Cymbalta for anxiety? Can it calm the storm?

When you have anxiety, navigating everyday life can be a challenge. It can feel like you’re fighting your way through an uncontrollable storm of intrusive thoughts, worries, and fears. But with the right treatment, you can take back control and regain your sense of calm. One medication that often comes up in discussions about anxiety management is Cymbalta (duloxetine). Is Cymbalta for anxiety the right treatment for you?

In this article, we explore everything you need to know to answer that question. We share how Cymbalta works, potential side effects, reviews of Cymbalta, and more. 

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What is Cymbalta (duloxetine)?

Cymbalta is the brand-name version of  the generic drug duloxetine. It’s a prescription medication in a class of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs). It’s an oral medication that you take every day

Cymbalta works by increasing the levels of serotonin and norepinephrine in the brain. These neurotransmitters help regulate your mood and response to stress. 

The U.S. Food and Drug Administration (FDA) approved Cymbalta to treat several conditions, including depression and anxiety, specifically the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD), as well as certain types of chronic pain, including diabetic peripheral neuropathy nerve pain, fibromyalgia, and chronic musculoskeletal pain.

Cymbalta is also sometimes prescribed for off-label uses for other conditions, such as chemotherapy-induced peripheral neuropathy (nerve damage from cancer treatment), to treat chronic pain from osteoarthritis (OA), and for stress urinary incontinence (accidental leakage of urine due to activities like laughing or exercise in women). 

How Cymbalta works for anxiety 

Cymbalta helps calm down anxiety by balancing 2 chemicals in the brain that influence mood and emotional regulation, specifically serotonin and norepinephrine. Normally, these chemicals get reabsorbed by your nerve cells after they’ve done their job. SNRIs like Cymbalta or Effexor (venlafaxine) block their reabsorption (or “reuptake”), increasing the levels of serotonin and norepinephrine circulating in your brain. 

This in turn has the effect of enhancing your dopamine levels. Dopamine is a chemical messenger that affects feelings of pleasure, satisfaction, and motivation. With more dopamine, you feel more balanced emotionally. And you can experience fewer symptoms of anxiety — including excessive worry, restlessness, and panic.

One of the benefits of Cymbalta is that it relieves anxiety relatively quickly, often within 1 to 2 weeks of starting it. It can take up to 4 weeks or longer though to experience the full benefits of Cymbalta. 

Cymbalta for generalized anxiety disorder

Cymbalta is FDA-approved to treat generalized anxiety disorder (GAD). GAD is characterized by excessive, uncontrollable worry about everyday events for at least 6 months. Research on duloxetine to treat GAD shows that Cymbalta can significantly reduce anxiety symptoms in people with GAD and provide relief from fear, tension, and restlessness.

Dosage of Cymbalta for GAD

For generalized anxiety disorder, Cymbalta is prescribed in doses ranging from 30 to 120 milligrams daily. 

• Adults ages 18 to 64 may take a starting dose of 30 to 60 milligrams daily for the first week. Depending on how you respond to treatment, your healthcare provider may then increase your dose in 30-milligram increments up to 120 milligrams a day until you have the desired effect. 
• Older adults and children may start at 30 milligrams daily for the first 2 weeks. If a higher dosage is needed, the healthcare provider can increase the dose in 30-milligram increments.

The maximum dose of Cymbalta for GAD is 120 milligrams a day.

Cymbalta for other anxiety disorders

Cymbalta is sometimes prescribed off-label (for something it’s not FDA approved for) for other anxiety disorders such as social anxiety disorder (SAD) and panic disorder (PD). While not FDA-approved specifically for these mental health conditions, studies on duloxetine for social anxiety suggest that Cymbalta may be effective in reducing symptoms like social fear, avoidance, and panic attacks.

Cymbalta dosage for other anxiety disorders

There are no official dosing guidelines for using Cymbalta for anxiety disorders other than GAD. Your healthcare provider will use their discretion in determining the best dose for you, based on your symptoms and how you respond to Cymbalta. 

