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Cymbalta For Anxiety: Benefits, Side Effects, and More

Daniel Z. Lieberman, MD

Reviewed by Daniel Z. Lieberman, MD

Written by Jill S.S.

Published 10/16/2022

Updated 08/24/2024

Anxiety: Everyone with it hates it. It can reduce joy, quality of life, and the quality of relationships. Luckily, there are medications to treat it, like Cymbalta®.

If you’ve been prescribed Cymbalta for anxiety — or heard about it as a potential treatment option — you may have some questions about how, why, and when this medication can help manage your mental health condition.

Let’s get right to it.

It’s hard to answer that question directly — what works for some folks may not work for everyone else. But Cymbalta does work for many people with anxiety, whether in combination with therapy or on its own.

Understanding why an antidepressant drug like Cymbalta might help with mental health conditions other than depression is a little complicated, but we’ll break it down for you.

If you’re new to Cymbalta for anxiety, you’ve come to the right place. Keep scrolling for information on the benefits of Cymbalta, common side effects, and the timeline for how long this medication takes to start working.

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Cymbalta is the brand name for the generic drug duloxetine. It’s a particular type of antidepressant medication called a selective serotonin and norepinephrine reuptake inhibitor — or SNRI for short.

SNRIs affect the levels of two neurotransmitters in the brain: serotonin and norepinephrine. It’s thought that abnormalities in the activity of these brain chemicals may contribute to the extreme lows that can come as a result of psychiatric disorders like major depressive disorder (MDD) and bipolar disorder.

Essentially, your brain is always recycling its supply of neurotransmitters floating around. But sometimes, your brain overdoes it on the cleanup, leaving you with too little active neurotransmitter when it’s time to regulate your moods.

Antidepressants like Cymbalta are typically understood to be a treatment for, well… depression. But many of them can also be used to treat the symptoms of anxiety disorders like generalized anxiety disorder (GAD), either on- or off-label.

In the case of Cymbalta and generic duloxetine, anxiety treatment is an on-label use, meaning this is one of the things the FDA (U.S. Food and Drug Administration) has approved it for. Specifically, duloxetine is approved to treat both MDD and generalized anxiety disorder.

Interestingly, duloxetine is also used to treat chronic pain like nerve pain from diabetic peripheral neuropathy and in the treatment of fibromyalgia. But that’s not what we’re here to talk about — it’s just a cool factoid.

Yes, Cymbalta can be good for anxiety.

With regard to its anxiety-fighting powers, a 2020 review of eleven studies found that duloxetine was more effective in treating generalized anxiety disorder than a placebo. What’s more, this medication seemed to work better than certain other antidepressants.

Specifically, duloxetine was more effective than the selective serotonin reuptake inhibitor (SSRI) escitalopram (Lexapro®) and the SNRI venlafaxine (Effexor®).

Cymbalta comes in the form of delayed-release capsules to be taken once daily. It’s important to take Cymbalta exactly as directed by your healthcare provider.

If you miss a dose, take the missed dose as soon as you remember. However, if it’s already near time for your next dose, just skip the missed dose and take your next dose at the typical time.

The dosage of Cymbalta you’ll take for anxiety symptoms can depend on a few factors. For the treatment of generalized anxiety disorder, a daily dose of Cymbalta might vary based on the patient’s age, height, weight, sex, and other biological and genetic factors.

It may also simply be a question of need. Every person’s needs are different, which is why medication doses vary.

Starting Doses and Maximum Doses of Cymbalta for Anxiety

A starting dose of Cymbalta for children, adolescents, and older adults with anxiety is about as low as it goes — 30 milligrams (mg). Over time, the daily dose of Cymbalta can be increased to 60 milligrams daily for these age groups.

For most adults, the starting dose of Cymbalta is typically 60 milligrams — double what younger and older people take.

At the other end of the spectrum, the maximum dose for anyone in any situation is 120 milligrams per day.

Cymbalta is unique in one respect: There’s not currently any research proving that a higher dose than 60 milligrams offers any specific benefits to the user. Now, just because evidence doesn’t exist doesn’t mean higher doses don’t work. But from studies the FDA has seen, there’s no known benefit for the average person to exceed 60 milligrams a day. It’s important to remember, though, that not everybody is average. For some individuals, doses above 60 mg work better.

