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The Long-Term Side Effects of Cymbalta

Last Updated on May 21, 2024 by Diane Ridaeus

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

Long-term side effects of Cymbalta aren’t mentioned in advertising. Claims do suggest Cymbalta acts to reverse a deficiency of serotonin but the implications of such treatment remain poorly understood and even controversial.1,6,16

Medical professionals may neglect to enlighten their patients about the long list of potential side effects and complications that may worsen over time. These long-term side effects of Cymbalta can result in serious repercussions on an individual’s health.

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Understanding the Risks of Cymbalta Long-term Side Effects

Cymbalta is an antidepressant medication that alters the chemistry in the brain and the entire body and is referred to as an SNRI. SNRIs are intended to interfere with nerve cells in the brain. The natural function of these targeted nerve cells is to facilitate the reabsorption of neurotransmitters (natural chemical messengers) that the body produces and to the destinations where these chemicals are designed to operate as regulators throughout the body. risks of taking cymbalta too longHowever, an SNRI prevents the absorption of serotonin and norepinephrine, and to a lesser extent, dopamine. The idea is to cause an artificial build-up of these chemicals from continuing on their natural journey. Serotonin regulates the immune system, mood, sleep, body temperature, motor function, and innumerable other vital tasks. These functions become immensely important in those who are suffering critical illnesses.18 It is no wonder that this manipulation (blockage) causes adverse side effects over time, like a domino effect throughout the entire body. These long-term Cymbalta effects are still under study even as several SNRI patents are soon to expire.17

Drug companies suggest that Cymbalta (duloxetine) works by keeping these chemicals available to serve their biological purpose within the brain. Yet, it is important to understand that this theory has never been proven clinically valid.16 When the body isn’t producing the right chemical messengers or hormones, or the right amounts at the right time, or factors such as poor diet or toxic exposures are present, there is no drug that will completely fix these issues.

Despite reservations regarding the effectiveness of antidepressants such as Cymbalta, the drug is FDA-approved to address MDD (major depressive disorder), GAD (generalized anxiety disorder) Diabetic Neuropathy, Fibromyalgia, and Chronic Musculoskeletal Pain. Off-label uses are known to include pain after chemotherapy and stress urinary incontinence.4 Due to the persistent nature of these conditions, many of which were chronic, Cymbalta often leaves patients still suffering old symptoms along with a host of new ones after long-term Cymbalta effects begin to occur.


Depression can present in a variety of ways. Cymbalta is often prescribed after diagnosis of numerous types of depression, including major depressive disorder (MDD).2 Depression is characterized by a long list of symptoms, and not everyone will experience the same combination.

Common symptoms of depression include:

  • Feeling sad, empty, worthless, or helpless
  • Losing interest in activities and hobbies that were once important
  • Eating too much or too little
  • Sleeping too much or too little
  • Low energy
  • Difficulty concentrating
  • Suicidal thoughts

Researchers are still searching for more understanding about how SNRIs and their blockage of the brain’s normal behavior could help relieve symptoms of major depression. In theory, preventing the reuptake of serotonin and norepinephrine in the brain is claimed to relieve some of the symptoms of depression. However, much more research is required to say with any certainty that medication like Cymbalta is truly beneficial, especially given its long list of negative long-term effects.

Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is characterized by a constant state of worry about everyday problems that can last for more than six months. Its symptoms can be heightened by external factors that add to the stress, such as losing a job or breaking up with a partner. Common symptoms of GAD include:

  • Fatigue
  • Restlessness
  • Irritability
  • Difficulty concentrating
  • Sleep disturbances
  • Muscle tension
  • Feeling on-edge

Pharmaceutical companies advertise the use of Cymbalta to treat GAD for the same reason it is used to treat depression—the effects it has on the normal reuptake of serotonin and norepinephrine in the brain.3 However, while restoring neurotransmitter balance in the brain may help to manage many of the severe symptoms associated with this condition, the theory that Cymbalta actually restores this balance remains arguable at best.

How Is Cymbalta Taken?

