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Cymbalta Withdrawal Symptoms – Timeline & Treatment

Cymbalta is a specific brand name for the generic drug duloxetine hcl. It’s an antidepressant, central nervous system agent, and neuropathic pain agent that’s used to treat depression, anxiety, diabetic peripheral neuropathy, fibromyalgia, and chronic musculoskeletal pain (such as osteoarthritis).

Other brand names of Cymbalta include Duzela, Yentreve, Xeristar, and Ariclaim.

Officially, Cymbalta works as a serotonin and norepinephrine reuptake inhibitor. There are slow release and regular capsules that work the same way.

Cymbalta is generally considered safe for people aged 24 years old and above. However, there are known withdrawal-like symptoms for people who discontinue treatment with this medication.

Withdrawal Symptoms

If you stop taking Cymbalta abruptly, you can experience a myriad of uncomfortable withdrawal symptoms. Reportedly, at least half of the people who stop taking Cymbalta experience adverse effects that are directly related to the change in medication. Withdrawal symptoms are common with many of these types of antidepressants.

The symptoms of stopping Cymbalta can be lumped into the term “Cymbalta Discontinuation Syndrome”. This is the name given by doctors to refer to the withdrawal symptoms.

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Withdrawal symptoms for Cymbalta specifically include:

  • Irritability
  • Insomnia
  • Nausea
  • Dizziness
  • Drowsiness or fatigue
  • Increased sweating
  • Vomiting
  • Vivid nightmares
  • Muscle spasms or tremors
  • Headache
  • Paresthesias
  • Seizures
  • Electrical shock sensations (sometimes called “brain zap”)
  • Depressive symptoms
  • Feelings of anxiety
  • Malaise

You are still likely to experience withdrawal even if you take the recommended path to discontinuing the medication. However, the symptoms will not be as strong and will be better managed by your doctor.

Some people will not experience the symptoms of withdrawal in the same way that others will. In some patients, certain symptoms could be stronger than others. While many people report similar symptoms, some experience a particular symptom worse than others. This is unpredictable, which is why it’s important to talk to your doctor about anything you’re feeling while you’re discontinuing Cymbalta.

You may experience some symptoms that others don’t experience. The severity of your symptoms may also be stronger for certain symptoms and lesser for other symptoms. There is no way of knowing which symptoms you’ll experience, if you will experience any, or how severe they will be.

Withdrawal Symptoms or Your Original Symptoms?

Because Cymbalta is an antidepressant, it’s important to be able to distinguish the symptoms of withdrawal from your actual underlying condition that was being treated by the drug. There are a few signs that help you know if you’re experiencing withdrawal or something else:

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Problems begin immediately after stopping reducing your dose of Cymbalta

If you were not experiencing any negative symptoms until you stopped or reduced your Cymbalta dose, it’s likely the symptoms you experience are from withdrawal. These would include symptoms that show up a few hours, days, or a week after your first missed or reduced dose.

As long as the underlying problem was well-controlled on the medication, there’s little chance of it developing strong symptoms this early after changes to your routine. You would be more likely to experience chronic symptoms after a long period of time.

This applies mostly to cases where Cymbalta is used to treat depression or anxiety. Treatment of pain or pain-related conditions may cause different withdrawal symptoms.

Symptoms stop or clear up quickly after taking a full dose again

If you start experiencing negative symptoms that immediately clear up once you return to your full dose, those symptoms are likely related to withdrawal. Chronic underlying problems treated by Cymbalta are unlikely to have rapid changes in symptoms based on short-term adjustments.

Original symptoms are accompanied by new symptoms

Some of your original symptoms, such as depression or anxiety, can be symptoms of withdrawal as well. However, it’s unlikely (not impossible) that you’ll only experience those particular symptoms if you are suffering from withdrawal. If symptoms similar to your original symptoms occur alongside new symptoms, they are all likely to be related to withdrawal.

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You have developed Cymbalta dependency

If over time you need to increase your dose of Cymbalta to get the same benefits as you did from your original dose, you’re likely to have formed a dependency on the drug. Dependency increases the likelihood of experiencing withdrawal symptoms if you decide to stop taking the medication.

Cymbalta Withdrawal Timeline

The withdrawal timeline varies significantly from person to person. You may experience symptoms for weeks or months after your last full dose. The average time to experience strong symptoms of withdrawal is 2-3 weeks.  Your treatment approach is unlikely to affect the amount of time you experience symptoms.

