A bottle of generic delayed-release Duloxetine (Cymbalta) 30 mg

We have received so many complaints about duloxetine side effects that we have lost count. Far more disturbing are the number of people who tell us how hard it is to discontinue this drug.

Decades ago doctors might have told patients taking a drug like Cymbalta that if they experienced anxiety, irritability or strange sensations after stopping the drug, it was probably their underlying psychological problem returning. Now we know it is withdrawal from the medicine.

The History of Cymbalta:

Cymbalta was originally approved by the FDA in 2004 for the treatment of major depression. It is officially an SNRI-type antidepressant. In doctorspeak that means it is a serotonin-norepinehprine reuptake inhibitor and is somewhat similar to other antidepressants such as Effexor (venlafaxine) and Pristiq (desvenlafaxine).

The FDA also approved Cymbalta to treat nerve pain associated with diabetes in 2004. In 2007 the drug got a green light for anxiety and in 2008 the FDA agreed that it could ease the discomfort associated with fibromyalgia. It was also approved to treat musculoskeletal pain associated with arthritis and lower back pain in 2010.

In other words, here was a drug that could relieve your blues and your aches and pains. And the drug company that makes Cymbalta (Lilly) has been aggressively marketing it as a good way to deal with chronic low back pain and osteoarthritis. Perhaps you have seen the commercials on TV promoting the pain relieving power of the drug with the slogan “Cymbalta can help.” It sounds almost too good to be true.

Ah…and there is the rub. Although there is a long list of serious side effects mentioned during the commercial, the video images seem quite reassuring and trump the scary message the FDA requires for this medication. So, let’s set the record straight. Here, without visual interference, are a list of potential complications associated with this medication.

Cymbalta (Duloxetine) Side Effects

  • Nausea, stomach pain, constipation, diarrhea, decreased appetite, vomiting
  • Dry mouth
  • Insomnia, anxiety, tremor
  • Dizziness, fatigue, sleepiness
  • Sweating, hot flashes
  • Blurred vision
  • Headache
  • Sexual dysfunction, lowered libido, erection difficulties, lack of orgasm
  • Liver damage
  • Serious skin reactions, rash, hives (requires immediate MD assistance!)
  • Glaucoma
  • Irregular heart rhythms
  • Bleeding problems
  • Blood pressure problems
  • Interaction with other drugs (leading to serotonin syndrome among other reactions)
  • Pneumonia
  • Seizures
  • Depressed mood, suicidal thoughts and behavior, suicide

Such a long list of side effects makes your eyes glaze over after the top 3 or 4. That is why we have included stories from real people so you can better understand what these complications feel like.

Stopping Cymbalta:

Even though such side effects are scary, there is another problem with Cymbalta. When people try to stop taking this drug they frequently report unpleasant withdrawal symptoms. An organization (QuarterWatch) that monitors the FDA’s database of serious adverse drug events has noted that:

“We observed a signal for serious drug withdrawal symptoms associated with duloxetine (CYMBALTA), a widely used antidepressant that is also approved to treat arthritis and back pain, anxiety, and fibromyalgia. In the first quarter of 2012 the FDA received 48 case reports of drug withdrawal identifying duloxetine as the suspect drug. They described a wide spectrum of withdrawal effects that began when the patients stopped the drug, including blackouts, suicidal thoughts, tremor, and nausea. Several cases involved hospitalization.

Probing deeper into the scientific record for duloxetine we found that withdrawal symptoms were reported in 44-50% of patients abruptly discontinuing duloxetine at the end of clinical studies for depression, and more than half of this total did not resolve within a week or two. In addition, we identified a serious breakdown at both the FDA and the manufacturer, Eli Lilly and Company, in providing adequate warnings and instructions about how to manage this common adverse effect.”

Doctors have taken to calling this “discontinuation syndrome.” These clinical words do not do justice to what it is like to stop antidepressants like Cymbalta, Effexor (venlafaxine), Paxil (paroxetine), Pristiq (desvenlafaxine) or Zoloft (sertraline) suddenly.