Cymbalta was designed to be taken orally once or twice a day, as prescribed by a medical professional. The ultimate dosage amount is based on age, medical condition, and how a person has responded to previous doses. Cymbalta is often touted as a long-term solution for managing major depression or anxiety symptoms.

However, is Cymbalta safe long-term? Unfortunately, that question has a range of answers, and it is critical that individuals understand the many negative side effects and health concerns associated with long-term Cymbalta use.

When used as directed, Cymbalta is considered safe for long-term use by the FDA, in that its benefits supposedly outweigh the negative effects it causes. However, it is important to note that research regarding Cymbalta’s long-term effects is ongoing. In fact, Cymbalta use comes with a long list of potential side effects that may become more severe over a period of time.

In addition, the medication requires strict attention to proper use, as missing a dose or improperly timing a dose could trigger withdrawal symptoms. Worse, stopping the use of this medication without proper guidance can be intolerable, often ending in a failed attempt, and resuming the medication.

Common Side Effects of Cymbalta

Prescription medications often harbor a list of adverse reactions and side effects consumers need to be aware of, both so you can understand the potential health risks involved and weigh those risks against the potential benefits the medication might provide. Cymbalta is associated with several side effects that could pose a serious risk to your health.4

Common Cymbalta side effects can include:
  • Dry mouth
  • Nausea
  • Loss of appetite
  • Tiredness
  • Increased sweating
  • Constipation
  • Diarrhea

Taking Cymbalta can also result in dizziness or lightheadedness, especially when starting the medication or when taking a higher dosage level. It is recommended that Cymbalta users remain mindful of how quickly they stand up and avoid driving when experiencing these issues.

Symptoms of lightheadedness and dizziness should also be carefully monitored and discussed with a healthcare provider as these could indicate underlying medical issues that need to be addressed.

Serious Adverse Side Effects of Cymbalta

Any uncomfortable reactions and individual experiences should be taken seriously, especially with Cymbalta used long term.  If concerning or unusual effects emerge, one is advised to contact your doctor as soon as possible:

  • Confusion
  • Decrease in sexual desire
  • Changes in sexual ability
  • Muscle cramps
  • Tremors
  • Difficulty urinating

High-Risk Side Effects of Cymbalta

Cymbalta use is also associated with several high-risk effects that impact your ability to live a normal life. Worse, several of these effects may pose a significant danger to your life. When experiencing these concerning effects, it is crucial to seek medical attention immediately:

  • Eye pain
  • Vision changes
  • Seizures
  • Vomiting
  • Black or bloody stool
  • Liver failure
  • Bleeding events
  • Orthostatic hypertension
  • Suicidal thoughts or behaviors

High-risk effects for Cymbalta occur every day in the US. Research has found that short-term Cymbalta effects are generally found to continue and intensify after long-term Cymbalta use. Chronic and life-threatening adverse reactions include liver failure, which can increase with alcohol use.

Other serious effects include the increased risk of bleeding events. This could result in gums that bleed more easily, frequent nose bleeds, gastrointestinal bleeding, or other types of uncontrolled bleeding. These events can be hazardous and even life-threatening depending on the circumstances.

Cymbalta use can also result in orthostatic hypertension, which is a condition characterized by a sudden drop in blood pressure, often while standing or getting up from a sleeping position. This can result in dizziness which could cause a person to pass out. The risk of experiencing this effect increases when using medication for high blood pressure.

Serotonin Syndrome

Long-term effects of Cymbalta on the brain vary, but many pose a serious risk to your health. As mentioned, Cymbalta blocks the normal function of the brain, impacting levels of important neurotransmitters.

One such condition caused by Cymbalta, though rare, is serotonin syndrome, which occurs when the drug forces the body to build up abnormally high levels of serotonin.5

Serotonin syndrome can cause dangerous changes in blood pressure and heart rate, loss of muscle control, and even seizures. Serotonin syndrome can occur when you start a new serotonergic medication or increase the dosage of one that is currently taken.

