From the Research
If you're experiencing involuntary head movements while taking Cymbalta (duloxetine), you should contact your healthcare provider immediately as this could be a sign of a serious side effect, such as dystonia or tardive dyskinesia, which are associated with significant morbidity and mortality if left untreated 1. Involuntary head movements can be a symptom of a hyperkinetic movement disorder, characterized by sustained or intermittent muscle contractions that cause abnormal repetitive movements, abnormal postures, or both, as described in a review of dystonia 2. These movements may represent tardive dyskinesia or other extrapyramidal symptoms, which are uncommon but significant adverse effects of certain medications, including some antidepressants like Cymbalta. Some key points to consider when evaluating involuntary head movements in patients taking Cymbalta include:
- The potential for dystonia, which can be characterized into two axes to describe clinical characteristics and etiology, allowing for correct identification and management 2
- The risk of persistent dystonia, as reported in a case associated with short-term fluoxetine use, which required treatment with botulinum toxin type A 3
- The possibility of duloxetine-related tardive dystonia and tardive dyskinesia, as reported in a case of a 58-year-old female with major depressive disorder who developed distressing oral dyskinesia, mandibular dystonia, and dystonia over the left neck after treatment with duloxetine for 18 months 1 Do not stop taking Cymbalta suddenly without medical supervision, as this can cause withdrawal symptoms. Your doctor may need to adjust your dosage, switch you to a different medication, or add another medication to manage these symptoms, and it is crucial to follow their guidance to minimize the risk of morbidity and mortality associated with untreated dystonia or tardive dyskinesia 1. Involuntary movements can occur because Cymbalta affects neurotransmitters in the brain, particularly serotonin and norepinephrine, which can sometimes impact the dopamine system that controls movement. While these side effects are relatively rare with Cymbalta compared to antipsychotic medications, they can occur, especially in older adults or those taking multiple medications. During your appointment, be prepared to describe when the movements started, their frequency, severity, and any other symptoms you're experiencing to help your doctor make the best treatment decision.