Cymbalta for Depression: Is It Effective?

Depression is one of the most common mental disorders. Around 21 million adults — just over eight percent of adults in the United States — have had a depressive episode.

The use of antidepressant drugs is on the rise as well, especially among women, who are using antidepressants almost twice as much as men.

But although they’re widely used, you may be curious how effective an antidepressant such as Cymbalta® is for depression, as finding the most effective treatment is a goal for many people with depressive disorders.

If you’re wondering whether Cymbalta for depression is effective and what the Cymbalta dosage for depression is, we’ve got more information about that. But let’s start with the basics of depression and this particular antidepressant.

Major depressive disorder is a mood disorder also referred to as major depression, clinical depression or depression.

Major depression in adults is characterized by a persistently low or “empty” mood or hopeless feeling that lasts for at least two weeks.

Depressive disorders can have both emotional and physical symptoms, and common symptoms of depression include:

• Irritability and anger, such as frustrated outbursts over minor issues

• Reduced appetite and weight loss

• Weight gain

• Fatigue

• Insomnia or oversleeping

• Feelings of restlessness, anxiety and agitation

• Physical pain, including headaches, abdominal pain, joint and/or muscle pain

• Digestive problems

• Difficulty concentrating or making decisions 

• Noticeably slower speech and movement

• Recurrent thoughts of death, suicidal thoughts and suicide attempts

Depressive symptoms can vary in severity and from person to person. Symptoms of depression can also vary by the depressive disorder someone has, with different types of depression having unique depressive symptoms.

There are different types of depressive disorders, with the most common ones being:

• Major depression. A mental disorder that causes negative changes to your mood and thoughts, with a loss of interest in everyday activities like work, sleeping and eating.

• Persistent depressive disorder (dysthymia). A type of depressive disorder that has less severe symptoms than major depression, but typically lasts longer, for at least two years.

• Perinatal depression. A type of depressive disorder characterized by major depression while pregnant or after giving birth — which is then called postpartum depression.

• Bipolar disorder (previously manic depression).  A condition characterized by someone experiencing both depressive episodes (periods of low moods with symptoms of depression) and periods of high or euphoric moods (mania).

• Seasonal affective disorder. A disorder where symptoms of depression are experienced in the late fall and winter and go away in the spring and summer months.
  

You can learn more about different depressive disorders in our guide to depression types, symptoms and more.

The treatment of depression usually includes medication, therapy or a combination of both. The most common medication treatment for major depression is antidepressant drugs, typically selective serotonin reuptake inhibitors (SSRIs).

Cymbalta is the brand name of the drug duloxetine. Duloxetine belongs to the group of antidepressant drugs known as serotonin-norepinephrine reuptake inhibitors (SNRIs).

These medications work by preventing the brain from reabsorbing the chemicals serotonin and norepinephrine, thereby increasing levels of these chemicals in your brain.

These two chemicals play a role in mood and behavior and are also associated with major depression.

Cymbalta is approved by the Food and Drug Administration for the treatment of several different psychiatric disorders, including major depression and generalized anxiety disorder, as well as diabetic nerve pain (also known as diabetic neuropathy), fibromyalgia (a disorder of widespread musculoskeletal pain) and chronic musculoskeletal pain.

Your healthcare provider may prescribe Cymbalta for depression based on different factors, including your symptoms of depression and your general health.

As with many antidepressant drugs, Cymbalta does have side effects.

Common side effects of duloxetine include:

• Nausea

• Drowsiness or sleepiness

• Headache

• Dry mouth

• Decreased appetite

• Increased sweating

• Sexual side effects

Cymbalta can also affect your sleep, although in different ways. You can learn more about these effects in our guide on how to sleep while taking Cymbalta.

Weight gain or weight loss may also be other common side effects. These side effects are covered in more detail in our article on Cymbalta and weight gain.

There can also be adverse effects, or more serious side effects, while taking Cymbalta for depression or other mental disorders.

Although these adverse effects are rare, they’re still possible. Whether or not you might develop these rarer side effects depends on many different factors.

