For many people with depression, a diagnosis from a psychiatrist often means accepting that you will be on antidepressants for most of your life. You may decide to delay the first prescription for as long as possible, but after some time, antidepressants may be your last option. Unfortunately, from the time you accept medication, even as your symptoms lift, another heavy cloud hovers – the fact that the medications you now depend on can have adverse side effects at any time.
While stopping your medication might not be your best option, understanding the potential long-term effects of the medication is essential.
Today, we look at the effects of the long-term use of Cymbalta.
What is Cymbalta?
Cymbalta refers to the brand-name for duloxetine, the antidepressant that’s prescribed for the treatment of the symptoms of depression as well as anxiety, fibromyalgia, bone pain, and even diabetic nerve damage.
It belongs in the serotonin-norepinephrine reuptake inhibitors (SNRIs) class of medications and works by increasing the circulating levels of serotonin and even norepinephrine which are effective in mood regulation and in blocking the pain signals through the brain. The SNRIs cause neurotransmitter dysregulation. They change the normal function of neurotransmitters.
It was approved for human use by the FDA in 2004 under the brand name Cymbalta, and in 2013, the generic version of the drug, duloxetine was approved. In a 2012 study that was published in the International Journal of Clinical Practice, it was reported that Cymbalta was effective in easing osteoarthritis pain. At the same time, it was reported that the drug could cause fewer Cymbalta side effects in comparison with the traditional NSAIDs. The researchers, in their report, concluded that doctors might want to incorporate antidepressants into the treatment regimen for patients suffering from osteoarthritis.
Effects of Cymbalta
In the short term, patients starting their Cymbalta treatment or individuals increasing their dose reported a significantly higher risk of developing suicidal thoughts and behaviors. This risk is higher for patients under 24 years, therefor requires close monitoring by a medical professional. This side-effect is why the drug isn’t prescribed to anyone under the age of 18. Besides the suicidal thoughts, patients could also experience panic attacks, irritability, abnormal excitement, extreme worry, restlessness, and aggression.
In the long term, some of Cymbalta’s possible side effects include:
- Weight gain: In a 2011 study on the long-term use of Cymbalta, it was reported that patients taking Cymbalta for a long time recorded weight increase of up to 16 percent from their initial weight.
- Worsening Glaucoma: Patients suffering from the uncontrolled and narrow-angle glaucoma taking Cymbalta reported worsening of the glaucoma symptoms
- Increased risk of liver damage: The long-term use of this antidepressant, especially in persons who abuse alcohol is an increased risk of liver damage because alcohol exacerbates the effects of the drug.
- High blood pressure: prolonged use of the drug causes high-blood pressure and lightheadedness, especially if you stand up too fast after lying down or sitting.
- Loss of libido: this has been reported in as high as 72 percent of individuals using antidepressants with 65 percent of the patients unable to reach orgasm.
- Emotional numbness: caring less about others, and not feeling like yourself.
- Increase of suicidal thoughts
- Inability to stop the medication because of the extreme withdrawal effects.
Attempting to stop the drug has effects that doctors don’t normally mention or deny they exist. Cymbalta withdrawal is now being referred to by doctors as “Cymbalta discontinuation syndrome” which explains the severity of the drug’s withdrawal symptoms. Because of the discontinuation syndrome, patients are discouraged from going off cold turkey. This goes for any other antidepressant as well – always taper!
Much of the anecdotal evidence reports the effects of withdrawal include distress, agitation, self-harm, and other life-threatening effects. Patients with the discontinuation syndrome note that the experience is horrific with some describing it as “Going through Hell” or it being in a “Nightmare.”
Multiple placebo-controlled studies found that 44.3% of people quitting Cymbalta (duloxetine) reported withdrawal symptoms compared to the 22.9% of people in the placebo group. The most common symptoms included dizziness, nausea, and headaches.
Common discontinuation syndrome symptoms include:
- Nausea and vomiting
- Flu-like symptoms
- Sensory disturbances
- Loss of balance
- “Brain Zaps”
One extremely common withdrawal effect people report experiencing is what the internet is now referring to as “brain zaps”. The name brain zap was given to the electric shock-like or sensations in their head when discontinuing the medication.
The Times cited another study that looked at 180 long-term antidepressant users and 130 of the reported withdrawal symptoms. The studies authors mentioned “Many were critical of the lack of information given by prescribers with regard to withdrawal. And many also expressed disappointment or frustration with the lack of support available in managing withdrawal.”
While the easiest way of getting through or avoiding the discontinuation syndrome would be as simple as reducing a patient’s dosage gradually, aka a micro-taper. Cymbalta is available in three doses of 20mg, 30mg, and 60mg; and it only comes in capsule form making it very difficult to actually taper the dosage. At the same time, the directions for administration of the drug warn against crushing, chewing or opening the capsule, or even sprinkling the contents in food or mixing with a liquid.
You should consider speaking to your doctor about a safe discontinuation plan. Often, the plan involves switching to another antidepressant that you can taper off with ease. But, if you would like to learn about alternatives, see our Cymbalta withdrawal stack.
It is now apparent that the absence of data on the long-term use of antidepressants is to blame for the high number of patients now struggling with health issues arising from being on antidepressants for too long. According to data analyzed by The Times, up to 58 percent of older white females have made antidepressants their long-term solution with the number of long-term users piling annually.
Unfortunately, there is no consensus on the best way to use antidepressants among doctors with some of the drug manufacturers denying the severe effects of the drugs in the long term. When starting Cymbalta or any other antidepressant, it is best to get a second opinion on both the duration of use as well as the tapering plan from another doctor.