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HomeAddictionPrescription DrugsAntidepressantsCymbalta Withdrawal

10 Minutes

Edited & medically reviewed by THE BALANCE Team
Fact checked

Cymbalta (duloxetine) is an antidepressant and antianxiety medication that is also used to treat diabetic neuropathy and fibromyalgia. It belongs to the class of drugs known as serotonin and norepinephrine reuptake inhibitors (SNRIs).  SNRIs have a profound effect on the brain, increasing the activity of norepinephrine and serotonin neurotransmitters. Some people develop withdrawal symptoms when they stop taking SNRIs.

When you stop taking Cymbalta, your brain may take some time to acclimate to being without it. You may have flu-like symptoms and dizziness during this period. In the days and weeks after your last dose of Cymbalta, you may have headaches, vomiting, and nausea. Nightmares or unsettling dreams, as well as pins and needles sensations that appear and disappear throughout the body, are more upsetting symptoms. 

Even though these symptoms are usually minor, they might be worrisome if they occur unexpectedly. When patients stop taking antidepressants, they are rarely told about the possibility of withdrawal symptoms. If your physician did tell you, it’s possible they used the term “antidepressant discontinuation syndrome,” which can be confusing or misleading.

According to a pooled study of six distinct placebo-controlled research trials, 44.3 percent of patients who stopped taking duloxetine (Cymbalta) experienced withdrawal-like symptoms, as opposed to 22.9 percent of those who took the placebo. Dizziness was the most prevalent symptom, second by headache and nausea.

The majority of individuals in the duloxetine (Cymbalta) studies described their complaints either as mild or moderate. Around 65 percent of those reporting withdrawal symptoms indicated their problems went away in roughly a week.

Since SNRIs like duloxetine do not produce a euphoric “high” like other prescription medications, they are not commonly abused.

A more typical kind of abuse is when a person believes he or she needs to take a higher-than-normal dose of duloxetine to attain greater results. Some folks will crush their duloxetine tablet and combine it with a drink to experience the effects faster.

The following are symptoms of duloxetine abuse:

  • Increasing the dose without seeking medical advice
  • As a result of ingesting duloxetine, you may experience drowsiness or pass out.
  • Vomiting
  • Blood pressure fluctuations
  • Bloodshot eyes
  • Slurring of speech
  • Changes in physical looks that happen unexpectedly
  • Changes in sleep habits that are noticeable

Cymbalta might provoke suicidal ideation or seizures in some people, and these adverse effects can be fatal. Those who are diagnosed with serious depressive disorder or who use more than one kind of antidepressant are at a higher risk of misusing duloxetine, therefore users and loved ones should be aware of this.

Your brain must adjust to reduced amounts of norepinephrine and serotonin when you stop taking Cymbalta. Your brain may take days or weeks to adjust to its new normal. Depending on the specific condition of the individual, Cymbalta’s negative effects might manifest as both withdrawal symptoms and side effects. It is critical to maintain an open and honest flow of information with your psychiatrist and doctor so that they can assist you in overcoming any bad effects that the drug may have on you.

It’s important to keep in mind that any physical reliance you may have acquired is not your fault and is not something to be embarrassed about. Your mental and physical health is far more essential than any guilt or shame you may feel about revealing you’re experiencing duloxetine withdrawal symptoms. Your physicians want the ideal for you, therefore they will do everything they can to assist you in overcoming your dependency.

You may have a variety of symptoms throughout this time, such as:

  • Dizziness
  • Headaches and lightheadedness
  • Nausea
  • Needles and pins
  • Vomiting
  • Nightmares
  • Anxiety
  • Unusual sensations such as buzzes in the head
  • Sleeping problems
  • Irritability

Symptoms usually emerge 2 to 4 days after you stop taking your medication and linger for several weeks. While tapering—slowly reducing your dose—is a common therapeutic method, some evidence suggests that you may still suffer symptoms of withdrawal even with this strategy.

Cymbalta withdrawal symptoms are usually mild, relative to other SNRIs such as venlafaxine. If you’ve read anywhere that SNRIs cause severe withdrawal symptoms, the writers were most likely talking about venlafaxine (Effexor). 

Some of the widespread and severe symptoms from duloxetine withdrawal constitute a syndrome called Cymbalta Discontinuation Syndrome, which is a well-known issue. As mentioned, according to a 2005 study on generic duloxetine, 44 percent of participants had withdrawal symptoms. Eli Lilly paid lawsuits in 2016 from patients who claimed that the seriousness of the withdrawal symptoms was misrepresented to them.

Some people have experienced abdominal cramping, sexual dysfunction, and convulsions in more severe situations. Those who try to bypass the extended-release capsule by combining the powder into a drink are more likely to experience this.

One record of a withdrawal seizure and one account of withdrawal symptoms that came and went over a ten-month period have been reported in research studies on Cymbalta withdrawal.

It’s also important to remember that because duloxetine is an antidepressant, any abrupt dosage adjustments might cause severe psychological withdrawal symptoms. Rebound anxiety, worsening depression, sleeplessness, and suicidal ideation are examples. Because of the severity of these possible withdrawal symptoms, it’s usually advisable to go off duloxetine gradually under the guidance of a medical practitioner.

When people go through the discontinuation syndrome, they typically wonder how long it takes to get off Cymbalta. Based on the drug dose, the amount of time a patient has been getting therapy, and other factors, the process can take a long time. The detoxification and withdrawal process can take many months on average.

