Serotonin and norepinephrine reuptake inhibitors (SNRIs) are medications used to treat depression, anxiety and certain nerve pain conditions. They can help with the intense feelings that come along with depression and anxiety and some of the physical symptoms, like decreased appetite and sleep issues.

Before you start taking any psychiatric medication, it’s important to understand its intended effects and the potential side effects. You should also work closely with a psychiatrist or a clinician who’s qualified to help with medication management. 

This article describes how Cymbalta works and what side effects you should be aware of. It outlines the mild side effects that are common with Cymbalta and others that are rare but serious. 

What side effects of Cymbalta should I be aware of?

It can take several weeks to acclimate to a new SNRI, and in these first few weeks, some mild side effects are common. These typically go away after your body adjusts to the new medication. Don’t stop taking Cymbalta unless you have specific instructions from your doctor. You may experience some withdrawal symptoms or antidepressant discontinuation syndrome. Let your prescriber know about any medical conditions, drug allergies or other medications you’re taking before you start any antidepressant. 

Cymbalta can cause more serious side effects, too, such as drug-induced movement disorders, confusion, serotonin syndrome and high blood pressure. With antidepressants, there’s always a risk of developing suicidal ideation. Mention any side effects you’re noticing to your prescriber, even if they’re mild. They need an accurate idea of when the side effects started and how the medication is affecting your overall well-being. 

Cymbalta may cause the following side effects:

• Headache
• Cough
• Dry mouth
• Lack or loss of strength
• Muscle ache
• Nausea
• Sleepiness or unusual drowsiness
• Insomnia
• Decreased appetite
• Difficulty having a bowel movement 
• Ear congestion
• Frequent urination
• Sneezing
• Sore throat or loss of voice
• Stuffy or runny nose
• Increased sweating
• Weight loss

Less common side effects of Cymbalta

Imbalances of serotonin and norepinephrine can cause serious effects in the body, which is why it’s important to disclose all the side effects you’re noticing to your prescriber. Some of the more serious side effects of Cymbalta include drug-induced movement disorders, such as tremors or tardive dyskinesia. High blood pressure and confusion are also side effects that can have dangerous outcomes. 

Serotonin syndrome can occur with any drug that affects serotonin levels — it occurs when there’s too much serotonin present in the brain. Some symptoms of serotonin syndrome include mental state changes such as confusion or hallucinations, rigidity, nausea, vomiting, overactive reflexes, and involuntary muscle contractions. Some signs of autonomic dysfunction due to serotonin syndrome can present as flushing, rapid heart rate or elevated body temperature. This condition can be life threatening, so prompt recognition and treatment is critical. 

The following side effects are rare but serious reactions that are possible with Cymbalta:

• Sexual dysfunction
• Indigestion or sour stomach
• Sensations that feel like “pins and needles” or tingling, prickling, burning, crawling, itching or numbness
• Change in taste
• Difficulty moving
• Feeling of warmth or redness of the face, neck, arms or upper chest
• Heartburn
• Loose stools
• Trembling in the legs, arms, hands or feet
• Swollen joints

What to know before taking Cymbalta

Cymbalta, or the generic version duloxetine, is sometimes used to treat pain caused by diabetic peripheral neuropathy (nerve damage), fibromyalgia and other types of chronic pain in addition to depression and anxiety. Like other SNRIs, Cymbalta works by increasing the amount of neurotransmitters called serotonin and norepinephrine in the brain. It does this by blocking the brain’s reuptake or absorption of these neurotransmitters so more of them remain available. 

The potential risks and benefits of taking drugs like Cymbalta are highly unique to each individual. People with advanced age or certain medical conditions like kidney or liver dysfunction, high blood pressure, heart disease, hyponatremia (low sodium), and others may be at a higher risk for serious side effects. Cymbalta comes with a particular risk of liver damage, especially for individuals with preexisting liver conditions or those who consume substantial amounts of alcohol. It has some potential drug interactions, including other psychiatric medications. People with bipolar disorder shouldn’t take Cymbalta. 

You may also want to learn about the functions of serotonin and norepinephrine in the brain and body. Serotonin and norepinephrine are both neurotransmitters and peripheral hormones that play important roles in other organs and systems. Serotonin controls several functions, for example, energy metabolism and motility in parts of the gastrointestinal tract. It helps regulate important cardiovascular and respiratory processes as well as cell growth and immune responses. Norepinephrine, on the other hand, helps regulate arousal, attention, cognitive function and stress reactions, including fight, flight, fawn and freeze responses.

Medication management is part of our treatment programs at Lightfully

Many different factors will affect your body’s response to different SNRIs, so it’s important that your prescriber has a detailed understanding of your past and present health conditions, any medications and supplements you’re taking, and the depression or anxiety symptoms you need help with. Based on your medical history, your prescriber can help you determine if you’re at risk for any serious side effects. 

At Lightfully, we take a holistic approach to mental health care that recognizes the important role of physical health. Our process-based treatment (PBT) model emphasizes each client’s active role in creating and carrying out their individualized treatment plan. When medication is necessary, our staff psychiatrists consult with clients about the symptoms they’re experiencing and the potential effects of recommended treatments. 

Are you looking for a treatment program that incorporates medication management and your overall health and wellness? Our Day Treatment Program and Residential Treatment Centers (RTCs) are safe environments where you’ll have a lot of support during periods of adjustment to new medications. Reach out to our Admissions Concierge Team. Let’s see if one of our programs is right for you.