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Cymbalta Withdrawal Symptoms, Duloxetine Adverse Events, Treatment Help

Last Updated on January 11, 2024 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr John Motl MD

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 patient-reported problems. In many cases, this can lead to misdiagnoses and missed opportunities for effective and meaningful treatment.37


Do Your Symptoms Require Cymbalta?
getting off cymbalta
Cymbalta use can cause serious reactions and debilitating Cymbalta withdrawal syndrome 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 17 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.

15 Years Experience by Professionals Who Understand Your Journey.
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Cymbalta Withdrawal Symptoms

Cymbalta withdrawal symptoms range from mild to severe and occur with more frequency if Cymbalta withdrawal is abrupt.6,24,25,28-30,32-35,37

Cymbalta withdrawal symptoms can include:
  • cymbalta serious adverse risksSeizure
  • Suicidal thoughts
  • Akathisia
  • Dizziness, nausea, vomiting, headache
  • Paresthesia, electric-shock sensations, prickling skin sensations
  • Irritability
  • Nightmares
  • Anxiety, panic attacks
  • Parkinsonism and other movement disorders
  • Withdrawal-induced mania
  • Withdrawal-emergent delirium
  • Sexual dysfunction
  • Brain fog, cognitive impairment, inability to concentrate
  • Muscle aches, tremors

Holistic Treatment Helps Cymbalta Withdrawal

At Alternative to Meds Center, we have found certain methods that can make the Cymbalta withdrawal process substantially more tolerable. We use a combination of inpatient medically monitored discontinuation techniques, orthomolecular-based dietary modifications such as organic diet and targeted supplementation, as well as counseling, and other daily support and peer support programs for encouragement. professional inpatient care sedona drug rehabOver 40 trained professionals including dedicated care managers and medical doctors provide services to our clients. Services include including lab testing, to assess vitamin and mineral deficiencies, genetic factors, and evidence of toxicity in the body, factors that can all be improved with the right treatments. Additional tools include neurotransmitter rehabilitation protocols, IV therapies, and holistic detoxification techniques to help alleviate a toxic body burden that may be contributing to neurochemical and psychological stress and impairments.

The client typically begins to feel better very early in the process. And, can relax and complete the withdrawal process without unnecessarily harsh Cymbalta withdrawal symptoms, worry, or strain. Our Cymbalta withdrawal program is uniquely tailored in order to address the specific needs of the client. This allows better focus on the things that will help them regain mental health naturally.

Fascinating research has shown that the adverse reactions to drugs may be the body’s protective responses to substances that are biologically harmful. This supports the overwhelmingly preferred use of drug-free support during Cymbalta withdrawal. And, which can also provide a broad range of mental wellness benefits in the process.39

We encourage you to view our other articles that cover various methods of Cymbalta withdrawal support and drug-free alternatives to Cymbalta which utilize natural approaches during the process of quitting Cymbalta.

About Cymbalta / duloxetine Dependence

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.

But recent research is successfully bringing these matters to the attention of the medical community. For example, in 2018, Fava et al authored an extensive review of 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 papers, the authors 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 for how to stop taking Cymbalta safely.18

Cymbalta Withdrawal compared to Benzo Withdrawal

Wilson et al published their research in Therapeutic Advances in Pharmacology Journal. The authors point out the extreme withdrawals of newer antidepressants such as Cymbalta and compare them to benzodiazepine withdrawals.30 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 reduction, or switching to a drug with a longer half-life. The authors also comment on the NIH’s lack of clarity on the matter and who appear unenlightened about the very common phenomena of withdrawal in any patients. Even more surprising, the NIH continues to discount the need to address antidepressant 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 duloxetine dependence or dependence on similar 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. The goal of treatment is not just to ease Cymbalta withdrawal, but also to reduce and even eliminate original symptoms without the need to rely on prescription medications.

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 overwhelming and consistent consensus has been that their recovery was well worth the investment.

Concerns About Cymbalta Withdrawal

The concerns about Cymbalta withdrawal, and about the drug in general, cover a wide range of topics. Below, these will be discussed in detail. You will read about the symptoms that may occur while trying to get off Cymbalta. And, about the drug’s mechanism of action upon the brain and body. Information is also given about interactions with other substances that one should be aware of. Also, the information below covers Cymbalta’s adverse 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.2,7,8 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 drug regulators and promoters. However, 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, trying to measure dose reductions generally involves opening the capsules and dividing up the beads, which can be frustrating at a minimum.

