb 15]

28. Perahia DG, Kajdasz DK, Desaiah D, Haddad PM. 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. Epub 2005 Nov 2. PMID: 16266753. [cited 2021 Feb 19]

29. Qadir A, Haider N. Duloxetine withdrawal seizure.Psychiatry (Edgmont). 2006;3(9):10. [cited 2021 Feb 19]

30. Wilson E, Lader M. A review of the management of antidepressant discontinuation symptoms.Ther Adv Psychopharmacol. 2015;5(6):357-368. doi:10.1177/2045125315612334 [cited 2021 Feb 19]

31. Bullock C, Bernstein C, “Discontinuation syndrome and antidepressants.” published by Harvard Health Publishing [online] April 4, 2019 [cited 2021 Feb 19]

32. Warner C, et al., “Antidepressant Discontinuation Syndrome.” published in American Family Physician [online] Aug 1 2006 Issue [cited 2021 Feb 19]

33. Read J. How common and severe are six withdrawal effects from, and addiction to, antidepressants? The experiences of a large international sample of patients. Addict Behav. 2020 Mar;102:106157. doi: 10.1016/j.addbeh.2019.106157. Epub 2019 Nov 30. PMID: 31841871. [cited 2021 Feb 19]

34. Ali S, Milev R. Switch to mania upon discontinuation of antidepressants in patients with mood disorders: a review of the literature. Can J Psychiatry. 2003 May;48(4):258-64. doi: 10.1177/070674370304800410. PMID: 12776393. [cited 2021 Feb 19]

35. Hengartner M, et al., “Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum.” Published in Therapeutic Advances in Psychopharmacology, Volume 10, Jan-Dec 202 [cited 2021 Feb 19]

36. Fava GA, Benasi G, Lucente M, Offidani E, Cosci F, Guidi J. Withdrawal Symptoms after Serotonin-Noradrenaline Reuptake Inhibitor Discontinuation: Systematic Review. Psychother Psychosom. 2018;87(4):195-203. doi: 10.1159/000491524. Epub 2018 Jul 17. PMID: 30016772. [cited 2021 Oct 29]

Originally Published Feb 13, 2021 by Diane Ridaeus

This content has been reviewed and approved by a licensed physician.

Dr. John Motl, M.D.

Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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Cymbalta Withdrawal Symptoms, Duloxetine Side Effects, Treatment Help
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