Cymbalta For Pain, Anxiety & Other Uses

Last Updated: June 17, 2021

Authored by Sharon Levy, MD, MPH

Reviewed by Michael Espelin APRN

Cymbalta (Duloxetine HCl) is an antidepressant drug that millions of people in the United States use daily. Like other antidepressants, Cymbalta for anxiety or depression is the most widespread use. However, there are other health conditions it is used to treat off-label. Although the medication is not generally considered addictive, it still has some abuse potential. Cymbalta abuse can occur even in those who only meant to use it as prescribed.

So, what is Cymbalta used for? Is it safe? What are the symptoms of misuse? And how to avoid abuse while taking it?

What Is Duloxetine?

Cymbalta, also known by its generic name of Duloxetine, is a prescription medication. The primary ingredient in the medicine is Duloxetine HCL. It was developed for the treatment of major depressive disorder; however, it is now used to treat numerous mental health conditions and some pain disorders.

Upset stressed man coping with depression.

The Duloxetine drug class is an antidepressant. It belongs to the antidepressant subclass called selective serotonin norepinephrine reuptake inhibitors, or SNRIs. It has the potential to cause Duloxetine interactions when taken with other substances. Additionally, users can be allergic to the ingredients used in the Cymbalta medication. Close medical supervision can help keep users safe.

Doses and Strengths

What Duloxetine dosage is needed depends on the patient and the condition being treated. In general, whatever the dosage, it is taken once per day.

The capsules, which are the main dosage form, should be swallowed whole and not crushed or chewed.

Here Are the Main Dosage Forms and Strengths:

  • 20mg opaque green capsule with “Lilly 3235 20mg” imprint
  • 30mg opaque white and blue capsules with “Lilly 3240 30mg” imprint
  • 60mg opaque green and blue capsules with “Lilly 3270 60mg” or “Lilly 3237 60mg” imprints

Is Cymbalta Safe?

Many patients worry that Duloxetine treatment is dangerous to use. While there are Duloxetine side effects that can be severe, they are rare. Users need to be aware of the risks of Cymbalta medication but should trust their doctor’s guidance in prescribing it.

All drugs come with risks and health benefits. For most users, the benefits make any side effects worth it.

These Benefits Include:

  • Stimulation of two neurotransmitters (serotonin and norepinephrine) that impact depression rather than just one
  • More balanced sense of emotions when compared to single-action antidepressants
  • The ability to treat physical symptoms of depression
  • Lower occurrence of side effects when compared to some other antidepressant drugs

However, this does not mean that Cymbalta medication is suitable for everyone. For example, Cymbalta sexual effects in men can outweigh the benefits the medication offers. Also, using the drug during pregnancy is not recommended. Ultimately, patients must work closely with their doctor to determine if Duloxetine is the proper treatment they should choose.

Overall, the use of Duloxetine is safe. As long as the patient is taking Duloxetine hydrochloride as directed by a doctor and has proper medical supervision, the chances are good that nothing will go wrong. However, if the medication is misused, problems will arise.

What Is Cymbalta Used For?

There are many health conditions among Cymbalta uses. They can be divided into two classes: those with FDA approval and those done off-label. Even though off-label indications are not FDA approved, there are studies that prove its effectiveness for these specific conditions.

FDA-Approved Cymbalta Uses:

  • Depression, including bipolar disorder
  • Diabetic peripheral neuropathic pain
  • Generalized anxiety disorder
  • Fibromyalgia
  • Chronic musculoskeletal pain, including that caused by arthritis

Off-Label Cymbalta Uses:

  • Migraines
  • Back pain
  • Glaucoma
  • ADHD
  • Restless Leg Syndrome (RLS)
  • Obsessive-Compulsive Disorder (OCD)
  • Chronic Fatigue Syndrome (CFS)
  • Multiple Sclerosis (MS)
  • Urinary Incontinence (SUI)
  • General chronic pain, not caused by one of the FDA-approved conditions

Cymbalta For Anxiety and Depression

Among all psychiatric disorders, anxiety is the most common one. Approximately 31% of US citizens experience anxiety at some point in their lives. As a result, the choice for anti-anxiety drugs has become broader. Many drugs are indicated for this condition, including Duloxetine.

Despite treating many different conditions, the best-known Cymbalta uses are to treat depression and anxiety. Because the drug’s classification is an antidepressant, the general association between the medicine and these conditions makes sense.

Cymbalta for anxiety brings balance to two neurotransmitters, serotonin, and norepinephrine. It restores balance by preventing these neurotransmitters from quick absorption. This way, it fights anxiety.

Taking the drug for depression requires heavy monitoring, as one of the side effects is new or increasing suicidal thoughts. There is also a risk when taking Cymbalta for anxiety. However, the risk is greatest with depression.

Cymbalta For Pain

Cymbalta for pain is another indication for use. Many doctors prescribe it for neuropathic pain related to diabetes or injury. However, it is generally recommended that Cymbalta for pain only be considered once other drugs have been proven ineffective.

Besides, it is becoming more and more common for doctors to prescribe Duloxetine for fibromyalgia. It is unsurprising, as studies have found it more effective than many options of traditional treatment. As with treating nerve pain, it is known to cause adverse effects, but given that it can treat both the pain of fibromyalgia and the depression suffering from the condition often causes, many doctors are using it as their go-to for fibro treatment.