FDA Warns Against Stopping Cymbalta Abruptly

If you are currently taking Cymbalta or a similar SNRI medication, are suffering from Cymbalta dependence, or considering Cymbalta withdrawal, please remember the FDA warning against abruptly stopping Cymbalta.18 Stopping Cymbalta all at once is definitely a health risk — with one exception, in the case of Serotonin Syndrome because it is a medical emergency that requires immediate transport to the hospital. You can find more details about this phenomenon in the Cymbalta adverse effects section of this article.

Testimonial
Cymbalta Withdrawal
Success

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.

-Jackie

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.9,41
  • In 2006, the FDA approved Cymbalta for GAD or general anxiety disorder.17
  • In 2008, the FDA granted approval for prescribing Cymbalta to manage symptoms relating to Fibromyalgia. Fibromyalgia is a medical condition that causes widespread pain throughout the entire body, rather than pain localized to a specific area or body part.31
  • 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.38

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. If you feel your prescribing physician is becoming desperate or starts referring to your case as “treatment resistive”, this is a good opportunity to begin to research alternative holistic solutions that carry no such liabilities as pharmaceutical products are associated with.

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 or other chemotreatment.10
  • Chronic pain.40

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 “LASA” drugs, meaning drug names that look or sound 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 fluoxetine and Symbyax as 2 drugs that are often confused with Cymbalta (duloxetine). Symbyax is a compound drug that combines two drugs:

  • The generic version of Prozac, called fluoxetine, and
  • An antipsychotic drug called olanzapine

Fluoxetine is the generic name for Prozac, which is an antidepressant in the SSRI class, in contrast to duloxetine, which is classed as an SNRI.

These similarities make Symbyax and fluoxetine “LASA” drugs that might be confused with Cymbalta (duloxetine) but are, in fact, much different from each other in how and when they would be prescribed, despite their similar-sounding names.

Cymbalta Adverse Events

In addition to Cymbalta withdrawal symptoms, the drug may cause a number of potentially harmful reactions. 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 blocked 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.

Drug-induced Changes to Neurotransmitters

The brain and nervous system respond to drug therapy by adapting in ways that eventually diminish the effect of the drug. This phenomenon is called antidepressant tachyphylaxis.12 Tachyphylaxis presents as a weakened response to repeated doses of medication. drug induced changes to neurotransmittersCertain humanized rat and mouse studies indicate that antidepressants like Cymbalta can diminish active serotonin.13 The drug itself does not create serotonin. Antidepressant drugs can cause a lasting change in the chemical states of the brain. This is known as neuroplasticity.15

The result of drug-induced neuroplasticity is not completely understood but might explain why some people will feel the drug’s effects in a couple of weeks, and others may wait 8 weeks or longer to get a positive effect from Cymbalta.16 Initially perceived benefits can often be overshadowed by other troubling consequences that begin to appear after weeks or months.

In studies on pregnant women, antidepressants 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 with some of the drug’s undesirable effects. Below are the most commonly reported 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. The list of Cymbalta’s adverse effects below is taken from the FDA label, and other sources as noted.18

Cymbalta’s Adverse Effects May Include:
  • Suicidal behavior, suicidal ideation, especially in those under the age of 25 2
  • Seizures
  • Dysphoria (a state of persisting unease and dissatisfaction) 23
  • Gastrointestinal hemorrhage, or other areas of internal bleeding 19
  • Pain in the upper right abdomen area
  • Blurred vision, dilated pupils
  • Back or neck pain, muscle spasms (dystonia) 20
  • Anorgasmia, premature ejaculation, decreased libido, erectile dysfunction
  • 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)
  • Hyperhidrosis (excessive sweating)
  • Spiking blood pressure 21
  • Heart palpitations, cerebrovascular accident, hypertension, myocardial infarction, transient ischemic attack, increased blood pressure, increased heart rate.42
  • Fatigue
  • Vertigo
  • Decreased appetite
  • Weight loss
  • Weight gain (less common) 22
  • Worsened depression
  • Anxiety
  • Hyponatremia (abnormally low sodium level, that can result in seizure, coma, spasms, mental confusion, muscle weakness, inability to speak clearly, vomiting, swelling of the body, etc.)11
  • Insomnia, abnormal dreams, sleep disorders
  • Emotional blunting (reduction or total absence of normal emotional responses)
  • Mental confusion, inability to focus or think clearly 11
  • 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.)
  • Dizziness
  • Tremors
  • Vomiting
  • Darkened urine (may be a sign of liver or other organ dysfunction and should be medically assessed without delay.)
  • Abdominal pain
  • Dry mouth 11
  • Unusual bruising or tenderness in the upper abdominal area may be a sign of internal bleeding and requires medical attention.11
  • 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
  • Cymbalta Discontinuation Syndrome
  • Controlled Narrow-Angle Glaucoma

This is an astonishing list of possible adverse reactions. Some doubt has been expressed concerning the quality of drug safety trials before duloxetine was approved for commercial sale.2,42 Considering our success rates at transitioning people off of Cymbalta and managing symptoms effectively without debilitating adverse 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 option to consider.

