Cymbalta is an anti-depressant medication that is used to treat chronic pain, mood disorders, and anxiety. Classed as a serotonin-norepinephrine reuptake inhibitor (SNRI), this type of anti-depressant works by increasing serotonin and norepinephrine in the brain, resulting in reduced pain, improved mood, and a decrease in anxiety.

While Cymbalta often provides relief for patients, it is known to be a difficult anti-depressant to withdraw from. This is due to the physical symptoms and psychological challenges that arise if the drug is discontinued.

Luckily, however, there are several options when it comes to recovering from Cymbalta addiction. In this article, we cover the typical symptoms encountered during Cymbalta withdrawal and the timelines for recovery. We also address the range of treatment options available.

Overview

Successfully withdrawing from Cymbalta involves multiple stages of rehab that target the physical, psychological, and emotional causes of use. However, the first stage is to detox from the drug itself. This requires an individual to stop taking Cymbalta, and this is best done through medically supervised detox.

During detox, an individual will experience withdrawal symptoms, which can vary between each person. These are also dependent on several factors, such as:

  • Levels of tolerance
  • Individual physiology
  • Duration of use
  • Dose and frequency of use
  • “Poly-drug use” (using multiple drugs at once)
  • Co-occurring conditions or mental health issues

Cymbalta Withdrawal Symptoms


Cymbalta has a reputation as being a drug that is difficult to stop taking due to its withdrawal symptoms. These withdrawal symptoms are so common, in fact, that doctors have termed it “Cymbalta Discontinuation Syndrome.” However, while these symptoms are frequently encountered, they are not as severe as other SNRIs, such as Effexor.

General withdrawal symptoms from Cymbalta include:

  • Severe headaches
  • Dizziness
  • Nausea and vomiting
  • Paresthesia (burning or prickling sensation in arms, legs, hands, or feet)
  • Irritability
  • Nightmares and insomnia
  • Diarrhea
  • Anxiety
  • Excessive sweating
  • Vertigo
  • Fatigue
  • Seizures
  • Suicidal thoughts

Withdrawal Timeline

Individuals who abuse Cymbalta or other antidepressants may have been consuming the drug for a long time, or for longer than intended. While effects can vary, some studies note that as many as 40% – 60% of people report withdrawal symptoms. These can become more severe if the drug is discontinued abruptly.

While there is no universal timeline for Cymbalta withdrawal, an approximate one can look like the following:

First Phase (After 12 Hours)

Depending on the severity of use, the first phase of Cymbalta withdrawal can occur within the first 12 hours after the last dose (or reduced dose). By this time, around 50% of the drug is still in the system, so minor withdrawal symptoms can appear.

Second Phase (Days 1-3)

After 24 hours, a person can begin to experience acute signs of withdrawal. This includes nausea, sweating, agitation, and irritability. Symptoms typically peak by the second or third day.

Third Phase (Weeks 1-4)

Depending on the individual, withdrawal symptoms can last for a few days or for several weeks. The most difficult symptoms are psychological, as many individuals can experience rebound depression, anxiety, and suicidal thoughts.

Post-Acute Withdrawal Syndrome (PAWS)

If withdrawal symptoms last longer than a month, this is referred to as “post-acute withdrawal syndrome” (PAWS). The PAWS period differs depending on the drug, but for anti-depressants like Cymbalta, the effects can even last for several months. While many people report that withdrawal is mild, there have been other reports of severe symptoms like mood swings, debilitating “brain zaps,” and physical and neurological problems.

Is Withdrawal Dangerous?

Anti-depressant withdrawal is less dangerous than it is with street drugs, and rarely requires hospitalization. The primary concerns when it comes to detoxing are relapses and mood alteration. However, some of the risks that can occur during Cymbalta withdrawal include:

Injuries or Accidents

Withdrawal can result in increased fatigue and insomnia. Therefore, driving or activities that require concentration can be a struggle.

Severe Depression

One of the main withdrawal symptoms from Cymbalta is worsened depression, and this can become severe.

Suicidal Ideation

In some cases, Cymbalta can lead to suicidal thoughts and behaviors. As the withdrawal period is often characterized by rebound depression and anxiety, it’s best to be monitored in a safe environment.

There are other long-term health complications associated with Cymbalta, and these will depend on several factors, such as the duration and intensity of use.

Cymbalta Treatment Programs

The good news is that treatment for Cymbalta abuse is available. While every individual is unique and will have different needs, many centers provide tailored recovery plans. Below is a list of the most common forms of drug abuse treatment programs and what they entail.

