illustration of a head splitting in two with green waves of pain radiating out

Certain medications have the potential to cause a very disorienting withdrawal syndrome if they are discontinued abruptly. People should be warned about this possibility before they begin taking the drugs so that they will be prepared to phase off gradually when it is time to stop.

Q. I have suffered from depression almost my whole life. I’ve also been diagnosed with fibromyalgia and arthritis. I was prescribed Cymbalta, as it is supposed to help depression and fibromyalgia.

I lost my state health insurance when I got a new job, and there have been delays before I can get health insurance again. As a result, I had NO choice but to go off this drug cold turkey.

I had seizures the first four days. In addition, I had hot flashes, brain zaps, sensitive nerves, emotional swings, diarrhea, constant nausea and severe aches and pains. This has been the worst time of my life.

A. When health professionals prescribe duloxetine (Cymbalta) for fibromyalgia, arthritis, depression, nerve or muscle pain, they may not mention that stopping the drug can be challenging. The official prescribing information warns that discontinuation can lead to dizziness, headache, nausea, diarrhea, electric shock sensations, insomnia, anxiety and fatigue. Seizures have also been reported.

If stopping becomes necessary, very slow withdrawal is preferable. We are sending you our Guide to Dealing with Depression, which discusses a number of antidepressants and the difficulties of withdrawal. It also offers some ways to manage depression without drugs.

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  1. Jean
    Mt. Vernon, WA

    I have been on Cymbalta for 10 years or so. (60 mg) If I accidentally miss a dose, I have the brain zaps, ringing in my ears, and twice have felt as though I have the flu. Reading all of the above, I wonder if it is possible to get off Cymbalta. Living here in Seattle area, I have serious Seasonal Affective Disorder and was prescribed an extra 30 mg for that, but am hesitating to take the extra 30mg. My depression gets better around April., but I have struggled with depression all my adult life. I would like to taper, but I don’t have an expert that I feel knows enough.

  2. Terri

    Just stopped taking duloxetine 30mg 2 days ago. Bit hot and cold but nothing else so far. Wait and see I suppose

  3. Gretchen
    Ann Arbor, MI

    Has ANYONE had any luck with weaning themselves off this or have any advice? I’ve been on Cymbalta for less than a year and had NO IDEA this was going to be such an ordeal. I’m on 60mgs and never intended to be on it permanently.

    I’m tempted to:
    A) take 2 weeks off from work to just be in bed and deal with the symptoms (how long do withdrawal symptoms last?)
    b) Start counting pellets and ween myself over 6 months or more (does this even WORK?)

    I feel so trapped and worried for my health!

  4. Kim

    I had such horrible , hellish, mental and physical torture from discontinuing Cymbalta. at 120mg over a 12 year period of taking it that it took me over 3 years to feel somewhat normal again after discontinuing it. I say somewhat cause I feel the experience has left me with a bit of brain damage. My memory is terrible, my thoughts are scattered. I have terrible headaches which I never had before. I have brain fog when stressed. I am still not quite myself.

  5. Mateo

    I did read many, many horrible side effects of Cymbalta…and still allowed three different doctors to recommend it…much to my regret. I could not have imagined what “brain zaps” were or might even feel like…but, it is real and it occurs too often to not become familiar with it.

    It occurs more pronounced with eye movements (left or right) and head movements. Sometimes, even the “start” of a movement or reaction can “zap” along with a whooshing dizziness. Easy sweating (for me especially at night)…or with seasoning or strong emotions. Then there is the chest sensations (that accompany the zaps and swooshes)…makes it an intense sensation that is almost devastating.

  6. Dusty

    Had been taking Cymbalta for approx. 7 years for depression and initially it helped quite a bit. Now it has stopped working and I’ve been having trouble sleeping and terrible stomach pains, so why take it? Decided to start tapering off, from 60 mg to 30 mg, then one pill every other day and now down to a partial pill about every two days.

