Sleep is essential to keep us healthy, both physically and mentally. However, many things can affect the quality of our sleep.
If you’re struggling with a mood disorder, for example, you may be experiencing a lack of sleep as a side effect. Or if you live with debilitating chronic pain, your sleep may be affected as well.
Around 21 percent of adults in the U.S. experienced a mental illness, including depression and bipolar disorder, in 2020, respectively. Additionally, in 2019, over 20 percent of American adults experienced chronic pain.
If you struggle with major depression or chronic pain, chances are you’ve been prescribed Cymbalta®.
Cymbalta is a drug primarily used to treat the aforementioned conditions, which can include depression, anxiety and certain chronic pain issues.
But Cymbalta, as with many medications, may come with some side effects — some of which can affect your sleep.
In this guide, we’ll talk about how this drug works, its common side effects and how to sleep while taking Cymbalta.
One of the more common antidepressants prescribed, Cymbalta is used to treat mental health disorders like major depressive disorder and generalized anxiety disorder.
Cymbalta has also been approved by the FDA for use in helping those with fibromyalgia, nerve pain and damage from diabetes (diabetic peripheral neuropathy) and long-term musculoskeletal pain.
The brand name for duloxetine, Cymbalta is a serotonin-norepinephrine reuptake inhibitor.
Serotonin-norepinephrine reuptake inhibitors (or SNRIs) work primarily on two chemicals in your brain: serotonin and norepinephrine. Cymbalta works to prevent your brain from reabsorbing these two neurotransmitters. This then has a positive effect on your mood and helps relieve pain.
This works differently from selective serotonin reuptake inhibitors, which only prevent the reabsorption of serotonin.
Cymbalta can also help break the vicious cycle between depression and chronic pain. Chronic pain can lead to depression, which can then make the pain worse, or vice versa, according to research.
You may be prescribed an SNRI like Cymbalta if it’s the right treatment for your diagnosis and health at the time, or if selective serotonin reuptake inhibitors (SSRIs) have not worked before.
Cymbalta is sometimes used to treat depression from bipolar disorder. However, as with other SNRIs, it can cause several negative side effects. If you struggle with or have been diagnosed with bipolar disorder, talk to a healthcare professional before taking Cymbalta.
It’s possible to see improvements in energy, sleep or appetite within the first week or two of taking Cymbalta, indicating that the medication is working.
A depressed mood may take longer to see signs of improvement though, taking anywhere from six to eight weeks.
Many medications often have side effects, and Cymbalta is no exception.
Here are some of Cymbalta’s more common side effects:
Sleepiness or tiredness
Loss of appetite
Having trouble sleeping (insomnia)
Sexual side effects
Typically, these side effects go away or improve within a week or two.
As with any medication, there is a possibility of more adverse effects. These can include liver failure, severe dizziness, abnormal bleeding, abdominal pain, seizures or serotonin syndrome. Reach out to your healthcare provider if you experience any of these rare, but serious, symptoms.
Going off Cymbalta can also cause withdrawal symptoms, so be sure to speak with your healthcare provider before you stop taking the medication.
Our complete Guide to Duloxetine Side Effects goes over all the common side effects and risks of using Cymbalta for mood disorders.
Yes, Cymbalta does affect sleep — but in different ways. Two common side effects of Cymbalta are feeling tired and sleepy or having trouble sleeping.
How is it possible that one medication can produce opposite side effects? Well, different medications can have different side effects on different people.
In most cases, the more common side effects of Cymbalta are temporary.
Fatigue can be described as a constant feeling of tiredness or weakness and can be mental, physical or both. If you’re having trouble starting or maintaining activities, difficulty concentrating or a combination of the two, you may be experiencing fatigue as a side effect of Cymbalta.
However, a large number of people who take Cymbalta experience difficulty sleeping or insomnia. Insomnia, or trouble falling or staying asleep, has been reported in nine percent of those taking Cymbalta.
Some people also reported waking up earlier as a mild side effect.
Cymbalta and other serotonin-norepinephrine reuptake inhibitors work primarily to prevent your brain from reabsorbing serotonin and norepinephrine — chemicals that keep our brains active when we’re awake.
Norepinephrine and serotonin also play a part in suppressing rapid eye movement (REM) sleep, or the sleep that happens about 90 minutes after you fall asleep. This is when your brain has a mix of activity and most of your dreaming occurs.
Since Cymbalta helps keep more serotonin and norepinephrine in your system, you may feel more energized and have trouble falling asleep.
