Cymbalta Review

By Dr. Kensington

Cymbalta (Duloxetine) is a prescription medication used to treat depression, anxiety, and chronic pain.

It is a member of a class of drugs known as selective serotonin and norepinephrine reuptake inhibitors (SSNRIs) that work by increasing the brain chemicals serotonin and norepinephrine that help maintain balanced mood.


Cymbalta comes in capsule form. The following are general dosage guidelines to the most effective dosage; actual dosages for each individual will vary on a case-by-case basis.

For depression, a common dosage range is between 40 mg and 60 mg daily. A common starting dose is 30 mg daily, and it is rare to exceed over 120 mg total daily.

A common starting dose for General Anxiety Disorder is 30 mg or 60 mg once daily. It is rare to exceed 120 mg total daily.

The capsules are intended to be swallowed whole, not chewed or crushed. In addition, the contents of the capsules should not be opened or sprinkled on food or drinks.

If you miss a dose, take the missed dose as soon as you remember. However, skip the missed dose if it almost time for your next dose. Never double up doses to make up for a missed dose.

Side Effects

Side effects may include nausea, dizziness or lightheadedness, drowsiness, headache, fatigue, sweating and night sweats, constipation, diarrhea, heartburn, decreased appetite, antidepressants and weight changes, tremors or shakiness, muscle pain or weakness, and dry mouth.

More serious side effects may include stomach pain, bruising, itchy skin or rash, hives, loss of appetite, extreme fatigue, confusion, flu-like symptoms, fever, sweating, irregular heartbeat, blurry vision, difficulty breathing or swallowing, and swelling in any parts of the body such as the tongue, face, hands, feet, ankles, etc. These may also be symptoms of a serious and potentially life-threatening condition called serotonin syndrome. If you experience any adverse side effects report them to your doctor immediately.


This drug comes with the risk of withdrawal when abruptly discontinuing the medication or missing a few doses. Withdrawal symptoms may include dizziness, upset stomach, headaches, vomiting, irritability, skin tingling, and sleep disturbances or nightmares. As a result, in order to help avoid withdrawal, you should work with your doctor to gradually reduce your dosage over time.

Cymbalta Warnings

Cymbalta may harm developing fetuses in pregnant women and result in birth defects and other health risks, particularly if taken during the last trimester. Read the full warning about antidepressants and pregnancy.

Some complications associated with takings SSRIs or SNRIs during pregnancy include heart defects, cranial defects, respiratory distress, seizures, feeding difficulty, vomiting, hypoglycemia, tremors, irritability, and constant crying.

In addition, Duloxetine is excreted into human milk and the effects on nursing babies are unknown. According to the manufacturer Eli Lilly, breast-feeding is not recommended while taking Duloxetine.

As a result, the FDA has placed a category C warning on this medication. To be safe, notify your doctor immediately if you become pregnant while taking this drug.

Also, some research studies indicate that antidepressants may increase the risk of suicidal thoughts and behaviors when taken by children, teens, and young adults. See this article about antidepressants and suicide.

Further, alcohol should be avoided while taking this medication. For additional information about the dangers and health risks that can result from mixing alcohol and antidepressants, see antidepressants and alcohol.


Relay questions or concerns to your prescribing doctor. Remember to attend your regular medication monitoring appointments in order for your doctor to track your progress.

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