    Have been experiencing tremendous head pressure, worse tinnitus, severe nausea, dizziness, a feeling of sea-sickness, muscle cramps/pain, and severe lower back & hip pain. Been trying to alleviate the pain & symptoms using MJ, but other than helping my overall mood it is not helping with the pain of the withdrawals very much. Even ibuprofen isn’t helping. The nausea is persistent and debilitating.

    I do wish they would EMPHASIZE the WITHDRAWAL symptoms BEFORE recommending any medications. The side effects on most things you have to overlook because they seem endless, but if they highlighted how difficult getting OFF the pills would be; perhaps more people wouldn’t suffer so.
    (I have the same theory about marriage, in fact. If they made GETTING married as difficult as it is to get DIVORCED, then perhaps a lot of marriages wouldn’t happen in the first place).

  7. Susan

    I have been on Cymbalta and gabapentin for about 5 months I have tryed to get off gabapentin and I started a little to fast and got the Shakes so bad I had to go back on them I now am taking it slowly and it is working I will be taking to my pharmacist about going off Cymbalta. Thank you for all the information, I wish I had it before I started on it.

  8. Tshep

    I’ve been on Cymbalta 30 mostly. I was beginning to feel breakthrough with, when bad I was to take 5 of Valium. I wanted to quit taking for about 8 years …. Arthritis, joint pain and depression. It worked great but I was having bouts of sweats and getting nauseated, pressure in my head almost like blood pressure headaches. Of course about 35 pounds of weight gained. I was on Effexor before and it was bad coming off but Cymbalta awful. Started tapering 8 days ago. 30 mg every over day. I was doing good with just nausea, diarrhea, vertigo. I stopped it on Wednesday night… Friday night so sick couldn’t get to sleep til 630 am Saturday am and this was with a Valium mid-day and 5 of ambien.

    Nothing helped. That’s when wheezing and coughing started and my eyes feeling like they were jerking. I’m actually scared to even take a half of beads from a 30mg. I’ve been shut up I house for 4 days now, I can’t drive like this…. I can’t barely get up and walk around. Any input. Calling my md Monday … Is Lexapro what to change too? What’s up with the eye stuff? Has anyone’s pain come back????

    • Bern

      I have been taking Cymbalta for over two years. Over time I noticed the same effects such as yours; “Arthritis, joint pain, and depression. It worked great but I was having bouts of sweats and getting nauseated, the pressure in my head almost like blood pressure headaches. Of course, about 35 pounds of weight gained.”

      I found I now have a Pituitary Adenoma causing my prolactin to elevate. To make a long story short, over the process of testing I found out my adrenal gland hormone levels are 4 times higher than normal, except for my adrenaline, which is 0. My endo doc wants me to come off the Cymbalta for 6 weeks because it can interfere with the test. I am not a genius but it seems to me my symptoms are caused by these levels being too high, enough to mimic an adrenal tumor. So I am coming off Cymbalta either way. Hope this helps someone.

  9. sheryl
    United States

    I’m sooo down about this… I have been on Cymbalta for 5 years at the higher dose. I was having sweats and crying spells everyday… so my dr. is trying to taper me off. I have been sooo sick for days… I don’t know what to do. Will call her tomorrow… Just feel like throwing up all the time, and have to work everyday… Oh, well crying out to GOD too for all of you and myself to be able to get off of this crazy medicine.

    • Tshep

      Amen. Hope you are better.

  10. Shuger G.
    Kalkaska, MI

    My Dr. prescribed this to me, knowing I had bad reactions to antidepressants and claimed that this was not additive…..I asked the pharmacist and he said it had most of the same stuff. I opted out! So thankful after reading these nightmares…….

  11. Carol S

    I had awful “brain zaps” and ringing in my ears when I started weaning myself off sertraline (Zoloft). My doctor said that 2 weeks should do it. After a year or so, I’m still on the smallest dose because I do need a little help, but a couple of times a week I still have very mild “brain zaps.” I’m beginning to question all medications and their effect on my body.

