Foods to Avoid While Taking Cymbalta^®

If you’ve been diagnosed with depression, chronic pain, or an anxiety disorder like generalized anxiety disorder (GAD), your healthcare provider may prescribe the antidepressant Cymbalta^® to relieve your symptoms and help you make progress towards recovery.

Cymbalta — which contains the active ingredient duloxetine — is a modern antidepressant that first entered the scene in 2004. Unlike certain older medications used to treat depression, Cymbalta isn’t known to have food interactions. In other words, eating certain foods or using some cooking ingredients won’t interfere with how the medication works.

That said, there are still a few diet-related things you should be aware of if you’re prescribed Cymbalta or if you’re switching from another medication to Cymbalta.

Below, we’ll explain what Cymbalta is, as well as how it works as a treatment for depression, anxiety disorders, and chronic pain disorders. We’ll also share why you can temper many of your concerns around taking Cymbalta with certain foods, and the steps you can take to keep safe while using this medication.

Cymbalta — the brand name for duloxetine — belongs to a class of prescription drugs called serotonin-norepinephrine reuptake inhibitors, or SNRIs.

Currently, Cymbalta is approved by the FDA to treat the following conditions:

• Major depressive disorder (MDD)

• Generalized anxiety disorder

• Diabetic peripheral neuropathic pain (DPNP)

• Chronic musculoskeletal pain

• Fibromyalgia (FM)

As an SNRI, Cymbalta works by inhibiting the reuptake of the neurotransmitters serotonin and norepinephrine by cells in your brain. This increases serotonin and norepinephrine activity levels, which may improve mood and decrease pain.

This is because normal levels of serotonin activity — a naturally occurring chemical that regulates aspects of your moods and thoughts — are important for maintaining emotional stability. Lower levels of serotonin are associated with a higher risk of mood disorders and other mental health conditions, including major depression, anxiety, and obsessive-compulsive disorder (OCD).

Similarly, norepinephrine is a neurotransmitter that helps you stay alert, remain focused, and store information as memories. Low levels of norepinephrine activity are linked to lethargy, difficulty concentrating, attention deficit hyperactivity disorder (ADHD), and depression.

Researchers believe that these increases in neurotransmitter activity contribute to Cymbalta's effects as an antidepressant.

Other SNRIs include venlafaxine (Effexor^®) and desvenlafaxine (Pristiq^®).

The short answer is probably not.

If you’ve ever searched for lists of interactions involving antidepressants, you may have seen common foods and drinks listed alongside medications and recreational drugs as dangerous, potentially harmful substances. For example, the combination of grapefruit and antidepressants is a common one to avoid.

That said, these interactions usually involve older types of antidepressants, such as monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs), which first came onto the market in the 1950s. Many of these older classes of antidepressant medications pose a far higher risk of interactions and adverse effects than more modern drugs. While it’s okay to eat grapefruit occasionally while taking Cymbalta, moderation is the key.

For example, many MAOI medications prevent the breakdown of tyramine, an amino acid found in fruits, aged cheeses, fava beans, alcohol, and some types of fish and meat. 

When consumed with MAOIs, these foods can potentially cause dangerous reactions, such as elevated blood pressure. For this reason, healthcare providers are trained to warn people who are prescribed these medications to be extra mindful about their food intake and drinking habits. 

Cymbalta is a much newer antidepressant that doesn’t have the same effects on tyramine, so there’s no list of tyramine-rich foods to avoid while taking it.

In general, unless a healthcare professional specifically instructs you to avoid certain ingredients, it’s fine to stick to your normal diet while you’re taking Cymbalta. 

Although it’s generally okay to stick to your normal diet while using Cymbalta, it’s best to avoid drinking alcohol while you’re using this medication. 

In trials of Cymbalta, researchers found that heavy alcohol intake may contribute to liver problems and injury among people who take Cymbalta. As such, it’s best to cut out alcohol from your daily life while you take Cymbalta to treat depression, anxiety, or any other condition.

Using alcohol with antidepressants could also lead to drowsiness, affect your coordination, and increase your risk of injury. It may also worsen your depression or prevent Cymbalta from having its full therapeutic effect. One or two drinks only on special occasions works well for most people. However, since the combination of Cymbalta and alcohol can increase your level of impairment, you should never drive after consuming even a single alcoholic drink.

If you have a history of alcohol abuse or if you’re at risk of alcohol withdrawal, make sure to talk to your healthcare provider about this to work out a safe treatment plan before you start taking Cymbalta. 

Like other antidepressants, Cymbalta can cause side effects. Most side effects of Cymbalta are mild and improve gradually over time. However, some people prescribed Cymbalta may develop more persistent or severe side effects that require medical attention.

