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  • Cymbalta (Duloxetine)Cymbalta (Duloxetine)
  • Can It Treat Anxiety?Can It Treat Anxiety?
  • How to Take CymbaltaHow to Take Cymbalta
  • When Does It Start to Work?When Does It Start to Work?
  • Cymbalta DosagesCymbalta Dosages
  • Side EffectsSide Effects
  • Warnings & RisksWarnings & Risks
  • Is Overdose Possible?Is Overdose Possible?
  • Substances to AvoidSubstances to Avoid
  • Cymbalta AlternativesCymbalta Alternatives
  • Questions to AskQuestions to Ask
  • ConclusionConclusion
  • Additional ResourcesAdditional Resources

Cymbalta For Anxiety: Effectiveness, Dosage, & More

Diana Rangaves, PharmD, RPh

Author: Diana Rangaves, PharmD, RPh

Diana Rangaves, PharmD, RPh

Diana Rangaves PharmD, RPh

Diana Rangaves is an accomplished pharmacist and expert in behavioral health pharmacology. Her areas of expertise include patient education, medication cost-reduction, and patient-centered treatment.

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Headshot of Dena Westphalen, Pharm. D.

Medical Reviewer: Dena Westphalen, Pharm.D Licensed medical reviewer

Headshot of Dena Westphalen, Pharm. D.

Dena Westphalen PharmD

Dr. Dena Westphalen is a pharmacist with expertise in clinical research and drug information. She has interests in neurology, oncology, and global health.

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Published: January 13, 2023
  • Cymbalta (Duloxetine)Cymbalta (Duloxetine)
  • Can It Treat Anxiety?Can It Treat Anxiety?
  • How to Take CymbaltaHow to Take Cymbalta
  • When Does It Start to Work?When Does It Start to Work?
  • Cymbalta DosagesCymbalta Dosages
  • Side EffectsSide Effects
  • Warnings & RisksWarnings & Risks
  • Is Overdose Possible?Is Overdose Possible?
  • Substances to AvoidSubstances to Avoid
  • Cymbalta AlternativesCymbalta Alternatives
  • Questions to AskQuestions to Ask
  • ConclusionConclusion
  • Additional ResourcesAdditional Resources
Dr. Diana Rangaves PharmD
Written by:

Diana Rangaves

PharmD, RPh
Dena Westphalen, PharmD
Reviewed by:

Dena Westphalen

PharmD
Brand name:
Cymbalta
Generic name:
Duloxetine
Is the generic available:
Yes
Class of drug:
SNRI
Boxed warning:
Yes
FDA-approved treatments:
Major Depression, Generalized Anxiety Disorder, diabetic neuropathy, Fibromyalgia, musculoskeletal pain
Common Off-label Uses (non-FDA approved):
Chemotherapy-induced peripheral neuropathy, stress urinary incontinence, osteoarthritic pain
Common alternatives:

Zoloft, Celexa, Prozac

View Drug Class, FDA-Approved Uses, Off-Label Uses, and more

*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.

Cymbalta is an antidepressant used to treat generalized anxiety disorder (GAD) and major depressive disorder (MDD). It works by boosting levels of serotonin and norepinephrine in the brain, helping to improve anxiety symptoms. Always consult with your doctor before taking any antidepressants, as they pose the risk for adverse side effects in users.

If you’re considering Cymbalta as treatment for anxiety, online psychiatry platforms such as Talkiatry and Brightside Health can connect you with a provider quickly. They offer assessments and can provide a prescription if they determine X or another medication may help your symptoms.

Boxed Warning: Duloxetine (Cymbalta) – Risk of suicidal thoughts and behaviors in certain people

Click here to open and close the box warning container.

Cymbalta, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Duloxetine can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with duloxetine and any other medications before starting treatment.

What Is Cymbalta (Duloxetine)?

Cymbalta, also known by its generic name duloxetine, is an FDA-approved antidepressant for treating major depressive disorder (MDD) in adults and generalized anxiety disorder (GAD) in adults and pediatric patients over the age of seven. Cymbalta belongs to the serotonin and norepinephrine reuptake inhibitors (SNRIs) class of drugs that regulate serotonin and norepinephrine levels in the brain. This helps to improve symptoms of depression and anxiety.1

While effective, Cymbalta will not be recommended to everyone, as the drug will react differently in a person’s body depending on their health and genetic makeup. Adults and children above seven years old can take this antidepressant under their doctor’s guidance.

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Can Cymbalta Treat Anxiety?

If you have been diagnosed with an anxiety disorder, your doctor may prescribe an antidepressant to relieve your symptoms, one of which being Cymbalta. Antidepressants do not cure anxiety, but work to improve and reduce symptoms. Cymbalta belongs to the SNRIs class of drugs and works by regulating levels of serotonin and norepinephrine in the brain.