Sudden Withdrawal Symptoms

  • Brain “Zaps” (electric shock-like senstations in the brain)
  • Dizziness, light-headedness, vertigo, feeling faint
  • Headaches
  • Anxiety, irritability, hostility
  • Nausea, diarrhea, digestive upset
  • Tremor, hands shaking, nerve tingles, strange sensations
  • Fatigue, tiredness, lack of energy
  • Visual disturbances

Again, a list of symptoms does not do this problem justice. Below you will read some stories from people who have posted their comments to this website. We would love to hear your story, positive or negative. Share your experience with Cymbalta or any other antidepressant below.

Should you wish to learn more about dealing with depression through some other strategies, we offer our Guide to Dealing with Depression. You will also find a whole chapter on prescribing mistakes doctors make when treating depression and fibromyalgia in our book, Top Screwups Doctors Make and How to Avoid Them.

Cymbalta Withdrawal Stories from Readers

– D.G. shares a tragic story:

“My lovely, young daughter-in law, who was about to celebrate her 29th birthday, was prescribed Cymbalta, Klonopin, and Ambien and has committed suicide.

“She told her physician and her therapist that she’d had thoughts of suicide but no one took her seriously. She suffered from depression, as well as an eating disorder, and had very low body weight. She also used alcohol.

“Please remind your readers of the potentially disastrous effects these chemicals can cause when taken carelessly or in combination with alcohol.”

This from – P.J.:

“I have been on Prozac over the last 20 years off and on and it finally stopped working. The last time I took it about 2 years ago I was taking the generic from Barr – the blue and white capsule. I was feeling as if I were in the deepest dark hole there ever was.

“My doctor put me on Cymbalta from which I had a lot of side effects such as palpitations, feeling constant dread, panic attacks, sweats, lightheadedness and general feeling of not being well.

“She added Abilify which put me over the edge. I was in the worst depression I have ever been in. Finally after living like this for several months, I asked to be put back on Prozac. I was taking the generic from Sandoz. When the prescription ran out I ended up on the big blue and white capsules from Barr.

“Over the last couple of weeks it has been constant crying spells, arguing with everyone and feeling pretty low. I talked to my doctor and she wrote the prescription for Sandoz only generic. The blue and white capsules are like taking a placebo. My doctor said she had had other patients who complained of the same thing and she had to write prescriptions for a certain generic or name brand.”

– R.P. says:

“I took Cymbalta for 3 days and thought I’d go nuts. I’m off it now and refuse to try any other drug like this. My main complaint was extreme hot flashes that estrogen wouldn’t help. I thought I’d be given Prozac, but was given Cymbalta instead. It was a rough 3 days and I stopped it last night. I am extremely tired yet cannot sleep at night. I think I was sweating even worse and my legs started feeling like I had Lyme disease again. And to be honest, within those 3 days of taking it, I didn’t contemplate suicide, but I had this crappy attitude of “who would care?”

– Nancy relates how hard it was to get off Cymbalta:

“It took me 18 months to get off Cymbalta, with no doctor’s help. I can hardly believe that doctors have no exit strategy for this dangerous drug. I had to find this out on my own from reading and as soon as I weaned off that – about a month, the tinnitus that had occurred decreased almost completely. No doctor told me this.”

— J.K. shares a parent perspective:

“My daughter experienced severe side effects when trying to come off Cymbalta – she had nausea, vomiting, lost peripheral vision for 24-48 hours, had shaking, etc. This was while she was doing a clinical in a hospital for college. Had she known she would have stayed on it until after clinical. I called the manufacturer and they acted like there were no such side effects from withdrawal.

“She too took apart the capsules and it took awhile, but finally she is free from that drug. I think it is a crime that the manufacturers don’t publish more detailed information concerning withdrawal. They could even make money selling a one month or two month step down prescription so individuals aren’t taking the capsules apart themselves.”

– P.C. Tells what it is like to switch around from one drug to another:

“I just turned 52 today. I went on a very low dose of Zoloft about 8 years ago to treat generalized anxiety disorder. It really did help for a long time. I recently have been pretty depressed (however I can cover it up really well) and my psychiatrist switched me to Effexor which was terrible for me. Now I’m trying Cymbalta which has not done anything either except make me feel more anxious and headachy and weird.”