Inpatient Clinic for Cymbalta Withdrawal

The severity of duloxetine or Cymbalta withdrawal may overwhelm a person, especially after long-term use. 24,25 Choose treatment of a mild nature, with medical oversight and adequate proven drug-free treatments to ensure a safe and comfortable withdrawal experience. Careful planning can ensure overcoming Cymbalta dependence safely. Residential treatment offers the best choice to significantly reduce any discomforts that otherwise may make Cymbalta withdrawal without step-by-step help nearly impossible.

inpatient care for cymbalta withdrawal sedona drug rehabInitial lab tests get a snapshot of existing neurochemical anomalies and deficits and will reveal levels of toxic body burden. Then, the goal is to address each of these areas to safely and gently restore nutritive values, remove toxins, and stabilize a person’s neurochemistry.

Supporting the natural rebalancing of neurochemistry along with a wide array of adjunctive therapies allows 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, yoga classes, and trainer led exercise is offered. Also at the appropriate point in treatment clients may opt for personal counseling, along with other opportunities you can read more about on our services overview page. We offer our clients a truly enhanced health and healing experience.

We invite you to call us At Alternative to Meds Center for any information you would like for yourself or your loved one’s recovery. We provide safer, gentler ways to overcome dependency, achieve successful and comfortable Cymbalta withdrawal and regain natural mental health.

Sources:


1. Hoog SL, Cheng Y, Elpers J, Dowsett SA. Duloxetine and pregnancy outcomes: safety surveillance findings. Int J Med Sci. 2013;10(4):413-9. doi: 10.7150/ijms.5213. Epub 2013 Feb 28. PMID: 23471302; PMCID: PMC3590601. [cited 2023 Feb 13]

2. Spielmans G, Spence-Sing T, Parry P, Duty to Warn: Antidepressant Black Box Suicidality Warning Is Empirically Justified. Front. Psychiatry, 13 February 2020 [internet] [cited 2022 May 24]

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. Eur Urol. 2006 Jun;49(6):1075-8. doi: 10.1016/j.eururo.2006.01.038. Epub 2006 Feb 6. PMID: 16481094. [cited 2023 Feb 13]

4. “List of Confused Drug Names” Institute for Safe Medication Practices, [2019 Feb 28, updated July 26, 2023]  [cited 2023 Aug 30]

5. Wang RZ, Vashistha V, Kaur S, Houchens NW. Serotonin syndrome: Preventing, recognizing, and treating it. Cleve Clin J Med. 2016 Nov;83(11):810-817. doi: 10.3949/ccjm.83a.15129. PMID: 27824534. [cited 2022 May 24]

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 2022 May 24]

7. U.S. Department of Health and Human Services FDA Access Data Drug Safety-related Labeling Changes (SrLC) CYMBALTA (NDA-021427) (DULOXETINE HYDROCHLORIDE)  [cited 2022 Mar 9]

8. Santarsieri D, Schwartz TL. Antidepressant efficacy and side-effect burden: a quick guide for cliniciansDrugs Context. 2015;4:212290. Published 2015 Oct 8. doi:10.7573/dic.212290 [cited 2022 May 24]

9. Smith T, Nicholson RA. Review of duloxetine in the management of diabetic peripheral neuropathic pain. Vasc Health Risk Manag. 2007;3(6):833-844.[cited 2022 May 24]

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 2022 May 24]

11. StatPearls [Internet] Duloxetine Jaberpreet S. Dhaliwal; Benjamin C. Spurling; Mohammed Molla. Last Update: June 19, 2020. [cited 2023 Feb 13]

12. Targum SD. Identification and treatment of antidepressant tachyphylaxis.Innov Clin Neurosci. 2014;11(3-4):24-28.[cited 2023 Feb 13]

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 2023 Feb 13]

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 2023 Feb 13]

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 2023 Feb 13]

16. Korpi ER, den Hollander B, Farooq U, Vashchinkina E, Rajkumar R, Nutt DJ, Hyytiä P, Dawe GS. Mechanisms of Action and Persistent Neuroplasticity by Drugs of Abuse. Pharmacol Rev. 2015 Oct;67(4):872-1004. doi: 10.1124/pr.115.010967. PMID: 26403687. [cited 2023 Feb 13]

17. Carter NJ, McCormack PL. Duloxetine: a review of its use in the treatment of generalized anxiety disorder. CNS Drugs. 2009;23(6):523-41. doi: 10.2165/00023210-200923060-00006. PMID: 19480470. [cited 2023 Feb 13]

