Cymbalta, known generically as duloxetine, is an antidepressant medication classified as an SNRI, or serotonin-norpeinephrine reuptake inhibitor. It is used to treat major depressive disorder, fibromyalgia, chronic pain and urinary incontinence, according to the National Alliance of Mental Illness. While Cymbalta can have benefits, the possibility of adverse reactions exists.
Suicidal Thought and Actions
Cymbalta and other antidepressants cause increased risk of suicidal thoughts and actions in children, adolescents and young adults, according to a July 2007 alert issued by the Food and Drug Administration. Symptoms such as anxiety, irritability, agitation, panic attacks, difficulty sleeping, hostility, aggressiveness, impulsive behavior, decreased coordination, physical restlessness and unusual excitement can signify emerging suicidal behavior and should be reported to a physician immediately.
Antidepressant Discontinuation Syndrome
The American Academy of Family Physicians warns of antidepressant discontinuation syndrome when stopping Cymbalta and other antidepressants taken for six weeks or more. This syndrome can be misdiagnosed as other medical and psychiatric conditions. It can cause significant discomfort that results in psychosocial problems, being absent from work and hospitalization in severe cases. Symptoms include electric-shock sensations; parasthesias such as numbness, tingling and burning; flu-like symptoms; headache; difficulty sleeping; nightmares; dizziness; blurred vision; muscle jerking; low mood; anxiety; irritability; delirium; delusions; and hallucinations.
Serotonin Syndrome
A Food and Drug Administration alert issued in July 2006 warned of the potential for serotonin syndrome, a life-threatening reaction caused by Cymbalta and certain other antidepressants taken in combination with triptans. Triptans are medications classified as 5-hydroxytryptamine receptor agonists. Examples are Amerge or naratriptan, Axert or almotriptan, Frova or frovatriptan, and Imitrex or sumatriptan. Symptoms of serotonin syndrome include confusion, dizziness, respiratory failure, coma, mania, hallucinations, high body temperature, high blood pressure, sweating, shaking, weakness and impaired muscle coordination.
Liver Problems
Cymbalta can cause liver failure that can be fatal, according to DailyMed. Cymbalta should be discontinued if yellowing of the skin and eyes, called jaundice, develops. Abdominal pain, elevated liver enzymes and an enlarged liver are also serious signs of liver damage. Cymbalta can also react with alcohol and cause liver injury. It should not be used in patients with a history of alcohol abuse or liver disease.
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