Cymbalta (Duloxetine) Withdrawal & Detox

Cymbalta (generic name duloxetine) is an SNRI-type antidepressant commonly used to treat major depressive disorder, generalized anxiety disorders, neuropathic pain and fibromyalgia.

While Cymbalta is not classified as an addictive substance, patients on a course of Cymbalta are likely to experience withdrawal symptoms, also known as “discontinuation syndrome,” when they stop taking it. These symptoms vary in type and severity, with some people only experiencing them for a few weeks and some for several months. For this reason, it is important not to stop taking duloxetine suddenly or without medical supervision.

Withdrawal symptoms from duloxetine are so common and severe that Cymbalta Discontinuation Syndrome is a well-documented issue, with a history of controversy. According to the FDA (U.S Food & Drug Administration), there were 888 reports of adverse effects from duloxetine discontinuation in 2017, the highest number for any serotonin receptor-based antidepressant. In a 2005 study on generic duloxetine, it was found that 44 percent of users experienced withdrawal symptoms.

Following an investigation in 2009, the FDA concluded that the withdrawal symptoms of duloxetine were significantly worse than the manufacturer, Eli Lilly, had implied on their label and marketing. Additionally, a class-action lawsuit was filed in 2012 against Eli Lilly from several people who claim that the severity of the withdrawal effects had been misrepresented to them.

The Cymbalta label states that the following symptoms may be experienced when discontinuing the drug:

• Dizziness
• Headache
• Nausea
• Diarrhea
• Paresthesia (a burning or prickling sensation, particularly in the limbs)
• Irritability
• Vomiting
• Insomnia
• Anxiety
• Hyperhidrosis
• Fatigue

However, Cymbalta users have also described additional withdrawal symptoms including nightmares and vertigo. Several people have reported experiencing “brain zaps,” painful headaches that feel like electric shocks traveling along the spine to the base of the skull, often accompanied by nausea and dizziness.

Furthermore, the drug has a black box warning on its label for potential suicidal thoughts. This is the FDA’s strongest warning; however, it is present for all SSRI and SNRI antidepressants, not just Cymbalta. Some patients taking duloxetine have reported increased suicidal thoughts during withdrawal. Antidepressants are more likely to cause suicidal thoughts in children, teenagers, and young adults.

It is difficult to establish a precise timeline for withdrawal symptoms as these vary widely depending on the patient. Some people experience moderate symptoms for a few weeks, while others continue to experience the more severe symptoms for months following discontinuation. In one study, it was found that 50 percent of affected patients were still experiencing withdrawal symptoms two weeks after full discontinuation.

Slowly reducing the dose under the supervision of a doctor will help curb the worst of the withdrawal symptoms. Make sure you let your doctor know if you are experiencing particularly bad symptoms.

The FDA does not offer specific guidelines for how long weaning off the drug should take, so it will be up to your doctor to decide. Most of the time, coming off duloxetine will be done throughout a month or more, to keep the decreases gradual.

The good news is that there is an end to it. Many people report feeling better within a month of stopping completely, and even those for whom it takes longer do eventually feel better.

The main way to manage Cymbalta discontinuation syndrome is by slowly reducing the dose with the help of your doctor. Withdrawal symptoms may still happen, but they are likely to be less severe than what you would feel if you stopped suddenly. Check up with your doctor regularly, and let your doctor know how you are feeling.

Some physicians have reported success by prescribing fluoxetine (Prozac) to patients for a few weeks. By doing this, they can reduce the tapering time (you would still not come off the medication at once) and smooth out the overall process. Talk to your doctor to see if the option of prescribing another antidepressant is available to you. Do not, under any circumstances, attempt to switch or transition medications by yourself.

Coming off duloxetine can be extremely difficult and painful, and it is essential to do so under the supervision of a doctor. Because duloxetine is not a common addictive substance — despite its withdrawal symptoms — you should make sure any recovery center you seek help from has a specific program to assist with withdrawal from antidepressants.

Finally, it is not uncommon to feel alone when you are going through duloxetine withdrawal. Luckily, there are many online forums online dedicated to Cymbalta withdrawal where you can connect and share with people going through the same thing as well as those who have now recovered. Use these resources for comfort and communication, but do not take direct action or advice without consulting a doctor; what might have worked for someone else will not necessarily work for you.
If you or a loved one would like additional support with duloxetine or another substance, contact The Recovery Village. Our staff are here to answer any questions you may have.