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Reviewed by Jill Johnson, DNP, APRN, FNP-BC
Written by Our Editorial Team
The world of mental health medications is a vast one. From SSRIs to stimulants and everything in-between, finding a drug that works well with your body and actually treats your condition can feel like a huge feat.
Cymbalta® is just one of these medications. And whether you’re considering taking Cymbalta or you’ve already started taking it, you’re probably wondering: when does this stuff start working?
Cymbalta can take six to eight weeks to start “working” fully, but it depends on a variety of factors.
In this piece, we’re going to cover what to expect when you start using Cymbalta® to treat your mental health, and how long you can expect it to take to work.
Cymbalta is a brand name for a drug known generically as duloxetine hydrochloride, or duloxetine for short.
It is also used to treat physical health conditions like diabetic peripheral neuropathy, fibromyalgia, chronic musculoskeletal pain, chemotherapy-induced peripheral neuropathy and urinary incontinence.
Today, we’re focusing on how duloxetine can be used to manage your mental health.
So, what exactly is a SNRI?
SNRIs are a class of drugs that are known as antidepressants, but can be used to treat a host of both mental and physical conditions.
They work by discouraging your brain’s reabsorption (or reuptake) of serotonin and norepinephrine, so that your body has a more readily available supply of these neurotransmitter-like hormones.
You can think of serotonin and norepinephrine as what you may have heard described as “happy hormones”,. Your brain uses these, along with others like dopamine, to regulate your mood, which is why SNRIs are effective for the treatment of depression and anxiety.
Duloxetine has the added benefit of increasing the production of dopamine in your brain. However, unlike its mechanism on serotonin and norepinephrine, it does not inhibit the reabsorption of this particular neurotransmitter hormone.
You can think of dopamine, serotonin and norepinephrine as messages that the nerve cells in your brain send to one another, allowing bits of information to pass between your nerve cells. The increased availability of them results in improvements in mood and anxiety.
In the world of mental health, Cymbalta is used for the treatment of generalized anxiety disorder, and major depressive disorder.
Anxiety disorders are the most common type of mental disorder. According to the American Psychiatric Association, they affect nearly 30 percent of adults at some point in their lives.
Anxiety and fear themselves are normal parts of our emotional regulation, and are our natural reaction to stressors.
Anxiety is related to stress surrounding the future, while fear is related to stress in the immediate moment.
When anxiety or fear become out of proportion to a given situation, age inappropriate, or hinder a person’s ability to live a normal life, it can be an indication that the person is suffering from an anxiety disorder.
There are a variety of anxiety disorders, including generalized anxiety disorder, panic disorder and a variety of phobias, to name a few.
Cymbalta is effective in the treatment of generalized anxiety disorder, a condition in which a person experiences uncontrolled fear or anxiety more often than not for a period of six months or more, and exhibits at least three of the following symptoms,:
A sense of impending doom, panic or danger
Feelings of nervousness, irritability or being on the edge
Feeling weak, tired or having trouble sleeping or concentrating
Experiencing an increased heart rate, trembling, sweating or hyperventilation
Experiencing gastrointestinal issues, including weight loss
It is important to note that regardless of its severity, anxiety should be taken seriously. In cases of mild or moderate anxiety, some people find themselves able to go forward with their everyday lives.
Individuals with severe anxiety may struggle to function and complete tasks like leaving the house.
The ability to keep functioning does not mean that anxiety is not valid. Over time, anxiety can have adverse effects on physical health, including complications like high blood pressure.
Options for treating anxiety include prescription medication, as well as therapy or online counseling with a mental healthcare provider.
These treatments can be effective for reducing feelings of anxiety and helping patients get back to living a more balanced life.
Like feelings of anxiety or fear, feelings of sadness every now and then are a normal part of our emotional regulation.
Major depressive disorder or clinical depression, however, is a medical condition that takes these feelings further to the point where they have a negative impact on quality of life.
