Cymbalta, clinically known as duloxetine, is a prescription medication indicated for the treatment of depression, anxiety, diabetic neuropathic pain and fibromyalgia. It works by increasing the availability of the neurotransmitters serotonin and norepinephrine. It was approved by the U.S. Food and Drug Administration in 2008, and in 2009, there were over 14 million prescriptions dispensed. Patients who stop taking Cymbalta may experience several side effects, and it is recommended that patients taper off of their doses rather than stopping abruptly. Side effects can also vary depending on the size of the dose taken as well as the length of time the patient was taking it.
Patients that discontinue Cymbalta may experience several psychological symptoms. These can take place within 24 hours after discontinuation and may last one to three days, but may last up to three weeks. The most common symptoms of atypical antidepressant withdrawal, including Cymbalta, are anxiety and low mood, such as apathy and rebound depression. Because Cymbalta strongly affects serotonin, after discontinuation it can take several days for the body's own serotonin system to return to normal. In a study published in the December 2005 issue of the Journal of Affective Disorders, Dr. David Perahia and associates found that up to 50 percent of patients taking Cymbalta for extended periods experienced one or more general withdrawal symptoms including psychiatric disturbances. These include anxiety, irritability, crying, depression and nervousness.
Movement and Sensory Symptoms
Patients that stop taking Cymbalta may also experience several movement and sensory disruptions such as dizziness, vertigo, electric shock sensations, tingling, numbness and restlessness. In the study by Perahia and associates, dizziness is the most common withdrawal symptom, occurring in about 19 percent of patients. Patients also report feeling a pins-and-needles type sensation during withdrawal. In addition, tremor and ringing in the ears are possible symptoms.
There are several other symptoms that may occur from discontinuing Cymbalta. These can include sleep, digestive and other physical disturbances. In the August 2006 issue of American Family Physician, Dr. Christopher Warner and associates stated that patients may experience flu-like symptoms, headache and weakness. Patients may experience gastrointestinal disturbances including changes in appetite, nausea and vomiting. Patients may also experience sleep disturbances including insomnia and nightmares. In the study by Perahia and associates, insomnia occurred in around 6 percent of long term patients, while nightmares occurred in around 3 percent of patients. In the same study, anorexia and diarrhea occurred in 2.5 percent of patients. According to eMedTV, headache occurs in around 5 percent of patients that discontinue Cymbalta.
- "American Family Physician"; Antidepressant Discontinuation Syndrome; Dr. Christopher Warner et al.; August 2006
- "Journal of Affective Disorders"; Symptoms Following Abrupt Discontinuation of Duloxetine Treatment in Patients With Major Depressive Disorder; Dr. David Perahia et al.; December 2005
- eMedTV: Cymbalta Withdrawal
- Encyclopedia of Chemistry: Duloxetine