“I am a registered nurse and I do not understand what the long term effects of these meds are and I am concerned. I really want to get off and see what I can do naturally for myself.”

– K.T. tells what it is like to try to stop Cymbalta:

“Getting off Cymbalta is challenging but not impossible. I, too, experienced the light-headedness, dizziness, and “brain zaps.” I described it as being able to “hear my eyes move.” It sounded like the light sabers on Star Wars. Very strange and disconcerting.

“The key is to do it very very slowly. Take the capsules apart and begin by removing 5 or 10 of the tiny balls inside. Do this for a week or so, then slowly increase the amount you remove each week or two as you can tolerate it.

“Your doctor will probably be no help at all. Mine wasn’t. He instructed me to wean off over a two to three week period and I almost lost my mind. I did it myself over about a YEAR or more. Be patient. I am completely off now and feeling GOOD.”

– Karen’s story:

“I was prescribed Cymbalta ‘off-label’ to manage fibromyalgia pain When I stopped taking it because it wasn’t delivering on the promised effect of reducing my pain, I became so horribly depressed that I required hospitalization as I had become SUICIDAL!

“I will NEVER take another anti-depressant for an off-label purpose….such as Elavil/amitriptyline as a “sleep aid” which is very commonly prescribed.

“I believe it should be criminal to prescribe ANY drug for a purpose other than the one it was approved to treat.”

– R.H. and Erectile Dysfunction:

“I’m a 76 year old man, my libido was very low. Taking Cymbalta for peripheral neuropathy added ED as a side affect of the drug. I had a testosterone blood test; it was 1/3 what the minimum should be. So I’m taking Androgel to raise testosterone levels and it is magic. I have great libido now and am working on minimizing the Cymbalta pills. In the meantime I have been prescribed Cialis for the ED. Each pill solves the sex problem for a couple of days.”

– M.O. on stopping Cymbalta:

“I have the exact symptoms as everyone else and it’s been a week. I only took Cymbalta for 2 months, but the side effects from stopping it are horrible. My doctor didn’t, nor did anyone else tell me, about any side effects and I did read the insert. Most of the time the listed side effects of meds don’t bother me, so I figured no problem.

“From reading other posts on this website and on other sites, the drug seems to affect every person the same way. I would never have taken it for my neck pain if I had known about the likelihood of side effects. The worst part for me is the dizziness, the brain zings and the sudden burst of tears for no reason. I would never take this drug again. I think the FDA needs to do longer studies on all drugs and be honest with their findings and that doctors should be honest and tell their patients what really happens when you take Cymbalta.”

Please add your own experience below in the comment section.

Revised 1/28/16

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  1. Stacy
    California
    Reply

    I have been on Cymbalta for about 7 weeks. Felt fine at first but all of a sudden I got anxiety X 10 while driving and had to pull over and be picked up and taken to work. Ever since then I feel anxiety when driving only. I decided it’s the Cymbalta, as I have never had this feeling EVER. I am working to wean off of this if it’s the last thing I do to get my peace back. Any weaning off tips appreciated.

  2. Jan
    Portland, Oregon
    Reply

    About 3.5 weeks ago after discussion with my doctor, I decided that I would like to discontinue Cymbalta. She had prescribed this for me to help with my fibromyalgia symptoms, and I do think it helped. However, I have very complicated health issues that have resulted in a handful of pills in the morning and evening. I’d been experiencing new complications that after lots of tests and scans had not resulted in any further diagnosis or help. I began to wonder if all these meds were warring with each other, creating additional health issues and wanted to eliminate something.

    After my primary care doctor and neurologist talked, they selected the Cymbalta as the place to start and set up a plan to slowly wean me off the drug. Six days ago I took the last last dose, and have felt increasingly bad. I’m hot one moment, freezing the next, short of breath, and have diarrhea. I’ve been crying a lot, which I discounted. I lost my husband of 46 years, 2 and a half years ago and find birthdays (both his and mine), when I miss him a lot. But this is way beyond that. I had been feeling stronger and felt like I was moving forward with this new chapter in my life. I’m beyond exhausted and yet have had trouble sleeping. I feel horrible. Today has been the worst, which is why I started searching. I thought about what had changed in this last week – no Cymbalta! Not exactly sure what to do now! Suggestions anyone?