18. FDA Access Data CYMBALTA® (duloxetine hydrochloride) Delayed-release Capsules.  [cited 2023 Feb 13]

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 2023 Feb 13]

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 2023 Feb 13]

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 2023 Feb 13]

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 2023 Feb 13]

23. Sansone RA, Sansone LA. Duloxetine-related acute dysphoria.Psychiatry (Edgmont). 2007;4(11):65-68. [cited 2023 Feb 13]

24. 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 2023 Feb 13]

25. Pangallo BA, Zhang Q, Desaiah D, Perahia DG, Detke MJ, Kennedy SH. Long-term safety of duloxetine during open-label compassionate use treatment of patients who completed previous duloxetine clinical trials. Curr Med Res Opin. 2010 Nov;26(11):2643-51. doi: 10.1185/03007995.2010.522157. Epub 2010 Oct 11. PMID: 20932222. [cited 2023 Feb 13]

26. Sabljić V, Rakun R, Ružić K, Grahovac T. Duloxetine-related panic attacks. Psychiatr Danub. 2011 Mar;23(1):114-6. PMID: 21448113. [cited 2023 Feb 13]

27. Akagi H, Kumar TM. Lesson of the week: Akathisia: overlooked at a cost. BMJ. 2002 Jun 22;324(7352):1506-7. doi: 10.1136/bmj.324.7352.1506. PMID: 12077042; PMCID: PMC1123446. [cited 2023 Feb 13]

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 2023 Feb 13]

29. Qadir A, Haider N. Duloxetine withdrawal seizure.Psychiatry (Edgmont). 2006;3(9):10. [cited 2023 Feb 13]

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 2023 Feb 13]

31. Acuna C. Duloxetine for the treatment of fibromyalgia. Drugs Today (Barc). 2008 Oct;44(10):725-34. doi: 10.1358/dot.2008.44.10.1269675. PMID: 19137126. [cited 2023 Feb 13]

32. Warner C, et al., “Antidepressant Discontinuation Syndrome.” published in American Family Physician [online] Aug 1 2006 Issue [cited 2023 Feb 13]

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 2023 Feb 13]

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 2023 Feb 13]

35. Hengartner MP, Schulthess L, Sorensen A, Framer A. Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum. Ther Adv Psychopharmacol. 2020 Dec 24;10:2045125320980573. doi: 10.1177/2045125320980573. PMID: 33489088; PMCID: PMC7768871. [cited 2023 Feb 13]

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 2023 Feb 13]

37. White P, Faingold CL. Emergent Antidepressant Discontinuation Syndrome Misdiagnosed as Delirium in the ICU. Case Rep Crit Care. 2019;2019:3925438. Published 2019 Aug 4. doi:10.1155/2019/3925438 [cited 2023 Feb 13]

38. Skljarevski V, Desaiah D, Liu-Seifert H, Zhang Q, Chappell AS, Detke MJ, Iyengar S, Atkinson JH, Backonja M. Efficacy and safety of duloxetine in patients with chronic low back pain. Spine (Phila Pa 1976). 2010 Jun 1;35(13):E578-85. doi: 10.1097/BRS.0b013e3181d3cef6. PMID: 20461028. [cited 2023 Feb 13]

39. Horii I. Toxic effect onset and evaluations of medicinal drugs–horizon for Darwinian toxicological thought. J Toxicol Sci. 2010 Aug;35(4):425-35. doi: 10.2131/jts.35.425. PMID: 20686329. [cited 2023 Feb 13]

40. Urits I, Peck J, Orhurhu MS, Wolf J, Patel R, Orhurhu V, Kaye AD, Viswanath O. Off-label Antidepressant Use for Treatment and Management of Chronic Pain: Evolving Understanding and Comprehensive Review. Curr Pain Headache Rep. 2019 Jul 29;23(9):66. doi: 10.1007/s11916-019-0803-z. PMID: 31359175. [cited 2023 Feb 13]

41. Sloan G, Alam U, Selvarajah D, Tesfaye S. The Treatment of Painful Diabetic Neuropathy. Curr Diabetes Rev. 2022;18(5):42-96. doi: 10.2174/1573399817666210707112413. PMID: 34238163. [cited 2023 Feb 13]

42. Park K, Kim S, Ko YJ, Park BJ. Duloxetine and cardiovascular adverse events: A systematic review and meta-analysis. J Psychiatr Res. 2020 May;124:109-114. doi: 10.1016/j.jpsychires.2020.02.022. Epub 2020 Feb 27. PMID: 32135389. [cited 2023 Feb 13]


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 Adverse Events, Treatment Help
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Medication Withdrawal Success Stories

Can you imagine being free from medications, addictive drugs, and alcohol? This is our goal and we are proving it is possible every day!

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