Cymbalta is FDA-approved for the treatment of anxiety. Because every body reacts differently to its active ingredient duloxetine, symptom improvements vary greatly based on the individual. In some populations, certain antidepressants for anxiety may fail to work or lead to unwanted results.2

Cymbalta can help in the treatment of:3

  • Generalized anxiety disorder (GAD)
  • Social anxiety disorder
  • Panic disorder
  • Specific phobias
  • Separation anxiety
  • Obsessive-compulsive disorders

How to Take Cymbalta for Anxiety

Cymbalta is available as delayed release pellets that you swallow. Cymbalta is usually taken once daily with or without food. Like any other prescription, it should be taken as prescribed by a doctor. Abruptly discontinuing your Cymbalta medication can lead to severe withdrawal symptoms. If you want to stop your medication, consult with your physician to understand any possible risks and side effects.

How Long Does it Take for Cymbalta to Work?

How quickly a person will experience symptom relief while taking Cymbalta depends on several factors, such as their physical health, stress levels, and genetics. Most patients will notice symptom improvement after the fourth to eighth week of initial dosage.4 Cymbalta can also lead to sleep or appetite improvements within the first one to two weeks.2

Cymbalta Dosage for Anxiety Disorders

A Cymbalta dosage for anxiety disorders varies for each individual. Typically, a starting dose for adults is 60 mg per day and 30 mg per day for geriatric and pediatric patients. The maximum dosage for adults, geriatric, and pediatric patients is 120 mg per day.1 In order to ascertain the efficacy of Cymbalta, your doctor will start you off on a smaller dosage to note symptom improvements. Your doctor may increase your dosage after several weeks to the recommended maximum. However, your doctor may consider a better alternative if the medication does not produce desirable results.

Side Effects of Cymbalta While Treating Anxiety

Antidepressants are commonly associated with side effects that may or may not require immediate medical attention. You will likely experience some side effects within the first two weeks of starting your Cymbalta medication. These side effects commonly include dizziness, sleeping difficulty, and diarrhea.

Common Cymbalta side effects can include:1

  • Drowsiness
  • Fatigue
  • Diarrhea
  • Constipation
  • Headache
  • Dry mouth
  • Blurred vision
  • Sleeping difficulties
  • Sweating
  • Nausea
  • Sore gums

Serious Cymbalta side effects that may require immediate attention can include:1

  • Suicidal thoughts or ideation
  • Serotonin syndrome
  • Severe skin reactions
  • Low blood pressure that can cause a fall

When side effects persist or become severe, inform your doctor as soon as possible. Your doctor can help address the problem by providing better alternatives or tapering your dosage.

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Warnings & Associated Risks of Taking Cymbalta for Anxiety

While Cymbalta commonly results in mild side effects, more severe reactions can occur. How a person’s body responds to the drug, their pre-existing medical conditions, or interactions of substances such as alcohol or other antidepressants can lead to worsened effects. Mixing alcohol with Cymbalta will only worsen symptoms of anxiety. Older populations, breastfeeding and pregnant women, pediatric patients under seven years, and people with pre-existing medical conditions should only take the antidepressant under the guidance of a doctor.1

The medication should be taken as prescribed. Stopping Cymbalta can lead to withdrawal symptoms and serotonin syndrome. This includes worsening symptoms of agitation, irritability, hallucinations, and autonomic instability. If you are considering stopping your Cymbalta medication, consult your physician first.

Can You Overdose on Cymbalta?

It is possible to overdose on Cymbalta, resulting in severe and life-threatening symptoms. In the event of a Cymbalta overdose, call 9-1-1 for immediate emergency assistance. You should call your doctor as soon as possible or visit the nearest hospital quickly.

Possible symptoms of Cymbalta overdose include:

  • Vomiting
  • Dizziness
  • Seizures
  • Fast heartbeats
  • Coma

Substances to Avoid While Taking Cymbalta

Taking certain medications, herbs, or supplements alongside Cymbalta can change how Cymbalta works in your body or increase the risk for serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrists, and pharmacists know about all of the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Different antidepressants have different chemical components, and their interaction with the body varies from person to person. Therefore, mixing Cymbalta with other antidepressants can be life-threatening, as this can trigger or worsen the side effects of either substance.