• For social anxiety disorder, Cymbalta doses may range from 60 to 120 milligrams per day. 
• For panic disorder, Cymbalta doses may range from 60 to 120 milligrams per day.

How to get prescribed Cymbalta for anxiety

If you think Cymbalta could be a good option for managing your anxiety, the first step is to make an appointment with a healthcare provider. You can meet with your primary care provider or a psychiatrist. Or, you can find a new healthcare provider on a platform like Klarity Health. 

During your appointment, your provider will ask you questions about your anxiety symptoms, your medical history, and any other type of medications you’re taking. This information can help them determine whether Cymbalta is right for you. 

It can feel daunting to talk to someone about how you’re feeling, but be honest. Your healthcare provider is there to help you and find the most effective anxiety treatment for you.

Is Cymbalta good for anxiety? — what the research says

Research supports the efficacy of Cymbalta for anxiety, particularly for generalized anxiety disorder. Clinical trials referenced on DailyMed showed that Cymbalta reduces anxiety symptoms and improves overall functioning. Participants report fewer feelings of worry, tension, and irritability while on Cymbalta. 

For example, after taking Cymbalta for 10 weeks, almost 60% of people taking Cymbalta reported about a 50% reduction in their symptoms and improved quality of life.

Another study found similar results, with symptoms continuing to improve after the initial study period. People reported less anxiety and tension. They also felt more functional at home, work, and in social settings.

Cymbalta even works for people who haven’t responded to other treatments for anxiety or depression, according to another study. In just 4 weeks, participants started to feel less anxious and depressed in their day-to-day life.

What clinicians say about Cymbalta for anxiety

Healthcare providers who prescribe Cymbalta for anxiety say it can be a good fit for people who are dealing with chronic pain or concerned about sexual side effects from other antidepressants.

“[SNRIs] can be really effective. And I think certainly if someone’s tried a couple of SSRIs, an SNRI would be very reasonable. I like to use them if there’s a chronic pain element, especially duloxetine has, you know, an indication for fibromyalgia and chemically they’re similar to the tricyclics, which we also shouldn’t forget about as an antidepressant class.” — Dr. Eleanor Anderson, MD, psychiatrist and professor at Penn Medicine

“If you look at the serotonin-norepinephrine reuptake inhibitors (SNRIs) — duloxetine, desvenlafaxine, et cetera — those have a lower rate of sexual dysfunction. Norepinephrine probably mitigates some of these effects because serotonin is inhibitory on sexual functioning, and dopamine and norepinephrine are excitatory. The rate with SNRIs is that about 45% of patients will have some type of sexual dysfunction.” — Dr. Anita Clayton, psychiatrist and professor at University of Virginia School of Medicine

Cymbalta reviews for anxiety from people who take it

Reddit users describe their experiences taking Cymbalta on the r/cymbalta subreddit. Here’s what some of them say.

“Absolute game changer for me. I was having panic attacks 3 to 5 times a week. I’ve been taking cymbalta for almost 3 months now and I have zero panic attacks. I would say that my anxiety is about 98% gone! Sometimes I still get in my head but it quickly subsides.” — tacoflavored_kisses1

“I started at 20mg and worked my way up to 60mg over two months, very little side effects only dry mouth for me. I started for severe panic attacks, but I also had GAD. My generalized anxiety is at a zero. My panic attacks have made a huge improvement. It’s like I can feel them trying to start but something is blocking them from actually happening. I’ve been on Zoloft, Wellbutrin and Prozac. Cymbalta has given me the most noticeable difference” — lvmxfdn

“20mg for two months. Anxiety is 100% gone!!! Took about 10 days for me to start to feel it help and by week 3 all anxiety gone. It also eliminated my depression /ocd and pmdd.” — Downtown_Radish2334

“I’m on day 3 and very curious to see if it helps. Day one I had a pretty intense, short-lived reaction to it (dizzy, tingling in my face and hands, basically felt “drunk” for an hour and a half). I’m on 30mg and am trying to stay the course to see how it affects me. So far I’ve had some sleep disturbances on it, I’m more sleepy at night, and I wake up a lot throughout the night. Hoping this all passes as my body adjusts.” — LakashY

