Cymbalta, available as duloxetine, is a type of antidepressant. This drug is on the approved list of Food and Drug Administration (FDA) to manage generalized anxiety disorder (GAD). Moreover, Cymbalta has been prescribed off-label for anxiety disorders, namely panic disorder and social anxiety disorder. If you want to know more about Cymbalta for anxiety, this article is a must-read.
Is Cymbalta effective for anxiety?
Cymbalta is a member of a group of medications referred to as serotonin and norepinephrine reuptake inhibitors (SNRIs). Serotonin and norepinephrine are neurotransmitters that convey information and are responsible for transmitting signals between nerve cells.
Serotonin’s function is to regulate our mood, behavior, memory, and feelings of joy. Norepinephrine is associated with alertness, increased energy, preparing the brain and body for action, and recalling memories. A balance of neurotransmitters ensures mood regulation. Serotonin and norepinephrine are formed in nerve cells and then released into the space between two nerve cells. After exerting their desired effect, serotonin and norepinephrine can be reabsorbed back into the nerve cell and recycled/reused in the following signal transmission cycle. Cymbalta for anxiety works by delaying/inhibiting the body’s reabsorption of these two neurotransmitters in the central nervous system.
Additionally, Cymbalta also increases dopamine levels by acting on dopamine reuptake pumps. Cumulatively, this helps those who have generalized anxiety disorder.
What types of anxiety disorders are treated with Cymbalta?
Cymbalta for anxiety and depression is commonly prescribed now and is a popular option. Cymbalta and anxiety go hand in hand, and the treatment is for those who have generalized anxiety disorder. Cymbalta for social anxiety is another use for this drug. Some conditions treated by Cymbalta include:
- Major depressive disorder (adults)
- Generalized anxiety disorder (in those above 7)
- Diabetic neuropathy
- Long-term muscular pain (in adults)
- Fibromyalgia (mostly in adults)
How does Cymbalta work for anxiety?
Cymbalta, for anxiety and panic attacks, helps by balancing the neurotransmitters serotonin and norepinephrine in the brain. GAD can stem from poor neural functioning, particularly in association with serotonin and noradrenaline.
Duloxetine for anxiety helps restore this balance of these neurotransmitters in the brain, preventing serotonin and norepinephrine reuptake by the nerve cells and hence increasing the amount of these neurotransmitters in the synaptic cleft, enabling them to send anxiety-reducing signals and stabilize mood.
What is the dosage of Cymbalta for anxiety?
The dose of Duloxetine (Cymbalta) you are given will depend on factors such as age and the condition or diagnosis.
Typically, the starting dose can be between 30 mg and 60 mg. This dose is taken by mouth once daily. Your total daily dose may be divided into two smaller doses to be taken twice daily. The dose will be adjusted, and you will be maintained on the dose depending on how well you respond to the medication. Generally, in the case of anxiety, the maximum daily dose is 60 mg, as studies indicate no additional benefit is achieved at 120mg per day.
Cymbalta may not be the best option if you have certain pre-existing medical conditions. However, in some cases, it can still be given Cymbalta can still be given a shot, but only your physician can decide that.
Some of these medical conditions include:
- Liver or kidney disease
- Low sodium levels
- The manic phase of bipolar disorder
- Bleeding problems
- High blood pressure
- Urination problems
What time should you take Cymbalta?
Ensure you read the leaflet containing the medication information and follow your doctor’s instructions. Following are some guidelines if you are taking Cymbalta for anxiety:
- The pill can be taken with or without a meal or snack.
- You can take Cymbalta any time, in the morning or the evening, but if you feel drowsy, nighttime would be better. Stick to the same time every day after choosing the time of the day that works for you.
- In case you forget to take your dose, take the pill as soon as you recall in order to prevent unpleasant withdrawal symptoms. However, if it is time for your next dose, skip your missed dose, as you do not want to take a double dose.
How quickly does Cymbalta work for anxiety?
It is essential to realize that Cymbalta does not work immediately. It may take six to eight weeks for Cymbalta to show the positive effects. This is mainly because balancing the serotonin and norepinephrine levels can take time.
Having said that, you may notice an improvement in anxiety-related symptoms, including better sleep, better energy levels, and appetite a lot earlier. Do not abruptly discontinue Cymbalta, even if you start feeling better. This results in a discontinuation syndrome, causing withdrawal-like symptoms, including nausea, diarrhea, irritability, dizziness, numbness, and anxiety. If you want to discontinue taking Cymbalta, you will have to be gradually weaned off it.
Significant improvement appears after taking Cymbalta for at least six months. It is common for people to feel worse initially because Cymbalta may increase anxiety, but this usually subsides if you keep taking it consistently.
Should I separate Cymbalta from my other medications for anxiety?
Usually, taking Cymbalta separately from your other medications isn’t a requirement. Even though Cymbalta has several potential interactions, it may not be necessary to take the pill separately.
However, it is essential to be aware of some interactions:
- Cimetidine and ciprofloxacin: These medications impact how Cymbalta is metabolized and affect the drug’s concentration in the body.
- (NSAIDs) like naproxen and ibuprofen: These can cause bleeding, and Cymbalta can raise your risk of bleeding. So, taking it with other medications that can cause bleeding can be dangerous.
- SSRIs, tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs): These medications can raise serotonin levels, and Cymbalta has that tendency as well. Too much serotonin can lead to the development of a serious condition called serotonin syndrome.
- Alcohol: Cymbalta increases the risk of liver injury in people who consume a lot of alcohol.
- Benzodiazepines or opioids: Combining Cymbalta with such medications worsens side effects, including drowsiness and dizziness.
Always provide your complete medication list to your healthcare provider or pharmacist so they can be mindful of these potential interactions.
When should I see a doctor?
Anxiety disorders can be severe and can affect your life drastically. Cymbalta may be the right option for some individuals to manage anxiety disorders, and it is commonly prescribed. If you are considering whether Cymbalta is the right choice for you, it is time to discuss the pros and cons of Cymbalta for anxiety with our doctor at Your Doctors Online.
FAQs about Cymbalta for anxiety
Cymbalta does not come under the umbrella of addictive drugs. However, discontinuation syndrome can occur when suddenly stopping the use of SSRI antidepressants like Cymbalta, leading to symptoms such as dizziness, nausea, vomiting, lethargy, problems sleeping, anxiety, irritability, numbness, or tingling sensations. Although Cymbalta is non-addictive, people do fall prey to addictive behaviors and develop dependence because they feel the need to take an increased dose of the drug to prevent the undesirable side effects of withdrawal.
The elderly population is more sensitive to developing side effects related to Cymbalta; they have low sodium blood levels, putting them at a slightly greater risk.
There isn’t sufficient information to conclude whether duloxetine is safe during pregnancy. Research doesn’t show a transparent link between this medication and birth defects. However, some research states that pregnant females who took Cymbalta in the final month of pregnancy are at a higher risk of bleeding post-childbirth. Furthermore, Cymbalta may be dangerous to the growing fetus, especially in the third trimester, putting them at risk for respiratory distress, feeding difficulties, and tremors in the baby.