The risk of developing this syndrome increases with the use of other serotonergic medications concurrently, which can result in poisonous levels of serotonin being activated. Serotonin syndrome is also referred to as serotonin toxicity and the condition can be fatal. Symptoms of serotonin syndrome include:

  • Fast heartbeat
  • Muscle rigidity
  • Hallucinations
  • Coma
  • Tremor
  • Spontaneous convulsions, spasms
  • Confusion, disorientation
  • Severe dizziness
  • Fever over 100 degrees F or 38 degrees C
  • Severe nausea or vomiting

Overdose Risks

Due to its laundry list of potentially dangerous effects on brain chemistry, Cymbalta use demands the careful guidance of an experienced medical professional who understands the various complications associated with prescribing this drug as an antidepressant. Unfortunately, Cymbalta overdoses can occur and are a severe risk to your health. The risk of overdose increases with alcohol and other CNS depressants.

Overdosing can cause:
  • Extreme sleepiness
  • Vomiting
  • Blood pressure dropping or rising
  • Fainting
  • Seizures
  • Coma

With all these potential risks, Cymbalta may not be ideal for either short-term or long-term use for many individuals. Worse, drug dependence can develop resulting in Cymbalta long-term effects that persist. When you stop Cymbalta use either suddenly or gradually without strategies in place, you are at risk for discontinuation syndrome, a set of symptoms that emerge after dependence has developed.

Long-Term Side Effects of Cymbalta and Withdrawal

One of the most serious complications associated with long-term Cymbalta use is the risk of discontinuation symptoms after the last Cymbalta dose leaves the body.6 Also referred to as discontinuation syndrome, these are serious and can be life-threatening. Cymbalta comes with a Black Box Warning,7 one of the most serious medicine label warnings the FDA can impose. It indicates that this drug can cause withdrawals, suicidal thoughts, and suicidal behaviors. Suicidality is especially prominent when Cymbalta is prescribed to teenagers and young adults.

For these reasons, users of Cymbalta are warned to never stop taking the medication without following a proper tapering schedule with the guidance of a medical professional who is familiar with the process. Both short-term and long-term effects of stopping Cymbalta can be severe. Individuals wishing to stop taking Cymbalta should consult with a qualified physician as soon as possible to begin a gradual taper to zero.

If a person tries to stop Cymbalta without the help of a professional, any conditions they may have been experiencing can reappear and worsen. Re-emerging symptoms may include:

  • Dizziness
  • Confusion
  • Mood swings
  • Headaches
  • Changes to sleep cycles
  • Tiredness
  • Increased thoughts of suicide
  • clinical worsening

Similar symptoms — as well as new symptoms — can emerge as a direct result of stopping Cymbalta. Discontinuation syndrome occurs in most users who try to quit after long-term Cymbalta use, and the symptoms can be intense. Cymbalta withdrawal symptoms include:

  • Seizures
  • Suicidal thoughts
  • Dizziness, nausea, or vomiting
  • Irritability
  • Nightmares
  • Panic attacks
  • Brain fog
  • Muscles aches
  • Sexual dysfunction
  • Headaches

Users of Cymbalta can experience these symptoms over the course of weeks or even months and may linger even after Cymbalta use is completely stopped.8 These discomforts can persist regardless of how long it takes for Cymbalta to physically leave the system. The CNS and the entire body will need to correct neurotransmitter dysfunction, nutritional deficiencies and imbalances, and get back to normal for these symptoms to abate. Again, if you decide to stop using Cymbalta, begin a gradual reduction for safety.

Understanding Long-Term Side Effects of Cymbalta Use

Medications impact everyone differently. The list of long-term effects of Cymbalta continues to grow as more users report the ill effects they’ve experienced over time.9

Antidepressant drug addiction, though rare, is on the rise according to research that is ongoing on the topic.10 A person can develop a dependency on the way Cymbalta makes them feel. This dependency can also lead to the development of severe negative effects as well as potentially life-threatening cessation symptoms if a person tries to quit using Cymbalta too abruptly, and without proper guidance.