There are many reasons why you may be experiencing insomnia. But if you’re having trouble sleeping after starting medication, you may have Cymbalta-induced insomnia.
Trouble sleeping or insomnia can also be an adverse effect of Cymbalta withdrawal.
Poor sleep can also worsen depression in addition to your physical health, leading to a cycle of deteriorating emotional health and overall wellbeing.
If your sleep has been affected while taking Cymbalta, don’t worry. We have tips and strategies to help you manage any sleep-related issues.
Whenever you start a new treatment for depression or generalized anxiety disorder, it’s always good to keep track of side effects. It’s also a good idea to let your healthcare provider know if any new ones emerge.
For the first few weeks on Cymbalta, pay attention to your sleep and if you’re having trouble falling or staying asleep.
Your healthcare provider may recommend waiting to see if the side effect resolves itself on its own. If your insomnia doesn’t go away, they may try a different medication or treatment for your depression.
When starting a new antidepressant, you’ll typically be prescribed a lower dosage and your healthcare provider may gradually increase it until reaching the recommended amount (up to 60mg a day).
You should take the same dose for at least 14 days before increasing the dosage. If you start experiencing insomnia after increasing your dosage, your provider may wait for the side effects to subside and your body to adjust before increasing the amount of medication again.
Your healthcare provider may also reduce your Cymbalta dosage or have you fully stop taking the medication if insomnia persists. A higher dosage can make insomnia worse, as found in a single patient trial.
If your healthcare provider believes you’ll still benefit from Cymbalta for a depressive disorder or generalized anxiety disorder, they may reduce your dosage over time.
If stopping the use of Cymbalta is the best option for you, talk to your healthcare provider before you stop taking it. You’ll need to gradually taper off use so you don’t experience withdrawal effects.
If you’re having insomnia since starting Cymbalta, certain sleep aids can help.
Melatonin has been shown in some research to ease falling asleep and help establish better-sleeping patterns.
Melatonin is safe to use with the typical dosage of 1mg to 5mg nightly. However, using melatonin while taking Cymbalta can increase side effects of dizziness, drowsiness, confusion and difficulty concentrating.
You should speak with your healthcare provider if you are currently taking Cymbalta before taking melatonin as well.
Other sleep supplements and medications can have adverse effects when taken with Cymbalta. Some drugs that don’t interact well with Cymbalta include St. John’s wort, other antidepressants like monoamine oxidase inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, blood thinners, some migraine medications, high blood pressure medications and more.
Make sure to let your healthcare provider know about any other medications you are taking before starting a Cymbalta prescription to treat anxiety or depression.
If you notice that you’re feeling fatigued or more alert and energized after taking your Cymbalta dose, you may want to change up your dosage schedule.
Cymbalta can be taken any time of day so long as it is taken at the same time every day for the most effective results.
If you currently take Cymbalta at night but are having trouble sleeping, switch to taking it first thing in the morning. Be sure to pay attention to your energy levels and talk to your healthcare provider if you’re still struggling with insomnia.
While many of us turn to coffee to beat the afternoon slump, caffeine comes back with a vengeance when you’re trying to sleep.
Caffeine counteracts sleepiness by blocking the brain chemical adenosine, which signals our body to become drowsy and sleep to rebuild energy levels.
Try to eliminate that post-lunch cup of coffee or switch to a drink with lower levels of caffeine, such as green tea. You can also try some stretching or go for a quick walk around the block for an energy boost that won’t mess with your sleep.
A good way to make sure you get a good night’s rest is to make sure you have good sleep hygiene.
Keep a set bedtime and wake-up time, avoid large meals too close to bedtime, limit or stop screen time at least 30 minutes before bed and take time to unwind from the day. Establishing a routine before your head hits the pillows will help you sleep better at night.
Cymbalta is a common treatment option for depression, anxiety, bipolar disorder, nerve pain, fibromyalgia and more. As with many medications, there can be mild side effects or more serious adverse effects.
Having trouble sleeping or insomnia is a common side effect of Cymbalta. There are techniques though to improve your sleep.
Some effective ways to sleep while taking Cymbalta are to ensure you’re taking the correct dosage, using sleep aids and establishing good sleep hygiene to start.
These tips alone may not help your insomnia so talk to your healthcare provider about your side effects.
There isn’t a universal medication or treatment option for depression. You can seek medical advice online from our psychiatry service for an evaluation to learn about all your options and figure out which is the best fit for you.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
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