Cymbalta (Duloxetine)
Generic: Duloxetine
An SNRI that treats depression, anxiety, and chronic pain conditions
Important: This information is for educational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider before starting, stopping, or changing any medication.
Overview
Cymbalta (duloxetine) is a serotonin-norepinephrine reuptake inhibitor (SNRI) with FDA approval for depression, generalized anxiety disorder, diabetic neuropathy, fibromyalgia, and chronic musculoskeletal pain. This makes it particularly valuable for patients who have both mood disorders and chronic pain. At Next Step Psychiatry, we often prescribe Cymbalta when depression or anxiety co-occurs with pain conditions.
How Cymbalta Works
Cymbalta inhibits the reuptake of both serotonin and norepinephrine, increasing levels of both neurotransmitters in the brain. The dual mechanism helps with mood, anxiety, and also pain pathways—making it effective for conditions where depression and chronic pain overlap.
What Is Cymbalta Used For?
Conditions Treated at Next Step Psychiatry
Dosage Information
Starting Dose
30 mg once daily (may start at 20 mg for anxiety)
Typical Dose
60 mg once daily
Maximum Dose
120 mg per day
Important Notes:
- •Can be taken with or without food
- •Swallow capsules whole - do not crush or chew
- •May sprinkle contents on applesauce if difficulty swallowing
- •For anxiety, may start lower and increase gradually
- •Pain conditions may require 60 mg or higher
Side Effects
Common Side Effects
These may occur when starting the medication and often improve over time:
Serious Side Effects (Seek Medical Attention)
Important Warnings
- !Black box warning for suicidal thoughts in youth
- !Do not use with MAO inhibitors
- !Avoid in patients with uncontrolled narrow-angle glaucoma
- !Avoid in patients with significant liver disease
- !Can increase blood pressure - monitor regularly
- !Difficult to discontinue - must taper very slowly
- !Avoid heavy alcohol use
When to Seek Immediate Medical Help
Contact your doctor immediately or go to the emergency room if you experience:
- →Signs of liver problems (yellowing skin/eyes, dark urine, abdominal pain)
- →Suicidal thoughts or behaviors
- →Signs of serotonin syndrome
- →Severe allergic reaction
- →Manic symptoms
- →Severe discontinuation symptoms
- →Unusual bleeding
Drug Interactions
Tell your doctor about all medications, supplements, and herbal products you take. Important interactions include:
Frequently Asked Questions
Why is Cymbalta used for pain?
Cymbalta affects norepinephrine pathways involved in pain processing. It's FDA-approved for diabetic nerve pain, fibromyalgia, and chronic musculoskeletal pain, making it useful when depression/anxiety co-occurs with chronic pain.
Is it hard to stop Cymbalta?
Cymbalta is known for potentially difficult discontinuation. Stopping too quickly can cause significant withdrawal symptoms. Always taper gradually under medical supervision - never stop abruptly.
Can Cymbalta raise blood pressure?
Yes, SNRIs including Cymbalta can increase blood pressure in some patients. Blood pressure should be monitored, especially when starting or increasing the dose.
Crisis Support
If you're experiencing a mental health crisis or thoughts of suicide, call 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room. Help is available 24/7.
Other Medications We Prescribe
Questions About Cymbalta?
Our psychiatrists provide expert medication management and can help determine if Cymbalta is right for you.
4145 Lawrenceville Hwy NW, Suite 100, Lilburn, GA 30047