Cymbalta capsules on black background.

Less common among Cymbalta uses is back pain. However, many doctors believe that it is an effective use of the drug. Given that Duloxetine can help other kinds of pain, this is a logical conclusion.

There are two primary types of back pain Duloxetine is used to treat. Doctors use Duloxetine for osteoarthritis pain in the back, caused by arthritis developing in the spine and hip joints. They also use it for sciatica, which is considered a type of nerve pain.

Cymbalta Abuse

Cymbalta abuse is possible; however, it is less common than with other drugs. The drug has low abuse potential. This is because the supposed high it delivers is just the medication helping relieve depression, and abusing the medicine does not increase the feelings of euphoria. Additionally, misuse tends to increase the negative side effects to such a degree that most people tempted to abuse the medication will quickly stop doing so.

Despite this, some people misuse it. In most cases, addicts attempt to potentiate the drug with other substances, such as mixing Cymbalta and alcohol. Mixing any drug with alcohol is not a good idea. And speaking about Duloxetine, there are also many risks associated with this mix.

In any case, Cymbalta abuse is dangerous. When taken in high amounts or mixed with other substances, Cymbalta overdose is possible. Additionally, misuse can make Duloxetine withdrawal even stronger when the user stops the drug. Abuse of the medication should be avoided at all costs.

Symptoms Of Abuse

Cymbalta abuse is hard to observe as an outsider. Many of the signs and symptoms can look like side effects of the medication or may seem to be symptoms of the illness the drug is meant to treat. For example, abuse can increase Cymbalta weight gain, but doctors and loved ones might assume this is a natural effect of the medication. However, if multiple signs are observed, abuse should be suspected.

In Addition to Increased Side Effects, Signs of Duloxetine Abuse Include:

  • Unclear speech
  • Red eyes
  • Sudden and unreasonable changes in behavior, including hygiene and physical appearance
  • Loss of appetite
  • Sleeping problems: insomnia or constant sleepiness
  • Faking the symptoms to get a medication prescription
  • Lack of finances and often money borrowing

When symptoms are noticed, the user should be encouraged to seek help. They mustn’t stop the medication cold turkey, as this can result in serious complications.

Is Duloxetine Addictive?

The official stance of the medical community is that Duloxetine is not addictive. However, Cymbalta abuse and misuse undoubtedly occur, and both physical and psychological dependence is possible.

Abusing the medication generally means there are large amounts of the medication present in the body. Physically, a person’s body can become so dependent on the drug that withdrawal occurs not long after Duloxetine half-life is reached, pushing the user to take more of the drug. Mentally, users can fear what life will be like without the drug and feel compelled to continue taking and abusing it.

For many people misusing the drug, addiction and dependence do not feel all that different. Treatment for both is the same. The user must seek help in weaning off and then undergo therapy to help them avoid abuse in the future.

Stay Aware Of Duloxetine Dangers

When taken correctly, Duloxetine is almost always safe. However, abuse and misuse make the drug dangerous. Whether one uses Cymbalta for pain or depression, a danger of Cymbalta abuse may arise, and help is needed. Anyone who is taking the drug improperly should seek help in getting and staying clean. While the doctor can guide and advise to find the proper drug addiction facility, the patients need to be willing to undergo treatment for better outcomes.

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Page Sources

  1. FDA, Cymbalta (duloxetine hydrochloride) Delayed-Release Capsules for Oral Use. https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022516lbl.pdf
  2. National Institute of Mental Health, Any Anxiety Disorder, 2017. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder
  3. Ball, S. G., Desaiah, D., Zhang, Q., Thase, M. E., & Perahia, D. G. (2013). Efficacy and safety of duloxetine 60 mg once daily in major depressive disorder: a review with expert commentary. Drugs in context, 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3884746/
  4. Evans, E. A., & Sullivan, M. A. (2014). Abuse and misuse of antidepressants. Substance abuse and rehabilitation, 5, 107. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140701/
  5. Wright, C. L., Mist, S. D., Ross, R. L., & Jones, K. D. (2010). Duloxetine for the treatment of fibromyalgia. Expert review of clinical immunology, 6(5), 745-756. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056054/
  6. Lunn, M. P., Hughes, R. A., & Wiffen, P. J. (2009). Duloxetine for treating painful neuropathy or chronic pain. Cochrane database of systematic reviews, (4). https://pubmed.ncbi.nlm.nih.gov/19821395/
  7. Wright, A., & VanDenBerg, C. (2009). Duloxetine in the treatment of generalized anxiety disorder. International journal of general medicine, 2, 153. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840566/
  8. National Center for Biotechnology Information, Compound Symmary Duloxetine. https://pubchem.ncbi.nlm.nih.gov/compound/duloxetine
  9. Voznesenskaia, T. G., Leonova, A. R., & Kaverina, I. V. (2007). Treatment of chronic back pain with antidepressant cymbalta: an experimental study. Zhurnal nevrologii i psikhiatrii imeni SS Korsakova, 107(7), 20-24. https://pubmed.ncbi.nlm.nih.gov/18379477/

Published on: May 30th, 2019

Updated on: June 17th, 2021

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.