Cymbalta is a brand name for the selective serotonin and norepinephrine reuptake inhibitor (SSNRI) drug duloxetine that is prescribed to treat depression, nerve pain associated with diabetes (diabetic peripheral neuropathy), anxiety, and pain related to fibromyalgia.
The drug works by increasing levels and activity of some of the chemical messengers in the brain, serotonin and norepinephrine. These neurotransmitters are produced by the brain and travel along the central nervous system, helping to regulate moods and block pain sensations.
When abused, a medication like Cymbalta may create a pleasant “high,” as it causes a burst of “happy” signals in the brain. Cymbalta then has psychoactive properties, which makes it a target for abuse.
At the time of the 2016 National Survey on Drug Use and Health (NSDUH), over 6 million Americans had abused a psychotherapeutic drug in the previous month. Abuse of antidepressant drugs like Cymbalta are not explicitly recorded; however, the journal Substance Abuse and Rehabilitation publishes that they are abused, usually for the psychostimulant properties they can produce.
They may also be used to self-medicate mental health symptoms or physical discomfort.
Cymbalta may be abused by taking the drug without a prescription, taking more of it at a time than directed, taking it between doses, taking it after a prescription has run out, or taking it in a way other than intended, such as chewing the capsule or crushing it and then snorting or injecting the powder. The FDA, on the prescription label for Cymbalta, warns that individuals should not stop taking the medication without the monitoring of a medical professional due to the discontinuation, or withdrawal, side effects that may occur. These withdrawal symptoms can be significant even if the drug is taken as directed and with a legitimate and necessary prescription; however, they are even worse when the drug is abused.
Medical detox is the ideal environment to safely stop taking Cymbalta. Under medical supervision, individuals can allow the drug to process out of the body while possible withdrawal symptoms are managed.
Cymbalta Withdrawal Syndrome
Cymbalta is a relatively long-acting drug, with a half-life of around 12 hours. Withdrawal symptoms will typically start when the drug wears off, which is in about a day or so. This means that about 24 hours after taking the last dose of Cymbalta, a person may experience withdrawal symptoms.
Cymbalta works by changing the chemical makeup of the brain. With regular use, even when taken exactly as prescribed, the brain can get used to the interaction of the drug and even rely on it to keep the natural brain chemicals balanced. This is called physical dependence, and it sets in after someone takes Cymbalta continually for a length of time.
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Once a dependence has formed, the brain will struggle to keep its chemical makeup stable without the drug’s interaction. When Cymbalta wears off, withdrawal symptoms are a result of the chemical imbalance that has been created. Levels of serotonin and norepinephrine drop without Cymbalta, which can drastically impact a person’s moods and even have physical manifestations. This results in various symptoms.
Physical withdrawal symptoms:
- Feeling of electrical “shocks” in brain
- Tingling in arms and legs
- Hyperactive senses and heightened pain sensations
- Overactive reflexes
- Fast heart rate
- Tinnitus (ringing in the ears)
Psychological withdrawal symptoms:
- Intense nightmares and sleep disturbances
- Potential suicidal thoughts
- Racing thoughts
- Mental confusion and “mental fog”
- Trouble feeling pleasure
- Extreme mood swings turning into rage quickly and without warning
- Hypomania (inflated sense of self-worth and elevated moods)
The physical side effects of Cymbalta withdrawal typically peak in 2-3 days and then start to taper off over the period of a week or so. The emotional withdrawal symptoms can last a little longer and may continue for a period of a few weeks or even months, lessening in intensity over time.
The Journal of Affective Disorders published a study wherein nearly half of all those taking duloxetine suffered from significant withdrawal symptoms when the drug was stopped suddenly and they were not fully resolved after two weeks. Withdrawal symptoms can greatly impact a person’s quality of life and, in some cases, may even be fatal, especially if the drug is mixed with other medications that impact levels of serotonin in the brain.
The Ochsner Journal warns that serotonin syndrome, which can be caused by medications that interact with serotonin receptors in the brain as Cymbalta does, is potentially life-threatening. Another possibly fatal reaction to stopping Cymbalta suddenly is the potential onset of symptoms similar to neuroleptic malignant syndrome (NMS), which the journal The Neurohospitalist explains can be caused by stopping an antipsychotic medication “cold turkey.” Cymbalta is not a drug that should be stopped suddenly after taking it for a period of time.
Medical Detox from Cymbalta
Withdrawal is not exactly the same for every person who takes Cymbalta. There are several factors that can influence how intense the side effects may be and how long they will last. These include:
- Length of time taking the drug
- How much Cymbalta was taken at a time
- The manner in which the drug was taken (e.g., as directed through a prescription or altered and taken recreationally)
- Presence of co-occurring medical or mental health disorders
- Use or abuse of other drugs or psychoactive substances at the same time
- Environmental factors, such as high levels of stress or an unstable home life
- Biological aspects like metabolism, etc.
- Prior personal or family history of drug abuse and/or addiction
The more significant Cymbalta dependence is, the greater the odds are that the withdrawal symptoms will be more difficult and last longer. During detox for Cymbalta, the drug is typically tapered off slowly. The dosage is lowered a little bit each day until it is down to zero. By slowly weaning off the drug, withdrawal symptoms can be managed. The brain can slowly restore its chemical balance on its own as the drug processes out instead of expecting it to try and regulate itself all at once.
Medical detox is generally performed in a specialized facility where professionals can monitor a client’s vital signs and offer mental health support and encouragement in a stable, calming, and safe environment. Medications are often helpful during medical detox to manage certain symptoms of withdrawal. Mood stabilizers, sleep aids, anti-nausea drugs, and non-narcotic pain medications may be helpful.
Medical detox typically lasts about 5-7 days on average and gives the brain a chance to stabilize while under the direct supervision of medical and mental health professionals. Nutritional supplements and a healthy balanced diet during detox can be beneficial to enhance a person’s general health and sense of wellbeing. After detox, a treatment program that offers therapeutic and supportive services is needed to minimize lasting Cymbalta withdrawal symptoms and address the substance abuse issue.