The Initial Signs

The first signs of Duloxetine withdrawal show about 12 hours after the last dose has been taken. Because around half of the amount taken is still in the person’s system at that time, the impacts are likely to be minimal.

24 Hours Later

The person may experience nausea, agitation, sweating, and other symptoms 24 hours after ingesting the substance.

The Following Weeks

Duloxetine’s physical side effects normally peak after 2-3 days and can last for up to a week. Quitting duloxetine might cause psychiatric symptoms that continue for months. Strong emotional disturbance can cause the recurrence of anxiety, depression, or any other mental health issue that the antidepressant was designed to treat, even if it fades with time. Patients who are weaned off duloxetine have a higher risk of suicide during this time.

There Is No Such Thing As A Universal Timeline

The severity of Cymbalta withdrawal and the time it takes to cease experiencing symptoms are determined by the individual characteristics of each patient. It’s hard to predict how each person will react to the withdrawal of duloxetine. As a result, medical monitoring is urgently recommended to assist the patient in quitting duloxetine without causing harm to their health.

Duloxetine withdrawal requires medical assistance and supervision. Many people assume they can wean themselves off of antidepressants. Stopping any antidepressant, unfortunately, carries the risk of health consequences. There are also chances of consequences if a person switches drugs without medical supervision. It can also apply when a patient ceases using duloxetine in conjunction with other medications, like Cymbalta and Wellbutrin.

Duloxetine withdrawal can be accomplished in one of two methods: cold turkey or tapering (weaning) off the medicine. However, there is only one safe way to quit taking Duloxetine: tapering. Going cold turkey will cause withdrawal symptoms, which the patient will want to prevent because it can be fatal.

Quitting Cold Turkey

Knowing how risky it is to discontinue Cymbalta cold turkey, it may seem strange that people would explore this option. This is not always through choice, though. There’s a chance that if someone loses their insurance or can’t afford the next month’s drugs, they won’t have another alternative.

However, just because you don’t have any other options doesn’t imply quitting Cymbalta cold turkey won’t have effects. In the mild range, stopping Cymbalta cold turkey will result in mild withdrawal symptoms. On the other hand, abruptly discontinuing Cymbalta might cause convulsions, and suicidal thoughts, and possibly throw the individual into a coma.

If someone feels they have no option but to go cold turkey, they should speak with their doctor to see if there is anything they can do to assist them to quit taking it safely.

Tapering Off

The safest way to discontinue taking Cymbalta is to taper off the medication, often known as weaning off the pill. It should, however, be performed under medical supervision. There are appropriate and inappropriate ways to taper, and adhering to the patient’s specific taper timetable is crucial to success. It takes a few weeks for some patients to taper down, while it takes months for others.

The following is a typical taper schedule for Cymbalta:

  • 90 mg as a starting dose
  • 60 mg during the first taper
  • 30 mg for the second taper
  • 20 mg for the third taper
  • 10 mg for the fourth taper

Users should not, however, just follow this schedule. If they start on a larger dose or have a history of drug abuse, a different strategy is required. There may also be additional complex reasons that demand a change in the timeline. Always taper off with the assistance of a physician.

The best method to avoid symptoms of withdrawal like dizziness, headache, and nausea is to gradually discontinue Cymbalta over 2 to 4 weeks. Talk to your physician or pharmacist first if you want to stop treatment. It’s best not to stop taking Cymbalta (duloxetine) suddenly.

Cymbalta is a drug that acts in the brain to alleviate anxiety and depression. It works by boosting norepinephrine and serotonin levels in the brain. It may take many weeks for your body to adapt to function normally without the medicine once you stop using it. You may encounter side effects that are uncomfortable at this time. The most prevalent withdrawal adverse effect of Cymbalta has been shown to be dizziness, which affects over 12 percent of patients.

Slowly stopping treatment may not be enough to avoid all withdrawal symptoms. Even after a slow taper as suggested by your doctor, if you are still having withdrawal symptoms, seek medical advice again. They might opt to slow things down even more.

You and your doctors may decide to switch your therapy to another prescription in addition to a gradual withdrawal.

  • There are numerous alternatives for treating anxiety and depression, as well as other applications for this medication.
  • When quitting treatment, you may wish to talk to a therapist or seek counseling (talk therapy) to help you manage anxiety, mood swings, and other issues.
  • Inform your friends and family that you will be gradually discontinuing treatment over many weeks or months, so they are aware that you may experience side effects.
  • To keep your body strong and prepare yourself, eat properly, get plenty of sleep, exercise, and talk to your doctor as soon as your depression symptoms return.

The typical half-life of Cymbalta is 12 hours. However, based on the health condition of the patient, it may happen earlier or take longer. It indicates that Duloxetine withdrawal might begin 12 hours after the last dose of the medicine has been taken. Although knowing the half-life of duloxetine is crucial, it does not provide a whole picture.

The following are the details of the duration of time Cymbalta remains detectable in the system:

  • Blood. Duloxetine can be detected in the blood for up to 5 days after the last dose, as per lab tests.
  • Urine. It also appears in the urine for around 5 days.
  • Saliva. The quickest detection period is 2 days in saliva following the last dose.
  • Hair. Hair, on the other hand, has the maximum detection time, up to 9 months after the previous use.

Because duloxetine can be in the bloodstream for such a long time, the body may need some time to return to normal. Duloxetine’s sexual side effects, for example, may take many weeks to subside. Because Cymbalta is not safe to use while pregnant, this can help decide when it is safe to get pregnant.

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