13 Cymbalta (Duloxetine) Side Effects and How to Manage Them

Cymbalta (duloxetine) is a serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressant. It’s used to treat depression, anxiety, and certain nerve or muscle pain conditions. If you’ve been prescribed Cymbalta, you may be wondering what to expect.

With most antidepressants, you may experience side effects when you first start treatment. This is also true of Cymbalta. Nausea, dry mouth, and constipation are just a few examples. But for many people, these should improve over time. While rare, serious side effects are also possible.

Cymbalta (duloxetine) side effects at a glance

Many different side effects were reported by people taking Cymbalta in clinical trials. Many common side effects are mild and tend to resolve on their own. Rare but serious side effects may need medical attention.

Common Cymbalta side effects include:

• Nausea

• Dry mouth

• Drowsiness

• Fatigue

• Constipation

• Diarrhea

• Appetite and body weight changes

• Sweating

• Headache

• Dizziness

• Vomiting

• Abdominal pain

• Insomnia

• Sexual side effects

Rare but potentially serious Cymbalta side effects:

• Higher risk of bleeding

• Fainting and accidental falls

• Withdrawal symptoms (if stopped abruptly)

• Angle-closure glaucoma

• Increased blood pressure

• Liver damage

• Severe skin reactions

• Serotonin syndrome

• Seizures

• Suicidal thoughts and behaviors

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Below, we’ll discuss more about 13 Cymbalta side effects and how to manage them.

1. Nausea

Nausea is one of the most common Cymbalta side effects. Close to 1 in 4 people taking it during clinical trials reported nausea. Thankfully, it’s usually temporary and most commonly occurs in the first week of treatment.

Cymbalta can be taken with or without food. But if you’re feeling nauseated after taking your dose, try taking it with food. Let your healthcare team know if your nausea doesn’t go away or gets worse over time.

2. Dry mouth

Dry mouth is also a common Cymbalta side effect. While it can be bothersome, dry mouth isn’t usually serious in short-term or occasional situations. And it doesn’t typically cause people to stop taking the medication, either.

If you have dry mouth, you can try using a saliva substitute, such as Biotene or BioXtra. Chewing sugar-free gum, sipping on cold liquids, or sucking ice chips can also help. It’s also important to keep a good oral hygiene routine to prevent cavities, when possible.

3. Drowsiness

Some people have trouble falling asleep while taking Cymbalta. But others may feel drowsy. See how Cymbalta makes you feel before doing anything requiring mental alertness, like driving a car.

If you get drowsy when taking Cymbalta, talk to your healthcare team. Cymbalta is taken once or twice daily. Depending on your dosage, they may recommend taking it once daily before bed. If it makes you feel more awake, they may tell you to take it in the morning.

4. Constipation

Constipation is also a possibility with Cymbalta. If you experience constipation, consider increasing your fiber intake by eating more whole grains, fruits, and vegetables. Staying hydrated and getting routine exercise can also help get things moving again.

If these changes aren’t helping, let your healthcare team know. They may recommend an over-the-counter (OTC) laxative or stool softener. Other options may include lowering your Cymbalta dose or switching you to a different medication.

5. Appetite changes

Some people experience a decreased appetite after starting Cymbalta. However, this doesn’t seem to lead to a meaningful change in body weight over the long term. And it’s important to note that appetite changes are also a possible symptom of depression, which may improve over time.

Other Cymbalta side effects, like nausea, may also affect your appetite. Keep in mind, nausea should go away as your body gets used to the medication. But if you’re worried about appetite changes while taking Cymbalta, talk to your healthcare team. They can determine the best next steps.

6. Sweating

Increased sweating is a possible side effect of SNRIs, including Cymbalta. While sweating isn’t usually dangerous, it can be bothersome. It might help to use an antiperspirant, applied to dry skin right before bedtime. You can also try avoiding things that trigger sweating, like spicy foods, caffeine, and alcohol.

If sweating starts interfering with your quality of life, talk to your prescriber. They might decide to reduce your dosage or switch you to a medication that’s less likely to cause sweating.

While rare, sweating can be a symptom of a more serious condition called serotonin syndrome. More on that later.

7. Blood pressure changes

Some people experience blood pressure changes while taking Cymbalta. For example, you may feel dizzy or lightheaded when changing positions (like going from sitting to standing). This tends to happen within the first week of starting Cymbalta and after dose increases.