The risk of serotonin syndrome, for example, can increase if you’re taking another medication or supplement that increases serotonin levels. Taking selective serotonin reuptake inhibitors (SSRIs) with serotonin-norepinephrine reuptake inhibitors like Cymbalta can increase the risk of serotonin syndrome, for example.

Serotonin syndrome is a serious, potentially life-threatening condition that occurs when serotonin levels in the body are too high.

Other medications or supplements that shouldn’t be used while taking Cymbalta include monoamine oxidase inhibitors (MAOIs), amphetamines, blood thinners, anti-inflammatory drugs like aspirin or ibuprofen, diuretics, fentanyl, St. John’s wort, tryptophan and others.

Always let your healthcare provider know about any medications or supplements you’re taking before starting Cymbalta.

Liver failure is another very rare side effect of Cymbalta, and the risk can increase even further with substantial use of alcohol or if you have chronic liver disease.

A drop in blood pressure can also occur when standing up after sleeping while on Cymbalta, especially if you’re taking medication for high blood pressure.

Other rare but serious side effects of duloxetine include:

• Increased heart rate

• Irregular menstrual cycle

• Difficulty urinating or increased frequency of urinating

• Eye pain, changes in vision or other symptoms of angle closure glaucoma

• Severely elevated blood pressure

• Heart attack

If you stop taking Cymbalta suddenly, you may experience withdrawal symptoms such as irritability, vomiting, nightmares or a prickling or tingling sensation on the skin. Consult with a healthcare provider for medical advice before you stop taking this medication.

Many of the mild side effects and physical symptoms of Cymbalta such as nausea, headache, drowsiness or dry mouth are temporary and go away after the first week or two. However, the sexual side effects and increased blood pressure do not tend to improve.

You should discuss any new or lasting symptoms with your healthcare provider if you start taking Cymbalta.

Cymbalta for depression comes in a delayed-release capsule taken orally once or twice a day.

The Cymbalta dosage for depression typically starts between 40 and 60mg a day, with the maximum dosage being 120mg daily.

You may take a dose of 20mg twice a day or a dose of 30mg two times per day, depending on whether you’re treating new depression or trying to keep depressive symptoms from returning.

For the best treatment of depression, you should take your prescription around the same time every day and follow the directions carefully.

You may be wondering if Cymbalta is effective for treatment of depression. Multiple clinical studies have looked at the safety and effectiveness of duloxetine in adults with depression, musculoskeletal pain and neuropathic pain from certain medical conditions.

Across eight double-blind, placebo-controlled trials looking at Cymbalta’s effectiveness in treating depressive symptoms, duloxetine was found to be consistently more effective than a placebo.

A short-term study found that a 40 to 120mg daily dose of duloxetine was far more effective and well-tolerated in depressed patients compared to 20mg daily doses of a placebo or the SSRI antidepressant fluoxetine.

Another placebo-controlled trial included a double-blind study of 12 weeks of treatment using a higher 60mg dosage of duloxetine, which was effective in treating over 350 female fibromyalgia patients, with or without depressive symptoms, compared to a placebo.

Duloxetine has also been found to be effective and safe for use among elderly patients with depression. A placebo-controlled trial of elderly patients 65 years or older found that duloxetine led to significant improvements in depression symptoms, including the physical symptoms of chronic pain, after eight weeks of treatment.

Over longer periods, duloxetine was still found to be safe and effective in the treatment of depression. A year-long study on major depression in adults found that higher daily doses of duloxetine — between 80 and 120mg — were effective in managing symptoms of depression, with less than 10 percent of patients experiencing side effects.

The Cymbalta dosage for depression that works best for you will depend on several factors, such as how severe your depression is, what depressive symptoms you’re experiencing, any other medical conditions you have and more.

Whether you have a psychiatric disorder like a depressive disorder, bipolar disorder or generalized anxiety disorder, or chronic pain from diabetic neuropathy or musculoskeletal pain, a medication like Cymbalta may help manage your symptoms and improve your quality of life.

A consultation with an online psychiatrist can help you figure out what medication or other treatments could work for you.

It’s important to use Cymbalta as your healthcare provider prescribed it to you and to let them know about any adverse or new side effects you experience.