Much data on the long-term effects of Cymbalta and other antidepressants is derived from studies on rats, guinea pigs, and other animals, where 21 days is considered “long-term”. Research published in the International Journal of Risk and Safety in Medicine shows that on careful study, neither SSRIs nor SNRIs actually provided benefits over long-term use (months or years) to patients. The long-term effects of antidepressants are severely under-studied and rarely reported in the medical literature. The FDA lists many potential long-term effects on the package label and advises the medication to be discontinued if these emerge. Patients with cardio concerns should steer away from drugs such as SSRIs and SNRIs that may affect the heart adversely.12-15

Cymbalta side effects when taken long term can include:
  • Addiction
  • Dependence
  • Seizures
  • Suicidal thoughts or behaviors
  • Mania, hypomania
  • Jaundice
  • Liver failure
  • Abnormal bleeding, especially when NSAIDs or aspirin are taken concurrently
  • Severe renal impairment
  • Urinary hesitation, and retention
  • Hyponatremia (low sodium levels in the blood)
  • Severe weight gain
  • Cardiotoxicity issues: tachycardia, QT prolongation, blood pressure issues
  • Brain fog
  • Agitation
  • Fatigue
  • Low sex drive
  • Constipation
  • Diarrhea

While Cymbalta is advertised to help those dealing with severe depression, anxiety, or pain, its list of serious and life-threatening side effects may drastically outweigh any actual benefit.

Seeking Alternative Options to Side Effects of Cymbalta Long term Use

Dealing with serious symptoms of depression or anxiety can be difficult. For individuals struggling with these conditions, typically a patient is advised that prescription medication is the best option for treatment. However, medications like Cymbalta have proven to be potentially dangerous and even life-threatening due to their wide range of adverse reactions. The risk of harm may continue even after deciding to stop using the medication. Cymbalta should be tapered extremely slowly with the help of a professional. safely get off cymbalta sedona drug rehabWhen you’re considering taking a prescription medication to address symptoms of depression or anxiety, it is important to consider the risks. You might be surprised how little is still known about medications like Cymbalta.

Researchers study how SNRI drugs manipulate neurotransmitters but it is not known what the long-lasting effects of artificially altering the brain truly are. Pharmaceutical companies have promoted the ongoing theory that antidepressants can correct neurotransmitter deficiencies but have sold the theory as fact. The truth is that there is a lot more to be discovered about what antidepressants truly do to your brain and body.16

Fortunately, you may not need prescription medication to experience relief from your symptoms. There are several accepted non-pharmacological methods that can address depression and anxiety, and perhaps as well as, or more effectively than SNRIs. Clinically proven effective alternative therapies include correcting the diet, cleansing neurotoxins from the body, acupuncture, music and art therapy, physical exercise, life coaching, talk therapy, and stress-reduction techniques.

Similarly, rehabilitating the gut microbiome, and supplementing your diet with herbal remedies may help you find results like those you hoped to find with drug-based therapy, but without the long-term effects of Cymbalta and similar pharmaceuticals. 11

Avoid the Negative Long-term Side Effects of Cymbalta

Serious repercussions may impact an individual’s health, as a result of the long-term side effects Cymbalta is associated with.

Want to see how ATMC can help? Check out this Cymbalta Withdrawal Success Story to see how we helped Becky withdraw from Cymbalta so she could feel like herself again.


1. Cowen PJ, Browning M. What has serotonin to do with depression? World Psychiatry. 2015;14(2):158-160. [cited 2022 Sept 30]

2. Goldstein DJ. Duloxetine in the treatment of major depressive disorder. Neuropsychiatr Dis Treat. 2007 Apr;3(2):193-209. doi: 10.2147/nedt.2007.3.2.193. PMID: 19300553; PMCID: PMC2654630. [cited 2022 Sept 30]

3. Thase ME. Are SNRIs more effective than SSRIs? A review of the current state of the controversy. Psychopharmacol Bull. 2008;41(2):58-85. PMID: 18668017. [cited 2022 Sept 30]

4. Dhaliwal JS, Spurling BC, Molla M. Duloxetine. [Updated 2022 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: [cited 2022 Sept 30]

