Cymbalta (Duloxetine) for Panic Disorder

Uses, How It Works, Side Effects, and Precautions

Close-up of prescription drugs
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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 that as well.

Uses

Cymbalta is a medication that 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 later found to be an effective treatment option 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 such as 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 sometimes used to treat hot flashes that occur in menopause and urinary incontinence too.

SNRIs are considered a safe and effective way to treat panic disorder. They also tend to have fewer side effects than other types of antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs). 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 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:

  • Nausea or vomiting
  • Constipation
  • Diarrhea
  • Dry mouth
  • Drowsiness and fatigue
  • Dizziness
  • Headaches
  • Sexual effects like decreased libido
  • Decreased appetite
  • Increased nervousness
  • Upset stomach or abdominal pain
  • Insomnia
  • Sweating
  • Difficulty urinating
  • Weakness
  • Tremor

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.

How Long It Takes to Work

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

There are some precautions to consider when taking Cymbalta, including:

  • Black box warning: 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 cause suicidal thoughts and actions. Teens and young adults up to the age of 24 years old were found to be especially at risk for these adverse side effects. 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.
  • 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, as well as 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.
  • Alcohol consumption: Drinking alcohol while taking Cymbalta is not recommended. Alcohol consumption runs the risk of increasing the toxicity of Cymbalta, potentially impacting its effectiveness and leading to more serious side effects.
  • 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.

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