  12. Meg

    I too had trouble getting off of Cymbalta. I tried the tapering method per my MD’s advice, but I was still having horrible symptoms and could only get as low as 30 mg. I read online that the capsules of Cymbalta have miniature tablets inside of them (not beads or powder like some capsules). Each 30 mg tablet had 6 capsules of 5 mg each, so I bought some empty capsules and decreased the mini tablets by 5 mg each week. Each time I went down a tablet, I would experience withdrawal symptoms but none as bad as trying to go from 30 to 0, so I kept on until I weened myself off. I know that a lot of physicians, pharmacists and other providers would be very leery of a patient doing this, but had I not, who knows what I would have had to suffer through. I have heard that some doctors may be able to prescribe these lower doses that can be made at compounding pharmacies, if you want to try the protocol but don’t want to risk opening up the capsules yourself.

  13. Liz

    I was prescribed Cymbalta in 2005 and I still get violent muscle cramps in my legs even though I got off them gradually. I now have to take muscle relaxers daily and it doesn’t offer much relief.
    I was given Savella in April 2014 and within 10 days my tendons all over my body started to contract. My feet and hands started to turn into clawlike appendages that eased once I stopped taking it, but still suffer from severe tendon cramps that effect the whole side of my body from jaw to toes for hours or days at a time. Hydrocodone was helping but now of course can’t get a doctor to prescribe that anymore.

  14. Bryte

    I too, had a really rotten time stopping Cymbalta, and my doctor did not believe me when I told him of the withdrawal. I had the terrible brain zaps, shakes, feverish feelings, fog, etc. I am already on Tramadol for Fibromyalgia, and I also take Xanax for anxiety, and really, if I did not have those two drugs to help, I do not know how bad it would really have been, as I did a taper. The withdrawal symptoms lasted about a good 5 weeks, and I had been on the Cymbalta for slightly over a year. I have also JUST discontinued Lyrica after 6 weeks at 300 mgs daily…another drug that I was promised had no withdrawal symptoms…it does, plus it made my hands and feet swell badly and walking was challenging to say the least…as Ariel said above, I am going to refuse any more “new” drugs for Fibromyalgia, as I am really disheartened by false promises and bad drugs. I do wish that medical marijuana was an option for me, but just now, it is not.

  15. Amy

    My partner went off Cymbalta after tapering down to a low dose. Tapering did not help. He was in bed for two weeks. If I wasn’t unemployed at the time, he would have had to be hospitalized because he needed round the clock care. He will never go on that or Effexor again. He found two medications that have side effects but work much better. Cymbalta was a nightmare for him. Thank you for the great reporting.

  16. nasybax
    southeast USA

    Yours is the ONLY item appearing in my In-Box that I NEVER DELETE before reading.

    Please keep up your excellent, necessary work.

    Thanks, nasybax

  17. Danielle

    Some 20 years ago I went on Zoloft, it worked wonderfully for a while, then it didn’t. What a shock, literally, when I stopped it. There were no warnings back then to withdraw slowly and I went through hell with the brain zaps, panic, brain fog. My doctor thought I was exaggerating when I told her about it, saying she’d never heard of anything like that.
    Now that I have severe arthritis throughout my body, docs are trying to get me on Cymbalta. No thanks. I’m currently considering medical marijuana, it doesn’t come with a long list of severe side effects, though I know that anything you put in your body has some kind of effect.

  18. ariel

    I too had problems getting off of Cymbalta. I ended up having to see a psychiatrist who knew how to Taper me off of it. He told me that lots of patients had problems getting off this med.
    He said some people are never able to get off of it after starting using Cymbalta. This was a few years ago when it was a newer med on the market. He told me that he was going to stop prescribing the newer meds until they had been out on the market for a while.
    also.. Effexor gave my now x husband seizures. I have refused to be put on any of these types meds to help with my fibro. out of fear of side effects and my body getting addicted to
    these meds.

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