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)].
Tapering off duloxetine (Cymbalta) should be done by gradually reducing the dose rather than stopping abruptly. If symptoms become intolerable during the tapering process, the previous dose may be resumed and the dose decreased more gradually. 1
From the Research
Tapering Off Duloxetine (Cymbalta)
To taper off duloxetine, it is essential to follow a gradual and personalized approach to minimize withdrawal symptoms.
- The exact tapering schedule for duloxetine is not specified in the provided studies, but general guidelines for tapering off antidepressants can be applied 2, 3, 4.
- A hyperbolic tapering schedule, which involves gradually reducing the dose over a period of months, may be effective in minimizing withdrawal symptoms 2.
- Tapering strips, which allow for personalized titration of discontinuation, have been shown to be effective in facilitating antidepressant discontinuation, including for duloxetine 3.
- It is crucial to distinguish between withdrawal symptoms and relapse of the underlying disorder, as this can impact the tapering schedule and treatment approach 2, 4.
Considerations for Tapering Off Duloxetine
When tapering off duloxetine, the following considerations should be taken into account:
- The patient's medical history, including previous experiences with antidepressant withdrawal 3.
- The duration of duloxetine use, as longer use may require a more gradual tapering schedule 3.
- The presence of any underlying medical or psychiatric conditions that may impact the tapering process 5, 6.
- The potential for withdrawal symptoms, such as nausea, dizziness, and fatigue, and the need for close monitoring and support during the tapering process 5, 6.
Clinical Practice Guidelines
Clinical practice guidelines for tapering and discontinuing antidepressants, including duloxetine, are limited and often do not provide specific guidance on dose reductions or managing withdrawal symptoms 4.