From the FDA Drug Label
A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the healthcare provider may continue decreasing the dose but at a more gradual rate [see DOSAGE AND ADMINISTRATION (2.8)].
To taper off Cymbalta (duloxetine), a gradual reduction in dose is recommended instead of abrupt cessation. If intolerable symptoms occur during the tapering process, the previously prescribed dose may be resumed, and then the dose can be decreased again at a more gradual rate.
- The drug label does not provide a specific tapering schedule, so the healthcare provider should determine the best approach for each patient.
- It is essential to monitor patients for discontinuation symptoms, such as dizziness, headache, and nausea, when tapering off duloxetine 1.
From the Research
Tapering Off Cymbalta (Duloxetine)
To taper off Cymbalta (duloxetine), it is essential to follow a gradual and slow tapering schedule to minimize withdrawal symptoms.
- The tapering process should be personalized to the individual's needs and medical history 2, 3, 4.
- A hyperbolic tapering schedule, where the dose is reduced by a fixed amount at each step, can be effective in reducing withdrawal symptoms 2.
- Tapering strips, which provide a gradual reduction in dose over a period of time, can also be used to facilitate discontinuation of antidepressants, including duloxetine 4.
- The duration of the tapering process can vary, but it is recommended to taper over a period of months rather than weeks 2, 4.
- It is crucial to monitor the individual's symptoms and adjust the tapering schedule as needed to minimize withdrawal symptoms and prevent relapse 3, 5.
Key Considerations
- The first decrement in dose is critical, and it is essential to ensure that it is done gradually and safely 3.
- Females and individuals with a history of severe withdrawal symptoms, longer duration of antidepressant use, and multiple previous attempts at discontinuation may be less likely to successfully discontinue their antidepressant medication 4.
- The use of tapering strips can be effective in reducing withdrawal symptoms, but it is essential to select the appropriate strip and follow the recommended tapering schedule 4.
- Current clinical practice guidelines provide limited guidance on tapering and discontinuing antidepressants, and better guidance is needed to support clinicians and patients 5.