Even if you’ve been taking Cymbalta for a short time, you’re just as likely to experience withdrawal symptoms as someone who has taken the medicine for an extended time period. This was true for both low and high doses.

Withdrawal symptoms can last for weeks. Symptoms will be stronger and will probably last longer if you discontinue Cymbalta abruptly. You will likely experience the strongest symptoms shortly after large dosage changes. If you stop abruptly or reduce your dose by a large amount at once, your symptoms are likely to be stronger at that time and will reduce as time passes.

It’s not recommended to stop Cymbalta all at once. Some medical situations can make this necessary, but it’s not the recommended path to discontinuing the drug.

Treating Cymbalta Withdrawal

The main approach to Cymbalta withdrawal is to discontinue through tapering. There are a few different ways to do this.

Tapering

Gradual tapering is what many doctors recommend to help treat withdrawal symptoms from Cymbalta. Rather than stopping your treatment immediately, you will slowly reduce your dose until you are at a low enough dose to stop entirely. This process should always be supervised by your doctor, so they can monitor your health and adjust your dosage as needed.

Tapering involves gradually reducing your dose over a long period of time. You can still experience some withdrawal symptoms, but they’re likely to be less severe than they would be if you stopped abruptly.

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For tapering, some doctors will recommend that you switch from a capsule form to a liquid form of Cymbalta. This can help you make smaller reductions at a time, so you can follow a pace that suits you well. The speed that you reduce your dose depends on your exact circumstances, which is why it helps to have your regular doctor onboard with the plan. In most cases, it’s suggested not to reduce more than 10% of your dose per week.

Tapering can also be done by substituting some of your normal dose of Cymbalta with a similar medication, likely one with a lower risk of dependency. As you reduce your dose of Cymbalta, you will increase or maintain your dose of the other drug. Once you stop taking Cymbalta completely, you can either taper off of the other drug or switch to it entirely if that is necessary.

Rhythm Adjustment

Cymbalta withdrawal is similar to withdrawal experienced when stopping other drugs that affect your cell rhythm. Calcium blockers have sometimes been shown to stop some withdrawal symptoms when they’re taken as a substitute for an antidepressant like Cymbalta.

Verapamil is one of the most well-known calcium blockers that’s used for this purpose. However, it may not actually treat the symptoms and may cause you to experience them once you try to stop taking the Verapamil later on.

Treating Individual Symptoms

In some cases, you may be able to treat some of the specific uncomfortable symptoms of withdrawal like hypervigilance or pain. When symptoms are not too severe, your best approach could be to treat the most uncomfortable symptoms directly until they go away.

Histamine Stabilization

Most antidepressants, including Cymbalta, also act as antihistamines alongside their normal function. You may be able to combat withdrawal by switching to another less potent drug with similar effects, or an antihistamine without any serotonin effects. Common antihistamines may be able to help you withdrawal if the symptoms are caused more by dependence on the antihistamine properties of the drug.

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Potential Complications of Cymbalta Withdrawal

You may experience some complications from Cymbalta withdrawal. Common complications include:

Complete Ineffectiveness

Even if you reduce your dose slowly, you may find that your body will no longer receive any benefit from the medication at all. In this case, returning to a full dose or a higher dose will not give any relief. This will make withdrawal difficult for you, as you will not be able to stop it.

Psychological Symptoms

Some pyschological symptoms you experience will be directly connected to the physical changes happening in your body as you go through withdrawal. This connection can cause some strange reactions, such as negative reactions to food or drinks or even developing phobias.

Speciality therapies or cognitive behavioral therapy may be able to help you get past these strange symptoms without developing any lasting effects.

Sources

https://www.rxlist.com/cymbalta-drug.htm#warnings

https://www.medicalnewstoday.com/articles/248214.php

https://www.nami.org/Learn-More/Treatment/Mental-Health-Medications/duloxetine-(Cymbalta)

https://neuro.psychiatryonline.org/doi/pdf/10.1176/appi.neuropsych.12110265

https://www.drugs.com/slideshow/cymbalta-cause-for-concern–1207

https://www.mayoclinic.org/drugs-supplements/duloxetine-oral-route/precautions/drg-20067247

https://rxisk.org/guide-stopping-antidepressants/#Prominent_withdrawal_symptoms

https://www.medicines.org.uk/emc/files/pil.3880.pdf

 

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