Last updated: 17 October 2023 & medically reviewed by Dr. Celeste Small
Cymbalta (Duloxetine) is a form of SNRI antidepressant used to treat a range of depression and anxiety disorders. While many consider antidepressants like Cymbalta to be non-addictive, there is still a chance of dependence forming if the drug is abused in high quantities or over long periods of time.
- Cymbalta doesn’t produce euphoric effects like other drugs when abused but it is still often misused for its mood-enhancing and calming properties
- MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication
- Even when used in the prescribed amount, there is a chance someone who stops taking Cymbalta will develop withdrawal symptoms. These symptoms are so common that they have gained their own cynical term; Cymbalta Discontinuation Syndrome
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Understanding Cymbalta (Duloxetine)
Duloxetine is sold under the brand name Cymbalta and is a serotonin-norepinephrine reuptake inhibitor (SNRI) prescription antidepressant. Cymbalta is used to treat depression and generalized anxiety disorder, depressive disorder, and a range of other mental health conditions. The exact mechanism of action is unknown. It inhibits reuptake of serotonin and norepinephrine and is metabolized by the liver with a half-life of 12 hours.
It is also often used as pain relief for chronic pain conditions like arthritis, fibromyalgia, and musculoskeletal pain, as well as nerve pain associated with medical conditions like diabetes. It also helps rebalance the neurotransmitters in the brain responsible for mood and pain and can help improve sleep patterns, energy levels and decrease nervousness.
Cymbalta comes in a time-release capsule form of between 40 and 60 mg and is often abused by crushing and mixing with liquids to get the full dose at once. Abrupt discontinuance may result in negative symptoms (eg, dizziness, nausea, headache, paresthesia, fatigue, vomiting, irritability, insomnia, diarrhea, anxiety, hyperhidrosis, or excessive sweating)
Effects of Cymbalta abuse
The effects of taking Cymbalta in the recommended dosage can include a wide range of mental and physical benefits including improved appetite, sleep patterns, energy levels, and all-around mood. When abused, Cymbalta can also produce a wide range of adverse effects as well. These include psychological and physical symptoms, such as:
Loss of appetite
Low blood pressure
In rare cases, more extreme side effects may present themselves, usually only found in those who have abused Cymbalta for long periods of time or in large doses. These include liver disease, sexual dysfunction, and colitis. Liver damage can also occur for those who abuse Cymbalta alongside alcohol.
Cymbalta may impair platelet aggregation and increase the risk of bleeding events, ranging from ecchymoses, hematomas, epistaxis, petechiae, and GI hemorrhage to life-threatening hemorrhage; concomitant use of aspirin, NSAIDs, warfarin, other anticoagulants, or other drugs known to affect platelet function may add to this risk.
Cymbalta doesn’t produce euphoric effects like other drugs when abused but it is still often misused for its mood-enhancing and calming properties. When taken orally, the drug has an extended time release, meaning people who abuse Cymbalta will often crush the tablets and dissolve them in water to get their effects instantly. This method of ingesting the drug can cause complications such as skin rashes, convulsions, and abdominal cramping.
Cymbalta and other medications
Other medications can affect the removal of Cymbalta from the body, which may affect how duloxetine works. It is important to recognize these possible interactions if someone is abusing Cymbalta while on these drugs:
cimetidine, fluvoxamine, viloxazine, and certain quinolone antibiotics (such as ciprofloxacin, enoxacin)
antiarrhythmic drugs (such as propafenone, flecainide, quinidine), antipsychotics (such as thioridazine), tricyclic antidepressants (such as desipramine, imipramine, Elavil)
MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and at least 5 days after treatment with this medication.
Signs of Cymbalta abuse
While antidepressants like Cymbalta are generally considered to be non-addictive, there is still the possibility of a dependence forming if abused regularly or in large doses. Cymbalta also has adverse withdrawal symptoms that can develop even if a person takes the recommended dosage and stops.
This can lead to people continuing to abuse the substance in order to avoid withdrawal symptoms, which in turn can build up a tolerance to the substance, create a physical dependence, and ultimately addiction when the negative consequences of dependence accumulate.
As antidepressants like Cymbalta have become prevalent in today's society, and because the negative indicators of abuse may be indistinguishable at first from the positive benefits the drug can have for those suffering from mental health disorders, it is not always easy to spot the signs of misuse. Here are some signs that someone may be abusing Cymbalta:
Exaggerating symptoms (to get a prescription)
Financial difficulties from purchasing Cymbalta
Irregular sleep patterns
Cymbalta withdrawal, detox, and treatment
Even when used in the prescribed amount, there is a chance someone who stops taking Cymbalta will develop withdrawal symptoms. These symptoms are so common that they have gained their own cynical term; Cymbalta Discontinuation Syndrome. Cymbalta withdrawal symptoms can be extremely uncomfortable, including symptoms such as nausea and vomiting, migraines, and often rebound withdrawal symptoms such as increased anxiety, depression, insomnia, and suicidal ideation. It is for this reason that anyone who has a Cymbalta addiction or dependence should not attempt to quit taking the drug cold turkey or alone and should seek a medically assisted detox treatment to help with the effects of withdrawal. There is also the possibility for someone abusing Cymbalta to develop serotonin syndrome, a condition that can be fatal if left untreated.
Detoxing in an addiction treatment facility can ensure that the patient goes through the detox process safely and comfortably, and greatly increases the chances of full recovery. Withdrawal symptoms (even if assisted by a medical detox) can last for a couple of weeks and in some cases months. For the best chances for successful sobriety, those addicted to antidepressants like Cymbalta should attend an inpatient or outpatient rehab facility. These treatment centers will offer a detox program followed by a full course of rehabilitation practices as part of a treatment plan including therapy and medical treatment to manage cravings and withdrawal.
If you or someone you know is suffering from Cymbalta addiction, contact a treatment center today to see what help is available.