It has the effect of putting the sufferer in a negative state of mind, eliciting feelings of extreme sadness, unhappiness and discontent, resulting in difficulties around going about daily life.
There exist a variety of depressive disorders, including psychotic depression, seasonal affective disorder and persistent depressive disorder.
In order to be diagnosed with depression, symptoms must persist for at least two weeks.
Symptoms of clinical depression include:
Feelings of anxiousness, sadness, hopelessness, emptiness, worthlessness, guilt, helplessness or pessimism
Difficulty with memory, making decisions or concentration
Thoughts of self harm or suicide
Decreased energy, loss of interest in activities that normally provide pleasure and increase in fatigue
Feelings or irritability or restlessness
Trouble with falling asleep or staying asleep
Changes in appetite or weight loss or gain
It is important to understand that depression can present differently in men than it does in women, with men being more likely to hide or ignore the emotional symptoms of depression. They’re more likely to seek treatment when the symptoms cross into the physical, like aches and pains, headaches, and digestive issues.
Similar to anxiety, options for treatment of major depressive disorder include medications like Cymbalta and therapy with your mental health provider.
It’s also worth noting specifically that in people with bipolar disorder, using Cymbalta to treat depressive episodes can put them at risk of switching from a depressive state into a manic episode, so make sure you speak to your healthcare provider specifically if you have a history of manic episodes.
So, how long does it take for Cymbalta to work for depression or anxiety?
The answer is, it depends on your symptoms. Overall, it takes the drug several weeks of treatment to go into full effect.
However, for symptoms like lack of sleep, energy or appetite you may notice improvements within the first one to two weeks.
For other symptoms, like lack of interest in activities or depressed mood, you’ll need to wait closer to six to eight weeks to see full improvement.
You’ll also want to keep an eye out for common side effects of Cymbalta, and get in touch with your healthcare provider if you notice any of them.
Side effects that may occur but often go away within the first one to two weeks include:
Feelings of nervousness, restlessness, fatigue or trouble sleeping
Nausea, headache and diarrhea
Other common side effects include increases in blood pressure, and sexual side effects like trouble reaching orgasm or ejaculating. These, unfortunately, do not often improve over time.
Rare and more serious possible side effects of Cymbalta include drops in blood pressure when moving from sitting to standing, serotonin syndrome, increased heart rate, glaucoma (a symptom of which can be eye pain) and others.
Cymbalta also comes with a Black Box Warning from the Food and Drug Administration (FDA), which means children, adolescents or young adults age 24 and younger are at increased risk for suicidal thoughts and behaviors.
If you start noticing this after taking Cymbalta, contact your healthcare provider immediately.
To read about another potential side effect, check out: Does Cymbalta Cause Hair Loss?
First things first, do not, under any circumstances, stop taking your medication before getting medical advice from your mental healthcare provider.
It’s important that any change in your dosage of Cymbalta be guided by your provider to mitigate any potential negative effects from the change, especially if you’ve ever experienced suicidal ideations or are using Cymbalta to treat depression that is a function of bipolar disorder.
You’ll want to get in touch with your healthcare provider and talk about options available to you like shifting your dosage or shifting medications altogether.
Cymbalta is used to treat a host of medical conditions, from mental disorders to chronic musculoskeletal pain.
When using to treat anxiety or depression, remember that it can take several weeks to reach its full effect.
You’ll want to be in close contact with your healthcare provider as you begin treatment with this medication to ensure as smooth an experience as possible.
Dr. Jill Johnson is a board-certified Family Nurse Practitioner and board-certified in Aesthetic Medicine. She has clinical and leadership experience in emergency services, Family Practice, and Aesthetics.
Jill graduated with honors from Frontier Nursing University School of Midwifery and Family Practice, where she received a Master of Science in Nursing with a specialty in Family Nursing. She completed her doctoral degree at Case Western Reserve University.
Jill is a national speaker on various topics involving critical care, emergency and air medical topics. She has authored and reviewed for numerous publications. You can find Jill on Linkedin for more information.