5. Foong AL, Grindrod KA, Patel T, Kellar J. Demystifying serotonin syndrome (or serotonin toxicity). Can Fam Physician. 2018 Oct;64(10):720-727. PMID: 30315014; PMCID: PMC6184959. [cited 2022 Sept 26]

6. Gartlehner G, Gaynes BN, et al Comparative Benefits and Harms of Antidepressant, Psychological, Complementary, and Exercise Treatments for Major Depression: An Evidence Report for a Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2016 Mar 1;164(5):331-41. doi: 10.7326/M15-1813. Epub 2015 Dec 8. PMID: 26857743. [cited 2022 Sept 30]

7. Spielmans GI, Spence-Sing T, Parry P. Duty to Warn: Antidepressant Black Box Suicidality Warning Is Empirically Justified. Front Psychiatry. 2020 Feb 13;11:18. doi: 10.3389/fpsyt.2020.00018. PMID: 32116839; PMCID: PMC7031767. [cited 2022 Sept 30]

8. 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 2022 Sept 30]

9. Wang SM, Han C, Bahk WM, Lee SJ, Patkar AA, Masand PS, Pae CU. Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review. Chonnam Med J. 2018 May;54(2):101-112. doi: 10.4068/cmj.2018.54.2.101. Epub 2018 May 25. PMID: 29854675; PMCID: PMC5972123.. [cited 2022 Sept 26]

10. Chiappini S, Schifano F. What about “Pharming”? Issues Regarding the Misuse of Prescription and Over-the-Counter Drugs. Brain Sci. 2020 Oct 14;10(10):736. doi: 10.3390/brainsci10100736. PMID: 33066476; PMCID: PMC7602178. [cited 2022 Sept 26]

11. Cryan JF, O’Riordan KJ, Cowan CSM, Sandhu KV, et al The Microbiota-Gut-Brain Axis. Physiol Rev. 2019 Oct 1;99(4):1877-2013. doi: 10.1152/physrev.00018.2018. PMID: 31460832. [cited 2022 Sept 30]

12. Danborg PB, Valdersdorf M, Gøtzsche PC. Long-term harms from previous use of selective serotonin reuptake inhibitors: A systematic review. Int J Risk Saf Med. 2019;30(2):59-71. doi: 10.3233/JRS-180046. PMID: 30714974; PMCID: PMC6839490. [cited 2022 Sept 30]

13. Blier P, de Montigny C. Current advances and trends in the treatment of depression. Trends Pharmacol Sci. 1994 Jul;15(7):220-6. doi: 10.1016/0165-6147(94)90315-8. PMID: 7940983. [cited 2022 Sept 26]

14. FDA label Cymbalta (duloxetine hydrochloride) capsules approval 2004 [cited 2022 Sept 30]

15. Taylor D, Lenox-Smith A, Bradley A. A review of the suitability of duloxetine and venlafaxine for use in patients with depression in primary care with a focus on cardiovascular safety, suicide and mortality due to antidepressant overdose. Ther Adv Psychopharmacol. 2013 Jun;3(3):151-61. doi: 10.1177/2045125312472890. PMID: 24167687; PMCID: PMC3805457. [cited 2022 Sept 30]

16. Moncrieff J, Cooper RE, Stockmann T, Amendola S, Hengartner MP, Horowitz MA. The serotonin theory of depression: a systematic umbrella review of the evidence. Mol Psychiatry. 2022 Jul 20. doi: 10.1038/s41380-022-01661-0. Epub ahead of print. PMID: 35854107. [cited 2022 Sept 30]

17. Sansone RA, Sansone LA. Serotonin norepinephrine reuptake inhibitors: a pharmacological comparison. Innov Clin Neurosci. 2014 Mar;11(3-4):37-42. PMID: 24800132; PMCID: PMC4008300. [cited 2022 Sept 30]

18. Kanova M, Kohout P. Serotonin-Its Synthesis and Roles in the Healthy and the Critically Ill. Int J Mol Sci. 2021 May 3;22(9):4837. doi: 10.3390/ijms22094837. PMID: 34063611; PMCID: PMC8124334. [cited 2022 Sept 30]

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

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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