Panic Disorder Treatment Cymbalta (Duloxetine) for Panic Disorder Uses, How It Works, Side Effects, and Precautions By Katharina Star, PhD Katharina Star, PhD Facebook LinkedIn Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. Learn about our editorial process Updated on May 24, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Peter Dazeley / Getty Images Table of Contents View All Table of Contents Uses Method of Action Side Effects Timeline and Withdrawal Precautions Prescribed antidepressants are a common treatment option for panic disorder to help reduce the symptoms of panic attacks and anxiety. Cymbalta (duloxetine) is one type of antidepressant that's frequently prescribed for people who have been diagnosed with panic disorder. Because it's an antidepressant, Cymbalta can also help relieve symptoms of depression if you have been diagnosed with it. Uses Cymbalta belongs to a category of antidepressants called serotonin and norepinephrine reuptake inhibitors (SNRIs). Originally used to treat mood disorders like depression and bipolar disorder, SNRIs were found to be an effective treatment for anxiety disorders, such as panic disorder, generalized anxiety disorder (GAD), specific phobias, and social anxiety disorder (SAD), as well as agoraphobia. Additionally, these medications are prescribed to treat other mental health conditions. These include post-traumatic stress disorder (PTSD), body dysmorphic disorder, and obsessive-compulsive disorder (OCD). SNRIs can also be effective in treating pain associated with certain medical conditions like fibromyalgia, diabetic peripheral neuropathy, and chronic fatigue syndrome (CFS). They're also sometimes used to treat hot flashes that occur in menopause and certain types of urinary incontinence. SNRIs are considered a safe and effective way to treat panic disorder. They also tend to have fewer side effects than some of the older types of antidepressants. For these reasons, SNRIs have continued to grow in popularity for the treatment of mood and anxiety disorders. Aside from Cymbalta, other common SNRIs include Effexor (venlafaxine), Fetzima (levomilnacipran), and Pristiq (desvenlafaxine). Method of Action Neurotransmitters are naturally occurring chemicals that are located in your brain. These chemical messengers are responsible for relaying messages throughout your brain that impact many different bodily functions. It is thought that imbalances in some of these neurotransmitters can lead to mood and anxiety disorders. Cymbalta works to bring balance back to the neurotransmitters called serotonin and norepinephrine. Both of these chemical messengers are connected to panic disorder. Serotonin is involved in regulating many functions including mood and sleep and norepinephrine regulates the fight-or-flight stress response and reactions to anxiety. Cymbalta can restore balance by preventing your brain cells from quickly absorbing these neurotransmitters. By bringing equilibrium back to the chemicals in your brain, Cymbalta can help alleviate anxiety, lessen panic attacks, and improve your mood. Common Side Effects All prescribed medication has the potential for side effects and Cymbalta is no exception. Common side effects of Cymbalta include: ConstipationDecreased appetiteDiarrheaDifficulty urinatingDizzinessDrowsiness and fatigueDry mouthHeadachesIncreased nervousnessInsomniaNausea or vomitingSexual side effectsSweatingTremorUpset stomach or abdominal painWeakness Because side effects vary for different people, you may experience some, none, or all of these. Typically, these side effects will subside over time as your body adjusts to taking Cymbalta. Be sure to consult your doctor if you experience side effects that don’t seem to go away or if they become worse. Serious allergic drug reactions can also happen when taking Cymbalta. Contact your doctor or pharmacy immediately if you experience the side effects of vomiting, swelling of your mouth, tongue, and face, rash, hives, or difficulty breathing. Timeline and Withdrawal Don’t expect Cymbalta to immediately impact your symptoms of panic disorder. You may notice improvements within the first days to weeks of taking this medication. However, it can take up to several months to fully experience the benefits of Cymbalta. You may need to give your medication some time before deciding if it's working for you. Be sure that you don't just suddenly stop taking Cymbalta as you may experience uncomfortable discontinuation symptoms like dizziness, upset stomach, nausea, vomiting, diarrhea, headaches, anxiety, or sleeping difficulties. If you need to stop taking Cymbalta, talk to your doctor first so he or she can put you on a tapering schedule that gradually decreases your dose in order to avoid these withdrawal symptoms. Precautions Before you start taking a new medication it's important that you understand the risks. You should discuss the risks of taking Cymbalta with your doctor. Suicidal Thoughts and Actions In 2007, the U.S. Food and Drug Administration (FDA) decided to include a warning on SNRIs and other antidepressants. Known as a black box warning, the FDA cautions that these medications can potentially increase the risk for suicidal thoughts and actions. Children, teens, and young adults were found to be especially at risk for this. Your doctor should use caution and closely monitor you if you're taking SNRIs for a decline in your mood and/or suicidal thoughts, especially if you're in this at-risk age group. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. Other Concerns There are other precautions you should know about when taking Cymbalta. Alcohol Consumption Drinking alcohol while taking Cymbalta requires caution. Alcohol consumption runs the risk of increasing the toxicity of Cymbalta, potentially impacting its effectiveness and leading to more serious side effects. Other Medications Be sure to tell your doctor about all the other over-the-counter and prescription medications you're taking or plan to start taking. This also includes any vitamins, supplements, or herbal products, as many of these can interact with Cymbalta. Examples of drugs that are known to interact with Cymbalta include monoamine oxidase inhibitors (MAOIs), blood thinners, diuretics, migraine medications, certain other antidepressants, proton pump inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), and heart medications, among others. Special populations If you're pregnant or nursing, you should consult your doctor about taking Cymbalta, as it's possible to pass this medication to your baby. Older adults should also discuss the pros and cons of taking Cymbalta with their prescribing doctor, as older adults are at greater risk for experiencing the side effects of Cymbalta. A Word From Verywell The information provided here is meant to be an overview of the use of Cymbalta for panic disorder. The general information presented in this article does not cover all possible scenarios, such as potential severe side effects, overdose, and contraindications. Always consult your healthcare provider or pharmacist about any questions and/or concerns you may have about your Cymbalta prescription. Panic Disorder Treatment Options 4 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Muscatello MRA, Zoccali RA, Pandolfo G, et al. Duloxetine in Psychiatric Disorders: Expansions Beyond Major Depression and Generalized Anxiety Disorder. Front Psychiatry. 2019;10:772. doi:10.3389/fpsyt.2019.00772 Mosby. Mosby's Drug Reference for Health Professions. Elsevier Health Sciences; 2013. Nelson C. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Pharmacology, Administration, and Side Effects. UpToDate. Fornaro M, Anastasia A, Valchera A, et al. The FDA "Black Box" Warning on Antidepressant Suicide Risk in Young Adults: More Harm Than Benefits? Front Psychiatry. 2019;10:294. doi:10.3389/fpsyt.2019.00294 Additional Reading Dell'Osso B, Buoli M, Baldwin DS, Altamura AC. Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) in Anxiety Disorders: A Comprehensive Review of Their Clinical Efficacy. Human Psychopharmacology. January 2010;25(1):17–29. doi:10.1002/hup.1074. MedlinePlus. Duloxetine. The American Society of Health-System Pharmacists, Inc. National Institutes of Health. U.S. National Library of Medicine. Nelson C. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Pharmacology, Administration, and Side Effects. UpToDate. Silverman HM. The Pill Book. 15th ed. New York, NY: Bantam Books; 2015. By Katharina Star, PhD Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Panic Disorder Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.