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Reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
If you’re an expectant mother, you may have hundreds of questions on how to make sure everything you do keeps the baby healthy — like whether taking antidepressants is safe.
Antidepressants can be a lifesaver for so many people struggling with depression or anxiety. But if you use an antidepressant such as Cymbalta®, you may want to know if there are risks associated with pregnancy and Cymbalta.
Whether you’ve already been diagnosed with major depression or become depressed after giving birth, you may have questions about the safety of taking Cymbalta during this period.
This guide will give you all the information you need about pregnancy and Cymbalta as well as Cymbalta and breastfeeding.
First, we’ll briefly go over what Cymbalta is and what disorders this medication is used for.
Cymbalta and its generic version duloxetine are antidepressant medications. Approved for use by the Food and Drug Administration (FDA) in 2004, Cymbalta is used for several different mental health and medical conditions, including major depression, generalized anxiety disorder, diabetic nerve damage (or diabetic peripheral neuropathic pain), chronic musculoskeletal pain and fibromyalgia.
This medication belongs to a group of antidepressant drugs known as serotonin-norepinephrine reuptake inhibitors (SNRIs) that work by preventing the brain from reabsorbing the chemicals serotonin and norepinephrine.
There are potential common side effects of taking Cymbalta, such as nausea, dry mouth, sleepiness, fatigue, constipation, excessive sweating and decreased appetite.
There can also be adverse effects while taking Cymbalta that, although rare, are still possible depending on different factors.
The risk of serotonin syndrome, for example, can increase if you’re taking another medication or supplement that increases serotonin levels. Serotonin syndrome is a serious, potentially life-threatening condition that occurs when serotonin levels in the body are too high.
Taking serotonin-norepinephrine reuptake inhibitors like Cymbalta with selective serotonin reuptake inhibitors (SSRIs) can increase the risk of serotonin syndrome, for example.
Other medications or supplements that shouldn’t be used while taking Cymbalta include monoamine oxidase inhibitors (MAOIs), amphetamines, blood thinners, anti-inflammatory drugs like aspirin or ibuprofen, diuretics, fentanyl, St. John’s wort, tryptophan and others.
Other rare but serious side effects of duloxetine include increased heart rate, irregular menstrual cycle, eye pain, severely elevated blood pressure, difficulty urinating, heart attack and more.
You should immediately let a healthcare professional know if you experience any of these adverse effects. Always let your healthcare provider know about any medications or supplements you’re taking before starting Cymbalta.
While anyone can experience the more common side effects, the interactions between pregnancy and Cymbalta may not be as clear.
Depression is already a common mood disorder, with around 21 million adults having a depressive episode in the U.S.
Additionally, pregnancy can cause different types of depression for many expecting parents. An estimated 10 percent to 20 percent of women in the U.S. will experience peripartum depression, a depressive disorder that affects pregnant women and new mothers.
Typically, a healthcare professional may prescribe Cymbalta if you’re experiencing symptoms of depression. However, there isn’t much research on the effects between Cymbalta and pregnancy.
Cymbalta is labeled by the FDA as a Category C risk category medication, meaning that there haven’t been enough high-quality studies in humans on pregnancy and Cymbalta, but potential risks can’t be ruled out because the controlled studies on animals have shown that there may be risk to a fetus.
Some studies have found both normal and abnormal pregnancy outcomes in women who took Cymbalta while pregnant.
The chance of birth defects is still possible even if you don’t take an antidepressant. Generally, all pregnant women have a three percent chance of having a baby born with a birth defect.
A report from the Eli Lilly Safety System looking at 400 cases of women taking duloxetine found the most common adverse outcomes included premature births, congenital malformations (also known as birth defects), pregnancy complications and more. However, the number of birth defects from taking Cymbalta was similar to that of the general population.
An observational study found that out of 206 women who took duloxetine before becoming pregnant and during pregnancy, less than two percent had major birth defects.
Numerous studies have also found that cardiac malformations may possibly be associated with SNRIs such as Cymbalta and another antidepressant category, selective serotonin-reuptake inhibitors (SSRIs).
Adverse birth outcomes could depend on during which trimester of pregnancy you take Cymbalta. Peripartum depression, for instance, can develop during pregnancy — antidepressant treatment is one possible solution to managing symptoms of this disorder.
Some clinical findings have reported that taking Cymbalta in the third trimester of pregnancy could lead to the development of respiratory distress, constant crying, seizures and more.
However, more participants would be needed in future studies to determine if there’s a higher risk of adverse pregnancy outcomes such as premature birth, low birth weight or pulmonary hypertension in the baby (high blood pressure in the lungs).
Currently, this information suggests the risk of adverse birth outcomes is low if taking duloxetine or Cymbalta while pregnant compared to the general population.
While there is not an immediate, emergency warning against taking Cymbalta while pregnant, you should bring it to a healthcare provider’s attention if you become pregnant or plan to become pregnant soon.
Just as research is a bit unclear about the connection between pregnancy and Cymbalta, the same can be said of using this medication while breastfeeding.
Antidepressant medications can enter breast milk. However, from the limited research done on Cymbalta and breastfeeding, less than one percent of duloxetine has been found to transfer from breast milk to an infant.
The FDA has not assigned Cymbalta a lactation risk category, however, you should speak with your healthcare provider as soon as possible if you currently take Cymbalta.
While you may understandably have concerns over combining pregnancy and Cymbalta, you should also know the risks associated with untreated depression during pregnancy.
Women can develop perinatal depression during pregnancy as well as after giving birth.
Mothers with perinatal or peripartum depression feel extreme sadness, guilt, anxiety or fatigue that interferes with their day and caring for themselves or others.
A review on perinatal depression found that this depressive disorder can lead to bonding issues with the baby and contribute to sleeping and feeding problems.
Pregnant women with depression also have an increased risk of delivering babies at low birth weight or preterm, according to a review of studies.
If you’ve been taking Cymbalta before you got pregnant, discontinuing the use of the medication can also have an impact.
One small study found that 68 percent of women who stopped using antidepressants during their pregnancies experienced a relapse of depressive symptoms.
Depression during pregnancy can have some harmful effects on both you and your baby, from interfering with caring for yourself or your baby and bonding with your baby to an increased risk of using alcohol, tobacco and other harmful substances.
There are some increased risks of birth defects and adverse effects from taking antidepressants during pregnancy. But not taking care of mental health while pregnant can also have adverse effects on both the mother and the baby.
If you’re struggling with the symptoms of perinatal depression, there are ways to get help. Depression and anxiety medication are common treatments for perinatal or peripartum depression.
Talk therapy is another treatment option for depression and anxiety. There are numerous benefits of therapy from discussing anxieties and worries to breaking harmful thought and behavior patterns. You can connect with a mental health professional online to talk about your condition, your pregnancy and more to find what treatment could be helpful.
Talk with your healthcare provider to figure out if taking Cymbalta while pregnant is safe for you and your condition.
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