“I’ve been on cymbalta to help my social anxiety for about three months now and I really feel so much better. I feel happier and while I’m still anxious at times I’m actually able to function better at work and not completely shut down. I’ve stayed at 30 the entire time. Just asked my doctor to bump to 40 because a work thing just happened that makes me very anxious but I don’t plan on going up any more. Overall it’s been positive for me and a complete 180 from Zoloft.” — sassybread

“I was on 40mg for 1.5 weeks then went up to 60mg for 5 weeks. The 60mg worked great for my depression and anxiety, but gave me terrible restless legs at night. I am now down to 50mg for the last week. Restless legs feeling better, but my anxious worrying thoughts are back a little. Hoping it all balances out!” — CAA020780

You can also find user reviews of Cymbalta for anxiety on WebMD. Here are some highlights.

“I thought this was a wonderful drug until I forgot to take it for 2 days and started feeling horrible. I am on day 6 and still have a constant headache, anxiety, nausea, shaking, and my whole body becomes drenched in sweat. I am also now feeling my neck and arm pain more that I am guessing this medication dealt with. I don’t care how much pain I have to feel again I am not staying on something that has these types of horrible withdrawal symptoms. I just hope it ends soon so I can reclaim my life again and treat my pain, anxiety and adhd with meds that don’t have horrible withdrawals like Cymbalta. I have skipped doses of my anxiety and adhd medication and have never felt like what I am feeling getting off of Cymbalta.” — Hypersweeper

“I have been taking Cymbalta for some time now and it has helped me a lot with my anxiety but it does not help my depression much I started a 9/10 now I am a 6.5/10 the one problem with Cymbalta is the mood swings I can be happy and 10mins later if i had no mood swings i would love it.” — Matt12

“I have had serious anxiety that has been debilitating for some time. I have been taking Duloxetine (generic) for about a month and it has been a game changer. At first it made me super tired but once I got used to it, it just helps me sleep and stay asleep each night feeling rested. Therefore, clearer thinking and more stable emotions. I didn’t realize until reading this about helping with chronic pain but I have noticed less pain associated with my anxiety before. Overall I feel so much better.” — Jacqson

You can find more firsthand reviews of Cymbalta for anxiety on Reddit and WebMD. In the next section, we cover what else you need to know about taking Cymbalta.

What to know about taking Cymbalta for anxiety

While Cymbalta is a proven treatment for GAD, it’s important to be aware of potential side effects, adverse effects, and drug interactions before starting the medication. Cymbalta may be a good treatment option for you, or it may not, depending on your personal medical history and tolerance for certain side effects.

Common Cymbalta side effects

Nausea is by far the most common side effect of Cymbalta and affected nearly 1 in 4 people in clinical trials. Other common side effects of Cymbalta for adults include dry mouth, sleepiness, constipation, headache, reduced appetite, and increased sweating. In addition to nausea, children taking Cymbalta may experience vomiting, fatigue, and diarrhea. These symptoms are often mild and tend to subside after the first few weeks of treatment. 

SNRIs like Cymbalta can also cause sexual side effects, such as a reduced sex drive or delayed orgasm or ejaculation. These side effects typically don’t improve over time. If you have concerns about side effects on Cymbalta, talk to your healthcare provider.

Serious side effects

In rare cases, Cymbalta can cause serious side effects, including liver damage, severe skin reactions, or seizures. Cymbalta can also cause an increase in blood pressure and bleeding (such as nose bleeds). If you experience any of the following symptoms, contact a healthcare provider immediately:

• Yellow skin or eyes
• Confusion 
• Rapid heart rate
• Skin blisters
• Peeling rash
• Sores in your mouth
• Hives
• Mania
• Fainting due to a drop in blood pressure

Boxed warning

Cymbalta does have a boxed warning (the FDA’s most serious warning for suicidal thoughts and behaviors in children, adolescents, and younger adults. But studies didn’t find the same risks for people 24 and up. 