Detox Programs

Detox programs are available at certain clinics and medical facilities where they supervise a person’s drug withdrawal and provide supportive medications, where necessary. These clinics are usually staffed with a team of doctors and nurses who have experience with addiction and drug withdrawal.

The advantage of going to a detox center is that medical assistance is readily available. When it comes to anti-depressants, a tailored weaning off program is often necessary, as suddenly ceasing use can be dangerous. A detox center will place you in comfortable surroundings where you can be assured of help in case of emergencies. These clinics also provide medications to ease some of the symptoms.

Short-Term Inpatient (Residential)

Short-term inpatient centers typically start with medical detox and are followed by a program of addiction treatment such as therapy or counseling for 30 to 90 days. These programs range from basic inpatient to luxury options, all varying in terms of their amenities and types of therapy. These facilities usually provide 24-hour medical support and are often led by a team of counselors, clinicians, and doctors. Short-term inpatient rehab is ideal for individuals who need detoxing and therapy, but who don’t require long-term treatment.

Long-Term Inpatient

Long-term inpatient treatment programs vary in length, but typically range from between 3 to 18 months. This type of rehab is best suited to individuals with long-term chronic addictions, especially those who have co-occurring mental health issues. Long-term treatment also provides an opportunity for the individual to physically withdraw from Cymbalta while they focus on their mental and emotional rehabilitation. These centers also vary in terms of their provision of amenities, which range from basic to luxury options.

Partial Hospitalization Programs (PHP)

For individuals who are seeking intensive treatment but still prefer to live at home, partial hospitalization (PHP) or day treatment programs are also available. PHP typically consists of hospital treatment 5 to 7 days a week for 4 to 8 hours per day. Like inpatient treatment, clinical staff are on hand to assist with detox, medication management, and withdrawal symptoms. PHP also involves counseling and group therapy, as well as specialized services that focus on skill-building, relapse prevention, and employment assistance.

Intensive Outpatient Programs (IOP)

Intensive outpatient programs are less involved than partial hospitalization programs and typically take place at a treatment center or outpatient clinic. Clients receiving intensive outpatient treatment will usually visit the center 2 to 5 days per week for 2 to 4 hours per day. IOP is well suited to clients who have just completed inpatient rehab and who wish to receive intense treatment while living off site. Programs vary, but they often involve a mixture of individual and group therapy, case management, 12-Step programs, experiential therapies, cognitive-behavioral therapies (CBT), and services that cover topics like skill-building, goal setting, and relapse prevention.

Standard Outpatient Programs

Standard outpatient programs are suited to individuals who have just completed an inpatient program and want to continue some form of therapy. Standard outpatient programs are also ideal for people who may be juggling other responsibilities, such as work or school. Individuals typically report to a treatment center or clinic 1 or 2 days per week. These programs can include counseling, group therapy, 12-Step groups, skills development, goal setting, and relapse prevention training.

Cold Turkey

Stopping Cymbalta use on your own is not recommended. Not only it is dangerous because of the way the drug affects the central nervous system, but complications and uncomfortable side effects can also occur during withdrawal. Detoxing from Cymbalta is best done safely under medical supervision where clinicians can keep you safe and comfortable.

Therapeutic Modalities

During rehab, centers and clinics will provide a range of treatments, such as medications, counseling, and behavioral therapies. This is especially useful for anti-depressant substance abuse, as many individuals who take these drugs have co-occurring or underlying mental health conditions. Below are some of the more effective therapy options for anti-depressant abuse and addiction.

Dual Diagnosis

Rehab facilities that offer dual diagnosis are often staffed with psychiatrists or clinical therapists that can diagnose and/or treat co-occurring mental health conditions. This kind of treatment is especially useful for people who have underlying issues such as depression, anxiety, and post-traumatic stress disorder (PTSD). This allows clinicians to address these conditions alongside withdrawal from the Cymbalta itself.

Cognitive-Behavioral Therapy (CBT)

One of the most effective therapies for substance abuse and depression is cognitive-behavioral therapy (CBT). CBT helps individuals change negative cycles of thought and behavior into more positive ones. Clients receiving CBT often learn how to recognize “automatic thoughts” and dysfunctional thinking patterns, how to understand the behavior and motivation of others, and how to develop a greater sense of self-understanding and confidence. CBT also helps clients find solutions to triggers that might encourage drug use. CBT is known to be effective and long-lasting, as clients can continue utilizing these strategies once their therapy sessions have ended.

