Cymbalta® is an effective and popular antidepressant drug that may, if you’re struggling with forms of depression or anxiety (or a multitude of other issues), change your life. But it’s also a medication that may require some life changes to make work. Case in point? Cymbalta and alcohol.
Whether you’re a social drinker or someone who struggles with alcohol addiction, it’s definitely worth looking into whether or not Cymbalta is the right medication for you.
It’s used for a variety purposes, including neuropathy, fibromyalgia and musculoskeletal pain, as well as in the treatment of generalized anxiety disorder and major depressive disorder.
This medication essentially works to treat pain and mental disorders by regulating the supply of the neurotransmitters serotonin, norepinephrine and dopamine.
It increases serotonin and dopamine in the prefrontal cortex, essentially making it great for addressing the nerve and mood pains that ail us.
Unfortunately, this comes with some potential side effects and side effect risks. Duloxetine may increase your risk of suicidality, serotonin syndrome, insomnia, fatigue, erectile dysfunction, tremor, diarrhea, nausea and other conditions and common side effects associated with SNRIs.
And then there’s the danger of mixing it with booze.
The relationship between Cymbalta (duloxetine) and alcohol is sort of complicated.
On the one hand, there’s evidence to suggest that taking a low dose of duloxetine can actually decrease your alcohol intake and alcohol craving.
A study in rats found that low doses of duloxetine decreased self-administration of ethanol in the rat population. Basically, the rats’ depression and alcohol consumption went down on the drug.
So, if you’re an alcoholic trying to wean yourself off, a healthcare professional may actually prescribe this medication (off-label) with a secondary benefit to help you with alcoholism. Maybe
This information is interesting for people aggressively trying to quit drinking, but in people who are, well, still drinking, there’s a bigger problem to consider: suicide risk.
Numerous studies have shown that antidepressant use with simultaneous heavy drinking or alcohol abuse can increase the risk of suicidal ideation and suicidality.
The fact is that comorbid alcohol dependence and mood disorder is a dangerous place to be, and if you’re dealing with depression, you may want to lay off the drinking for the good of your mental health.
And then there’s the risk of liver damage.
In some cases, alcohol and Cymbalta consumption together can cause serious liver damage and even liver failure.
Duloxetine was associated with higher levels of ALT, AST, and ALP — liver enzymes that are markers for liver damage.
The research suggested that duloxetine can induce liver damage in patients with a medical history of chronic liver disease or alcohol consumption, as well as patients with major depressive disorder.
This is all aside from the other dangers associated with alcohol and antidepressant use. Seek medical attention if you’ve done this.
According to Cymbalta’s Food and Drug Administration (FDA) package insert, Cymbalta should not be prescribed to people with “substantial alcohol use” or anyone with any kind of history of liver issues.
However, the FDA is vague about what “substantial” means.
Could you drink a glass of merlot with dinner while also on Cymbalta? Maybe. Should you? Probably not.
Alcohol use with antidepressants is generally a bad idea, but it’s particularly bad with a medication that can cause the additional dangers of liver damage.
At the very least, it’s important to let your healthcare provider know about your alcohol usage before getting a prescription for this medication.
This is one of those “you have to answer honestly” situations, even if the topic of how often you drink — and how much you drink when you do it — feels embarrassing. Liver damage can lead to liver failure, and avoiding an awkward conversation is not worth that level of health risk.
Excessive alcohol is arguably the biggest danger when taking Cymbalta and other SNRIs, though it’s not the only one. The National Library of Medicine points to a few other things to avoid while taking Cymbalta, including another form of antidepressant called monoamine oxidase inhibitors or MAOIs.
There are warnings for new and expectant mothers because these medications can have effects on fetal development and can be transmitted through breast milk.
Elderly patients are also cautioned against SNRI use, but generally, the big conflicts are alcohol and other drugs for mood disorders.
Don’t drink while taking Cymbalta. That’s the big picture.
Still with us? Good. Medications like antidepressants should be discussed thoroughly with a healthcare professional before you begin taking them, and those conversations should include any other drugs, alcohol, tobacco consumption or other vices you’re keeping on the side.
There’s no shame in them, but failing to disclose some of your less-than-stellar vices could actually, genuinely lead to your death.
Treating depression does not have to be hard. It doesn’t have to drastically reshape your social life, but it does take honesty. Healthcare professionals can help you find the tools you need for your own tailored solution. If that means using a medication that still allows for a healthy drinking life, they can do that.
Treatment for depression might not even involve medication in your case — it may simply require therapy or changes in lifestyle to promote better health. You just won’t know until you talk to someone.
Ready to start that conversation? Do it right now; do it with us — online counseling is an option available to you immediately, so you can quit worrying about depression treatment, and start getting it.
Alcoholic beverage or otherwise, we’ll toast to that.
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Dr. Angela Sheddan has been a Family Nurse Practitioner since 2005, practicing in community, urgent and retail health capacities. She has also worked in an operational capacity as an educator for clinical operations for retail clinics.
She received her undergraduate degree from the University of Tennessee at Chattanooga, her master’s from the University of Tennessee Health Science Center in Memphis, and her Doctor of Nursing Practice from the University of Alabama in Tuscaloosa. You can find Angela on LinkedIn for more information.