So, if you’re not seeing results from a lower dose, you might want to ask your healthcare provider about increasing your daily dose.

You shouldn’t do this immediately after starting this medication, though. Antidepressants like Cymbalta need time to get going in your system before they improve your symptoms. How long does that take? We’ll get to that below.

Cymbalta will work at slightly different speeds for everyone, depending on body weight, age, and other factors like dosage and the severity of symptoms.

That said, an optimal dose of Cymbalta should start to reach an effective concentration in your blood after three days, according to the FDA’s prescribing information.

Still, it can take time for Cymbalta to improve anxiety symptoms in a noticeable way. Duloxetine-treated patients can start to see and feel the positive effects of Cymbalta on their mental health after two to four weeks of treatment. However, with the time it takes to adjust to the medication, it could take longer to see results. The reason for this is that even though blood levels are in the effective range within a few days, it takes the brain a few weeks to make the necessary adaptations that lead to lower levels of anxiety.

This also assumes your first dose was just right for you. In reality, it may take some time and even a bit of trial and error for you and your healthcare provider to find the right dosage for your needs.

In terms of improving your mental health and quality of life, it could be weeks of taking your daily Cymbalta medication before you notice that it’s working. But you’ll know when your anxiety symptoms are less severe, infrequent, or gone entirely.

Your family, friends, and other loved ones will likely notice positive changes in you too.

You might also have to find a balance between a dose strong enough for the desired effects and one low enough to manage the side effects. Like most prescription medications, people can experience adverse effects from Cymbalta. Let’s explore what those side effects might be like.

Unfortunately, the benefits of Cymbalta for anxiety may come at a price for some — in the form of side effects.

These side effects can be mild or severe, brief or recurring, irritating or incapacitating. And they can include a variety of physical, gastrointestinal, sexual, and emotional effects.

Cymbalta might cause any of the following at some point in your medication journey:

  • Constipation, diarrhea, nausea, or vomiting

  • Abdominal pain, discomfort, or tenderness

  • Dry mouth

  • Increased sweating or more frequent urination

  • Headaches

  • Dizziness

  • Drowsiness or fatigue

  • Decreased appetite

  • Weight loss or weight gain

  • Shaking

  • Heartburn

  • Muscle cramps or musculoskeletal pains

  • Decreased sex drive (low libido) or reduced sexual desire

  • Sexual dysfunction, including delayed orgasm and decreased sexual satisfaction

People taking Cymbalta should definitely consult a healthcare provider if they experience serious side effects or side effects that are persistent (or in the case of weight loss, significant).

While some side effects may decrease with time, you may want to ask a medical professional about anything you’re experiencing, just to be safe. You should also reach out to a healthcare provider if certain side effects, like those associated with sexual dysfunction, have negative effects on your quality of life.

And absolutely get medical attention immediately if you experience any of the serious adverse effects associated with Cymbalta. These include:

  • Liver problems, which can cause symptoms like yellowing of the eyes and skin, dark urine, severe itching, and swelling of the abdomen

  • Increased blood pressure

  • Unusual bruising or bleeding, including gastrointestinal bleeding, which leads to dark, tarry stools

  • Severe skin reactions, which can include rash, blisters, and skin peeling

  • Glaucoma

  • Mania

  • Orthostatic hypotension (a sudden drop in blood pressure when standing up that can lead to fainting or falls)

  • Seizures

Other adverse effects may occur depending on your individual risk factors. Talk to someone right away if you have suicidal thoughts or experience worsening symptoms of depression.

Be sure to tell your healthcare provider about any other medications — prescription or over-the-counter — as well as any vitamins or supplements you’re currently taking.

This can help you avoid negative drug interactions. For example, Cymbalta shouldn’t be taken with antidepressants called monoamine oxidase inhibitors (MAOIs) and certain other medications.

Informing your healthcare provider about other medications also helps you avoid serotonin syndrome. Serotonin syndrome is a potentially dangerous condition that can arise when you take too many medications that affect serotonin levels.

It’s also vital to talk to your provider if you become pregnant while taking Cymbalta. They can go over the potential risks associated with taking this medication during pregnancy and while breastfeeding and discuss next steps.

Lastly, always consult your provider before stopping treatment so they can help you avoid withdrawal symptoms.

