From the Guidelines
Duloxetine withdrawal symptoms can include dizziness, nausea, headache, paresthesia, irritability, anxiety, insomnia, fatigue, and flu-like symptoms, and to minimize these effects, the medication should be tapered gradually over at least 2 to 4 weeks under medical supervision. When discontinuing duloxetine, it is essential to follow a tapering schedule to reduce the risk of severe withdrawal symptoms. According to the study by Chen et al 1, duloxetine should be tapered over at least 2 to 4 weeks for those treated with therapy longer than 3 weeks. The symptoms of withdrawal from duloxetine can vary in severity and duration, but they typically begin within 1-3 days after reducing or stopping the medication and can last for 1-2 weeks. Some key points to consider when managing duloxetine withdrawal include:
- The severity of withdrawal depends on factors like dosage, duration of use, and how quickly the medication is discontinued
- A typical taper might involve reducing the dose by 30mg every 1-2 weeks, though this should be personalized by a healthcare provider 1
- Withdrawal occurs because the body has adapted to duloxetine's effects on serotonin and norepinephrine neurotransmitters, and needs time to readjust when the medication is reduced
- If you experience severe withdrawal symptoms, contact your healthcare provider immediately as they may need to adjust your tapering schedule or provide supportive treatments. It is crucial to work closely with a healthcare provider to manage duloxetine withdrawal safely and effectively.
From the FDA Drug Label
6 discontinuation symptoms: Do not stop duloxetine delayed-release capsules without first talking to your healthcare provider Stopping duloxetine delayed-release capsules too quickly or changing from another antidepressant too quickly may result in serious symptoms including:
- anxiety
- irritability
- feeling tired or problems sleeping
- headache
- sweating
- dizziness
- electric shock-like sensations
- vomiting or nausea
- diarrhea
The symptoms of withdrawal from duloxetine (Cymbalta) include anxiety, irritability, feeling tired or problems sleeping, headache, sweating, dizziness, electric shock-like sensations, vomiting or nausea, and diarrhea 2.
From the Research
Symptoms of Withdrawal from Duloxetine (Cymbalta)
The symptoms of withdrawal from duloxetine (Cymbalta) are common and can be distressing. According to the studies, the following symptoms have been reported:
- Dizziness 3, 4
- Nausea 3, 5, 6, 4
- Headache 3, 5, 6, 4
- Paresthesia 3
- Vomiting 3
- Irritability 3, 5
- Nightmares 3
- Fatigue 5, 6, 4
- Dry mouth 6, 4
- Constipation 4
- Decreased appetite 6
- Insomnia 6
- Upper respiratory tract infection 6
Characteristics of Withdrawal Symptoms
The withdrawal symptoms are generally mild, short-lived, and self-limiting, but can be distressing and may lead to missed work days and decreased productivity 5. The symptoms may be somatic (e.g., dizziness, nausea, fatigue) or psychological (e.g., anxiety, irritability) 5. Most patients rate the severity of their symptoms as mild or moderate 3.
Management of Withdrawal Symptoms
To minimize the symptoms of withdrawal, gradual tapering of the dose is necessary 3, 5, 7. The dose should be reduced gradually over a period of at least 2 weeks 3. Patients should be informed about the risk of withdrawal symptoms and the importance of gradual tapering 7. In case of severe symptoms, it may be necessary to reinstitute the dosage of the original antidepressant and slow the rate of taper 5.