Drug interactions and contraindications

Cymbalta can interact with other medications, including blood thinners, nonsteroidal anti-inflammatory drugs (NSAIDs), for example, aspirin and ibuprofen, and monoamine oxidase inhibitor (MAOI) antidepressants. Taking these medications with Cymbalta may lead to serious side effects. Before taking Cymbalta, be sure to tell your healthcare provider about all medications, supplements, and over-the-counter (OTC) drugs you take. 

Cymbalta may also not be safe for people with certain medical conditions, such as liver damage or glaucoma. Share your full medical history with your healthcare provider so they can ensure Cymbalta will be safe for you to take.

How to safely stop taking Cymbalta

You never want to stop Cymbalta without medical supervision to avoid discontinuation syndrome which causes withdrawal symptoms. Abruptly stopping Cymbalta can cause withdrawal symptoms, such as:

• Dizziness
• Headaches
• Vomiting
• Diarrhea
• Insomnia
• Tingling in the arms and legs

To lower your risk of experiencing these symptoms, your healthcare provider will have you slowly taper off Cymbalta.

Alternatives to Cymbalta for anxiety

If Cymbalta doesn’t work for you or the side effects become too much, you have plenty of other options for managing your anxiety. 

Other anti-anxiety medications, including other SNRIs such as Effexor or Pristiq (desvenlafaxine), can effectively treat anxiety. Effexor is FDA-approved for generalized anxiety disorder (GAD), as well as social anxiety disorder (SAD) and panic disorder, while Pristiq is FDA-approved for depression but is prescribed off-label for anxiety. 

There are also selective serotonin reuptake inhibitors (SSRIs) like Zoloft (sertraline) or Lexapro (escitalopram). Lexapro is FDA-approved for both depression and GAD. Zoloft is FDA-approved to treat depression, posttraumatic stress disorder (PTSD),  panic disorder, obsessive-compulsive disorder (OCD), and SAD. Other alternatives to anxiety medication include beta blockers and buspirone. 

Some natural supplements may also have a mild anti-anxiety effect. Lavender, lemon balm, or valerian root may be helpful, especially if you have trouble sleeping.

Finally, cognitive-behavioral therapy (CBT) is one of the most effective forms of therapy for anxiety. The goal of CBT is to help you identify the thoughts and habits that trigger your anxiety. Then, you learn healthier behaviors and thought patterns to replace them with. 

What to combine with Cymbalta for anxiety

Cymbalta can be even more effective when combined with therapy for anxiety, according to research. Therapy helps you address the root causes of your anxiety, reframe negative thought patterns, and develop healthier coping mechanisms so you can better combat the long-term effects of anxiety. You can access CBT individually, in group sessions, or through online anxiety therapy providers. 

Learning mindfulness and stress management techniques can also be effective. So can lifestyle changes. Some of the most effective lifestyle changes for anxiety include:

• Adopting a regular exercise routine
• Improving your diet
• Limiting caffeine and alcohol
• Stopping smoking

Key takeaways

• Cymbalta helps relieve anxiety symptoms associated with generalized anxiety disorder. It may also help with other anxiety disorders.
• It works by balancing serotonin and norepinephrine levels in the brain, so you feel more calm and less anxious.
• Common side effects include nausea, dizziness, and dry mouth. More serious side effects, though rare, can occur.
• Always consult a doctor before starting or stopping Cymbalta. The medication can interact with other prescription drugs and non-prescription drugs and health conditions.
• Other medications, therapy, and natural supplements may also be effective in treating anxiety.

Talk to a provider about Cymbalta in 24 hours*

Anxiety can feel debilitating, but it doesn’t have to. With the right treatment, you can get relief from your symptoms and enjoy more of your day-to-day life. Find a provider on Klarity Health to see if Cymbalta is a good option for your anxiety symptoms. Some providers have appointments available in as little as 24 hours.*