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One thing you don’t need to have anxiety over is your anxiety medication. Does duloxetine help with anxiety? Cymbalta and its generic version can be a good option for this mental health condition, but it’s not for everyone.

Here’s what to remember about Cymbalta for anxiety.

  • Duloxetine has been shown to be slightly more effective at combating anxiety symptoms than certain other antidepressant medications.

  • If you’re taking Cymbalta for anxiety and not seeing the results you want, don’t fool around with things yourself. Instead, talk to a healthcare professional about your concerns.

  • It’s possible that another class of medication, such as SSRIs, may be better at addressing your anxiety symptoms. Examples of SSRIs include fluoxetine (Prozac®), paroxetine (Paxil®), and sertraline (Zoloft®).

  • A healthcare provider can go over the many available treatment options for managing anxiety. We’ve covered a lot of those, from our guide to treatment for anxiety to our breakdown of the types of anxiety disorders.

  • Cymbalta is also used to treat mood disorders like depression, so if you’re struggling with both anxiety and depression, your healthcare provider may recommend Cymbalta for depression as well.

  • Even though there is a long list of potential side effects, many patients experience no side effects at all, and most patients have only mild side effects that are far preferable to the suffering caused by their anxiety.

The best thing you can do to treat your anxiety is to get medical advice from a professional. Professional help is key to navigating the treatment journey.

See our guide on how to get anxiety medication, or take our free mental health assessment to connect with a licensed provider about your treatment options.

4 Sources

  1. CYMBALTA (duloxetine delayed-release capsules), for oral use. (2023). https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/021427s055s057lbl.pdf
  2. National Health Service (NHS). (2022). About duloxetine. https://www.nhs.uk/medicines/duloxetine/about-duloxetine/
  3. National Library of Medicine. (2022). Duloxetine. https://medlineplus.gov/druginfo/meds/a604030.html
  4. Rodrigues-Amorim, D, et al. (2020). A systematic review of efficacy, safety, and tolerability of duloxetine. https://www.frontiersin.org/articles/10.3389/fpsyt.2020.554899
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Daniel Z. Lieberman, MD

Dr. Daniel Z. Lieberman is the senior vice president of mental health at Hims & Hers and of psychiatry and behavioral sciences at George Washington University. Prior to joining Hims & Hers, Dr. Lieberman spent over 25 years as a full time academic, receiving multiple awards for teaching and research. While at George Washington, he served as the chairman of the university’s Institutional Review Board and the vice chair of the Department of Psychiatry and Behavioral Sciences.

Dr. Lieberman’s has focused on , , , and to increase access to scientifically-proven treatments. He served as the principal investigator at George Washington University for dozens of FDA trials of new medications and developed online programs to help people with , , and . In recognition of his contributions to the field of psychiatry, in 2015, Dr. Lieberman was designated a distinguished fellow of the American Psychiatric Association. He is board certified in psychiatry and addiction psychiatry by the American Board of Psychiatry and Neurology.

As an expert in mental health, Dr. Lieberman has provided insight on psychiatric topics for the U.S. Department of Health and Human Services, U.S. Department of Commerce, and Office of Drug & Alcohol Policy.

Dr. Lieberman studied the Great Books at St. John’s College and attended medical school at New York University, where he also completed his psychiatry residency. He is the coauthor of the international bestseller , which has been translated into more than 20 languages and was selected as one of the “Must-Read Brain Books of 2018” by Forbes. He is also the author of . He has been on and to discuss the role of the in human behavior, , and .

Education

  • 1992: M.D., New York University School of Medicine

  • 1985: B.A., St. John’s College, Annapolis, Maryland

Selected Appointments

  • 2022–Present: Clinical Professor, George Washington University Department of Psychiatry and Behavioral Sciences

  • 2013–2022: Vice Chair for Clinical Affairs, George Washington University Department of Psychiatry and Behavioral Sciences

  • 2010–2022: Professor, George Washington University Department of Psychiatry and Behavioral Sciences

  • 2008–2017: Chairman, George Washington University Institutional Review Board

Selected Awards & Honors

  • 2022: Distinguished Life Fellow, American Psychiatric Association

  • 2008–2020: Washingtonian Top Doctor award

  • 2005: Caron Foundation Research Award

Publications

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