  3. Shelly H.
    Vancouver, WA
    Reply

    I have only been on Cymbalta for a month with bad side effects of lethargy, nausea and generally not feeling better. Going from 20mg up to 60mg. Was weaned off over a two week period. The day after I totally stopped I began having even more brain zaps then when I was on it. Uncontrollable crying. Lethargy so bad that my husband had to stay home to help me care for our special needs daughter. It’s been 3 days and I am still having horrible withdrawal effects. I hope that I feel better soon. If this drug is causing such severe withdrawal effects after such a short time being on it, I can’t imagine what people are going thru who have been on it for a long period of time. I’m upset that my psychiatrist even thought this drug would be a good fit for a person already in a depression. I think that the big pharma companies have too strong a hold on what the doctors prescribe. It always seems to be about the money and not what would be best for the patient. That’s my 2 cents on that.

  4. Rosemarie
    Manitoba
    Reply

    I have been taking Cymbalta for almost 4 months for Fibromyalgia and neuralgia pain in the base of my skull. Since the first few days of taking it, I have had really bad diarrhea and sometimes stomach pain and soreness. No over-the-counter anti diarrhea product is helping me. I don’t know what’s worse – pain or intense diarrhea. My doctor doesn’t seem to take my seriously when I tell her how bad I feel. I am glad to see posted stories of other Cymbalta users. I am going to ween off this medication as others have suggested. Doctors don’t have a clue and who knows you better than yourself. I am going to research natural remedies for my pain. I’m done!

  5. Jan
    Denver
    Reply

    After many years of taking a low dose of effexor following some depression, a physiatrist (a doctor who also treats patients for pain) switched me to Cymbalta to help relieve lower back pain following an ineffective double spinal fusion. I experienced brain zaps during the whole time (4 yrs.) while taking cymbalta. I told my internist about the brain zaps and was basically ignored. If I had been warned about the real side effects of this drug, I never would have taken it.

    Cymbalta did nothing for my pain. The brain zaps became so frequent, along with periods of brain fog and hot flashes ( I’m in my 70’s), I decided to wean myself off of it by opening up the generic capsules and removing 3 of the 12 balls inside, taking the remaining little balls each day for one week. The next week I removed 3 more and stayed on that dose for one week. By the end of one month, I had gotten off of the drug completely.

    The brain zaps are still there but have diminished in intensity. The same with the hot flashes. The muscle pain is worse. I have been experiencing wide emotional swings and general feelings of anger and hostility. I have been Cymbalta-free for 2 weeks now and refuse to take this dangerous drug again.

    Drug makers are able to get away without disclosing all of the true side effects of their drugs, and I am grateful for sites that enable patients to warn others as well as educate themselves about what big pharma is doing to us!

  6. Laurel
    western new york state
    Reply

    I was put on Cymbalta for pain relief from peripheral neuropathy while on chemotherapy. It has only been about two months but as chemo has proceeded, so did my pain and as a result, the dosage has been increased. After reading all of these horrible side effects, I have to say that I am worried.

  7. Sandra G.
    SC
    Reply

    After being on this drug for 15 years I decided to get off the 60 mgs.daily Cymbalta. I suffered a car wreck in 2004 which left me disabled. I was put on this drug immediately. Jump forward to 2018. I realized it was time to get off of some of the drugs that were no longer of benefit. Withdrawal has been hard but each passing day it’s lessened. The electric shock in my head was frightening but it did get less intense. So it’s been two weeks, and I am feeling so much better. Taking things one day at a time. And self education, watching, and researching all information I can find has helped me get more understanding. Sharing my experience with others and learning what they have experienced has helped immensely. Thank you.

    • Nancy
      new york
      Reply

      I’ve been on Cymbalta for 6 years with the current dosage at 60MG for about 3 years. I don’t think it’s working anymore and would like to wean off.

      How should I go about doing this??

      Your advice is appreciated.

      • Terry Graedon
        Reply

        Weaning off slowly, over months rather than weeks, is better for most people, with very gradually decreasing doses. Ask you doctor to supervise or to refer you to someone else with experience who can help you.

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