Taking higher Cymbalta doses or combining it with blood pressure medications can increase the risk of low blood pressure. Changing positions more slowly can help prevent you from falling down or passing out.

It’s also possible for Cymbalta to raise your blood pressure. But this increase is usually small. Even so, your prescriber may want to monitor your blood pressure during treatment. If you’re monitoring it yourself at home, let them know if your readings are higher than usual.

8. Sexual side effects

Sexual side effects, such as low libido, erectile dysfunction, and difficulty achieving an orgasm, can be common while taking Cymbalta. Typically, these side effects are more likely to happen with higher doses of Cymbalta.

If you’re experiencing changes in your sexual health after starting Cymbalta, or after a dose change, let your prescriber know. While having this conversation may be uncomfortable, there are a few things your healthcare team can recommend to improve your symptoms. Lowering your dose, changing the timing of your medication, or switching to a different antidepressant are all a few potential options.

9. Higher bleeding risk

Cymbalta can increase the risk of bleeding. For most people, this risk is very small and doesn’t prevent them from taking the medication.

But your bleeding risk goes up if you have a medical condition or take other medications that increase your risk of bleeding. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), are common examples. Let your healthcare team know you notice signs of bleeding, including new or unusual bruising.

Be sure your healthcare team has your complete medication list, including any OTC or herbal supplements you take. They should also have your complete medical history. This helps them check for potential interactions ahead of time.

10. Discontinuation syndrome

If you stop taking Cymbalta or other antidepressants too quickly, you might experience antidepressant discontinuation syndrome. This can also happen if you lower your dose too quickly. Symptoms are typically mild and temporary, but they can be uncomfortable. Examples include headache, dizziness, and trouble sleeping. More serious symptoms are also possible.

If you want to stop taking Cymbalta, talk to your prescriber first. They can help you discontinue it slowly and safely. Don’t try to stop taking it on your own — especially if you’ve been taking it for a while.

11. Liver damage

Although rare, liver damage has been reported in people taking Cymbalta. Most people with liver damage experienced abdominal pain. Some people also developed jaundice (yellowing of the skin or eyes). Let your healthcare team know right away if these symptoms develop.

If you already have liver damage, Cymbalta may not be safe for you to take. In this case, your prescriber may recommend a different treatment. And it’s best to avoid or minimize alcohol while taking Cymbalta, since that also increases your risk for liver damage.

12. Serotonin syndrome

Serotonin syndrome is also a rare side effect of Cymbalta. It’s a serious condition that can happen when there’s too much serotonin in your brain. Most cases are mild and can cause sweating, trouble sleeping, and tremor. Let your healthcare team know right away if these symptoms develop.

In severe cases, serotonin syndrome can be life threatening. Uncontrollable body movements, high fever, and confusion are more serious symptoms. Go to your nearest emergency room if any symptoms feel severe.

The risk for serotonin syndrome is higher if you take other medications that also affect serotonin (e.g., other antidepressants) alongside Cymbalta. Your prescriber and pharmacist can check for this interaction in advance.

13. Suicidal thoughts and behaviors

All antidepressants come with a boxed warning about an increased risk of suicidal thoughts and behaviors. This risk appears to be highest in those under age 25.

Talk to your healthcare team immediately if you notice any concerning changes in mood or behavior. These changes are more likely to happen during the first few weeks to months of taking Cymbalta or after a dosage change.

Keep in mind: Both depression and anxiety can also increase the risk for suicidal thoughts or behaviors. So it’s important not to leave them untreated. Your prescriber will determine if the benefits of Cymbalta outweigh the potential risks for you.

If you or someone you know is having thoughts of suicide, you’re not alone, and help is available. Call the 988 Suicide & Crisis Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.

When should I contact my healthcare team about Cymbalta (duloxetine) side effects?

Most people are able to take Cymbalta without experiencing side effects that cause them to stop taking it. And common side effects, like nausea, tend to go away over time.

But if you do experience side effects that start affecting your daily life, talk to your prescriber. They may decide to lower your dose to see if that helps. If not, they may recommend a different antidepressant or another treatment altogether.

While rare, some side effects like liver damage, serotonin syndrome, and suicidal thoughts and behaviors are possible. These may require immediate attention. If you think you are experiencing any of these side effects, don’t wait to get help.

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Written by:

Alex Evans, PharmD, MBA

Alex Evans, PharmD, MBA, has been a pharmacist for 12 years. His first job was floating in a community chain pharmacy.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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