Dialectical-Behavior Therapy (DBT)

Dialectical-behavior therapy (DBT) is a type of cognitive-behavioral therapy that focuses on mindfulness, how to live in the moment, cope with stress, and improve relationships. DBT also helps clients identify negative influences in their lives and learn how to develop healthy coping skills. This kind of therapy is useful for people who have been addicted to Cymbalta, especially those who have anxiety or mood disorders. DBT is also effective for PTSD and for people who exhibit self-destructive behaviors.

The Matrix Model

The Matrix Model is another form of therapy that has shown to be effective in treating various forms of substance abuse. This 16-week approach is comprehensive and consists of a mixture of behavioral therapy, individual counseling, 12-Step support, family education, drug testing, and encouraging non-drug-related activities. Through guided therapy, patients learn about issues connected to addiction and relapse. These sessions are designed to promote self-esteem and self-worth while the patient and therapist work together to reinforce positive behavioral changes.

Contingency Management

Contingency management is another effective treatment and is based on a reward system. In most cases, the therapist provides incentives to the patient in exchange for ongoing abstinence and acceptance of treatment. One well-known contingency approach is Motivational Incentives for Enhancing Drug Abuse Recovery (MIEDAR), which is effective for teaching individuals that it is possible to achieve abstinence using self-control. Participants who continue to abstain receive rewards, such as prize draws for money or in-demand objects.

Medications & Supplements

There are currently no specific medications for treating Cymbalta abuse. However, there are some medications and supplements that have proven to be helpful during the rehabilitation process.

Other Anti-Depressants

Depending on your situation, your doctor may prescribe other anti-depressants as part of the tapering process. For example, they may substitute a longer-acting anti-depressant for a shorter-acting one.

Supplements

During the detox process, doctors may also provide supplements to assist with the withdrawal symptoms. While some of the supplements below are recommended for weaning off other anti-depressants, they can also be beneficial for Cymbalta withdrawal:

  • Activated Charcoal: helps eliminate residual toxins in the body.
  • Melatonin: helps with regulating sleep cycles.
  • Fish Oil or Krill Oil: reduces symptoms like brain zaps, anxiety, and aggression.
  • Magnesium: helps calm and de-stress the body.
  • Vitamin B Complex: helps with energy and aids in the production of serotonin.
  • 5-HTP or L-Tryptophan: helps the body produce serotonin.
  • John’s Wort: a herb that naturally helps with rebound depression.

Alternative or Holistic Therapies

Many rehab centers also provide holistic therapies. The purpose of these therapies is to treat the whole person and not just the symptoms. These can be incredibly beneficial for providing calmness, spiritual support, emotional expression, improving physical health, and teaching valuable skills. Some of the popular holistic therapies include:

  • Nutritional therapy
  • Animal-assisted therapy (e.g., emotional support dogs)
  • Massage therapy
  • Adventure therapy (e.g., hiking or rock climbing)
  • Mindfulness and meditation
  • Art therapy and music therapy
  • Yoga
  • Equine-assisted (horse) therapy

Lifestyle Adjustments

Recovering from Cymbalta abuse can be challenging, but there are ways to make this process easier. Along with treatment, lifestyle adjustments and self-care can ease the symptoms while transitioning to a new life.

  • Exercise: can stimulate endorphins, which can help with anxiety, depression, and low mood. Examples include low- and high-intensity exercises such as walking, running, swimming, cycling, or yoga.
  • Meditation: can calm anxious or racing thoughts and improve cognitive function, which is useful when recovering from depression, anxiety, or chronic pain.
  • Eating Well: the right diet can help repair damage incurred following sustained drug use and lead to improved immunity, cognitive function, and energy.
  • Avoiding Triggers: learning to avoid triggers like certain people, situations, or circumstances can help prevent a desire to take drugs (even prescription ones).
  • New Hobbies: while cravings can be difficult to manage, hobbies such as sports, art, music, or crafts can be useful distractions.

Resources

If you or a loved one are struggling with Cymbalta abuse, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.

You can also find a list of treatment centers near you on our website to help get you on the path to recovery.

Key Sources

Pam, N. (2016). How to Deal with Zoloft Withdrawal. Psychologydictionary.org. https://psychologydictionary.org/article/how-to-deal-with-zoloft-withdrawal.

Perahia, D. (2005). Symptoms following abrupt discontinuation of duloxetine treatment in patients with major depressive disorder. J Affect Disord. 89(1-3), 207-12. https://doi.org/10.1016/j.jad.2005.09.003.

O’Keefe Osborn, C. How Long Does Withdrawal From Cymbalta Last? Verwellmind.com. https://www.verywellmind.com/cymbalta-withdrawal-symptoms-timeline-and-treatment-4707711#citation-1

Medical Disclaimer

At RehabAid.com, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.

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