What Are the Problems With Discontinuing Cymbalta?

Cymbalta (duloxetine) is a drug used to treat general anxiety disorder, major depressive disorder, fibromyalgia, and diabetic peripheral neuropathic pain. It is a selective serotonin norepinephrine reuptake inhibitor (SSNRI) and is thought to work by balancing the chemicals in the brain responsible for pain and depression.

Discontinuation syndrome

• A condition known as “discontinuation syndrome” has been reported in patients taking Cymbalta who abruptly stop or miss a dose.

Discontinuation symptoms

• Patients who miss a dose or stop abruptly can experience dizziness, nausea, headache, fatigue, paraesthesia, vomiting, irritability, nightmares, insomnia, diarrhea, and anxiety.

Adverse events

• Adverse events that have been reported include dysphoric mood, agitation, electric-shock-like sensation, hypomania, and seizures.

Prevention/Solution

• Eli Lilly, the manufacturer of Cymbalta, strongly recommends patients be monitored by their prescribing physician when stopping treatment. They also recommend decreasing the dose gradually.

Warning

• The Food and Drug Administration has issued a black box warning for Cymbalta because there is a risk that patients taking the drug may develop suicidal thoughts or behaviors.