Common side effects of Cymbalta include:

• Nausea

• Headache

• Dry mouth

• Fatigue

• Somnolence (sleepiness)

• Insomnia

• Dizziness

• Constipation

• Diarrhea

• Decreased appetite

• Hyperhidrosis (excessive sweating)

Cymbalta can cause sexual side effects, including a reduced level of interest in sex and difficulty reaching orgasm. In men, Cymbalta can potentially contribute to erectile dysfunction and slow or difficult ejaculation.

If you’re prescribed Cymbalta and start to develop side effects, make sure to let your healthcare provider know as soon as possible. They might help you adjust your dosage or make other changes to how you use your medication to try to prevent or reduce the severity of side effects. 

Our guide on how to sleep while taking Cymbalta can help if you're experiencing this side effect.

Other medications, particularly those that increase the amount of serotonin in your body, can interact with Cymbalta. In some cases, this interaction can increase the risk of serotonin syndrome, a condition that may cause confusion, seizures, and unconsciousness.

Medications and dietary supplements that may interact with Cymbalta include:

• Other antidepressants, like monoamine oxidase inhibitors (MAOIs) or SSRIs

• Amphetamines

• Anticoagulants

• Fentanyl and other opioids, like tramadol

• Diuretics (water pills)

• St. John’s wort (an herbal supplement)

• Some blood thinners, like blood thinners like warfarin

• Sleeping pills

• Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen

Other medications not listed above could also cause interactions when used with Cymbalta. Sometimes the interactions can be safely managed, but some drugs can never be used together. To reduce your risk of potentially dangerous interactions, inform your healthcare provider about all medications you currently use or have recently used before starting treatment with Cymbalta.

Here are a few other medical conditions and precautions to keep in mind and discuss with your doctor before taking Cymbalta:

• Cymbalta is not advised for people with glaucoma or a family history of glaucoma.

• Cymbalta can make it harder to control blood sugar. If you have diabetes, make sure to bring this up with your doctor if you’re considering taking Cymbalta.

• Cymbalta may not be suitable for people with bipolar disorder, as it may increase the risk of manic episodes. 

• Suicidal thoughts are another serious side effect in children, adolescents, and young adults up to age 24. Watch for worsening suicidal thinking and behavior in kids and young adults.

When used as prescribed, Cymbalta is a safe and effective medication for most people. To get the best results from Cymbalta and reduce your risk of side effects of interactions, use the tips listed below:

• Let your healthcare provider know about your medical history. Before you start to use Cymbalta, make sure to inform your healthcare provider about any existing health issues or medical conditions you have.

• Tell your healthcare provider what medications you currently take. To reduce your risk of drug interactions, inform your healthcare provider about any medications you use right now or have used in the last few months. And, when in doubt, it’s best to reach out for medical advice.

• Read the medication guide before taking Cymbalta. Make sure to check the dosage schedule and instructions for Cymbalta. Familiarize yourself with the most common potential side effects to quickly identify them if they occur.

• If you experience side effects, tell your healthcare provider. It’s far from uncommon to experience some side effects while using Cymbalta or other antidepressants. Let your healthcare provider know if your side effects are persistent or bothersome.

• Don’t abruptly stop taking Cymbalta. When stopped abruptly, Cymbalta can cause withdrawal symptoms. Don’t lower your dosage or stop taking Cymbalta without talking to your healthcare provider first. If you want to stop taking Cymbalta, your healthcare provider will likely suggest gradually tapering your dosage to reduce your risk of developing withdrawal symptoms.

• If Cymbalta doesn’t work immediately, try not to panic. Antidepressants can take several weeks to start working, and it’s common for symptoms such as sleep problems or a lack of focus to improve before your moods and feelings do. Unless you have severe side effects that don’t go away, take Cymbalta consistently for at least two to four weeks before judging whether it’s working for you.

• Be careful when driving after you start treatment. Cymbalta may make you feel tired, drowsy, or dizzy. Avoid driving a car or operating machinery before you understand how it makes you feel.

• Inform your healthcare provider about body weight changes. A small percentage of people who use Cymbalta experience mild weight loss. If you notice changes in your appetite, eating habits, or body composition, inform your healthcare provider.

There’s a lot to keep in mind when considering a new medication or adjusting one you’re already taking. Here’s what to remember about Cymbalta and diet:

• There isn’t a formal list of foods to avoid while taking Cymbalta that you’ll need to memorize before you start treatment. Unlike older antidepressants, Cymbalta doesn’t interact with the tyramine in cheeses, fruits, and certain types of meat and fish.

• Though not a food per se, drinking alcohol while you use Cymbalta can increase your risk of liver damage and worsen your depression, and, as such, drinking should be avoided. 

• To keep yourself safe and healthy while you’re taking Cymbalta, follow the instructions given to you by your healthcare provider. Make sure to let them know as soon as you can if you develop any side effects or adverse reactions during treatment. 

Ready to take the next step toward getting help for depression? We offer access to duloxetine (the active ingredient in Cymbalta) and other depression and anxiety medications online via our range of mental health services.