Other medications, such as monoamine oxidase inhibitors (MAOIs), can pose a great threat to one’s physical health and life. Cymbalta should not be used within 14 days of stopping MAOIs as it increases the risk of serotonin syndrome. This also increases the risk of overdose, which may require immediate medical assistance.1

Substances that can interact with Cymbalta include:1

  • Blood thinners
  • NSAIDs
  • Other antidepressants
  • Water pills
  • MAOIs
  • Benzodiazepines
  • Anti-anxiety medications
  • Migraine drugs
  • Medication for stomach acid

Alternatives to Cymbalta for Anxiety

Sometimes, taking Cymbalta for anxiety may not work or result in unwanted side effects. This can be influenced by several factors, including how the drug interacts with a person’s body, their current health conditions, or their genetic profile. A prescriber can offer alternatives to Cymbalta, such as Zoloft, Celexa, or Lexapro. Studies suggest that Zoloft may be more  effective in the treatment of symptoms relating to anxiety, agitation, and excessive fears.5
Some alternatives to Cymbalta to treat anxiety include:

  • Lexapro (escitalopram): Lexapro blocks serotonin reuptake only, while Cymbalta blocks the reuptake of both serotonin and norepinephrine in the neuronal synapse.6
  • Zoloft (sertraline): Cymbalta belongs to the SNRIs group of medications used to treat major depressive disorder and generalized anxiety disorder, while Zoloft is an SSRI antidepressant used to treat major depressive disorder.
  • Celexa (citalopram): Celexa is an SSRI antidepressant used to treat depression, while Cymbalta is an SNRI antidepressant used to treat MDD and GAD.

Questions to Ask Your Health Team

Cymbalta is an antidepressant that can lead to severe side effects if not taken as prescribed by your doctor. Before starting Cymbalta, you must consult with your doctor to understand the possible risks.

Cymbalta medication can be prescribed by a:

  • Doctor
  • Therapist
  • Registered nurse
  • Psychiatrist

Questions to ask your care team about whether Cymbalta is right for you include:

  1. Will Cymbalta be effective in treating my anxiety?
  2. Is Cymbalta more effective at treating anxiety than the medication I am already taking?
  3. Can I take Cymbalta with the medication I am already taking?
  4. Are there alternatives to Cymbalta to treat my anxiety?
  5. What are the benefits of Cymbalta?
  6. How can I stop taking Cymbalta if I cannot tolerate its side effects?
  7. Should I be concerned if I mix the antidepressant with alcohol?
  8. What role will my health condition and medical history play when taking Cymbalta?
  9. What side effects should I watch out for?
  10. How do Cymbalta vs Effexor compare for depression and anxiety treatment?

Final Thoughts

Cymbalta can be an effective medication for your anxiety symptoms. However, taking the antidepressant is associated with common side effects which may or may not require immediate medical assistance. Talking with your doctor before starting the medication is essential as they will determine if Cymbalta is an appropriate prescription for you.

Additional Resources

To help our readers take the next step in their mental health journey, ChoosingTherapy.com has partnered with leaders in mental health and wellness. ChoosingTherapy.com is compensated for marketing by the companies included below.

Virtual Psychiatry

Circle Medical – Anxiety and Depression Treatment. Meet with an online doctor today! All prescriptions are based on necessity determined by a medical professional. Diagnosis and prescription over video. Insurance accepted. No membership or hidden fees. Same day appointments. Visit Circle Medical

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Brightside Health – develops personalized plans that are unique to you and offers 1 on 1 support from start to finish. Brightside Health accepts United Healthcare, Anthem, Cigna, and Aetna. Appointments in as little as 24 hours. Start Free Assessment

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For Further Reading

Cymbalta Weight Gain: Everything You Need to Know
Cymbalta & Alcohol: Understanding the Risks
How to Get a Cymbalta (Duloxetine) Prescription: Everything You Need to Know

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Best Online Psychiatry Services

Online psychiatry, sometimes called telepsychiatry, platforms offer medication management by phone, video, or secure messaging for a variety of mental health conditions. In some cases, online psychiatry may be more affordable than seeing an in-person provider. Mental health treatment has expanded to include many online psychiatry and therapy services. With so many choices, it can feel overwhelming to find the one that is right for you.

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Sources

ChoosingTherapy.com strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • CYMBALTA– duloxetine hydrochloride capsule, delayed release. (2021). DailyMed. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2f7d4d67-10c1-4bf4-a7f2-c185fbad64ba

  • Duloxetine (Cymbalta). (2021) NAMI: National Alliance on Mental Illness. Retrieved from https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Duloxetine-(Cymbalta)

  • Any anxiety disorder. (n.d.). National Institute of Mental Health (NIMH). Retrieved from https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder

  • Posternak, M. A. (2005). How quickly do antidepressants begin to work? Psychiatric Times. Retrieved from https://www.psychiatrictimes.com/view/how-quickly-do-antidepressants-begin-work

  • Wade, A., Gembert, K., & Florea, I. (2007). A comparative study of the efficacy of acute and continuation treatment with escitalopram versus duloxetine in patients with major depressive disorder. Current Medical Research and Opinion, 23(7), 1605–1614. https://doi.org/10.1185/030079907×210732

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