11 Cymbalta Side Effects You Should Know About

The goal with antidepressants is to reduce major symptoms and then taper off after about nine months, Saltz says.

But it can be hard to quit Cymbalta when the time comes, in large part due to withdrawal symptoms. One study found that dizziness, nausea, headaches, and paresthesia (commonly called “brain zaps,” or a sensation of electric shock in the brain) were common when going off the drug. Withdrawal symptoms lasted about two weeks on average.

The longer you’re on Cymbalta, the more likely it is to be an issue. And the risks of staying on the drug for the long-term are unknown. “What we do know is it is always important for everyone to taper off slowly [and under doctor supervision]. Abruptly stopping is much more likely to produce symptoms,” she says.

People 24 and younger may experience thoughts of suicide on Cymbalta. According to the FDA, the risk is greatest in those under the age of 18 and elevated in people ages 18 to 24.

This may be because Cymbalta can worse or cause symptoms including anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, hypomania, and mania.

At the same time, suicide risk actually decreases in people 25 and over, particularly among people over the age of 65.

“Any of these drugs may increase suicidal thoughts in periods of time when there’s a big shift—when you’re starting or raising a dose,” says Saltz. “The numbers aren’t big, so we don’t know who will be affected.”

No getting around this one: Pretty much all antidepressants have the potential to zap your sex drive. In fact, low libido is one of the most common side effects of drugs like Cymbalta—although it doesn’t affect everyone.

If it does, your doctor might try decreasing your dose and/or your therapist may offer behavioral tricks to get around it. “Sometimes it goes away. Other times it may be intolerable, in which case it might not be a drug that’s good for you,” says Saltz.

If you find that you feel super-fatigued on Cymbalta, your doctor may suggest taking it at night before bed, when drowsiness isn’t a problem, or taking a divided dose, says Saltz.

While drugs like antihistamines don’t interact with SNRIs, your doctor will also advise you to skip them because, in combination, these two drugs can make you extra-drowsy.

With both SSRIs and SNRIs, increased blood pressure is possible. “Think of when you get a big adrenaline rush. You get basal restriction, which causes your blood pressure to go up,” says Saltz. A similar reaction can happen when you’re taking Cymbalta.

For most people, especially younger people, it’s not an issue. But if you already have borderline or high blood pressure, your doctor will want to keep an extra close eye on you.

Some people experience light-headedness or dizziness, especially when they first start Cymbalta. “It has to do with a shift in blood pressure. You’ll want to get up slowly from lying positions,” says Saltz. If it continues, or really bothers you, definitely check in with your doctor.

Both medications and alcohol are metabolized—i.e. processed—by your liver, and consuming either in high levels can cause jaundice and other more serious liver problems. “Liver problems are pretty rare but bad,” says Saltz.

The risk rises if you drink alcohol while taking Cymbalta: One drink is more like two. Certain other drugs, including some OTC ones, can also potentially interact with Cymbalta and be hard on your liver. “That’s why it’s very important to discuss all other medications you’re taking with your doctor,” Saltz says.

In very rare instances, taking aspirin, nonsteroidal anti-inflammatory drugs, warfarin, and other anti-coagulants while on Cymbalta can cause excessive bleeding. “Talk to doctor before you take those meds,” says Saltz.

One very rare but serious side effect of Cymbalta and other antidepressants is serotonin syndrome. “Raising serotonin levels a certain amount can be helpful, but a lot can cause toxicity and even kill you,” explains Saltz. If you experience fast heartbeat, loss of coordination, extremely restlessness, agitation, and/or hallucinations, tell your doctor right away, who will likely take you off of the medication immediately.

Overdose can also be a problem. “Someone who purposely took a bottle might say they’re only antidepressants, but it’s very dangerous. And if your kid gets a hold of a bottle, call poison control and head to the ER right away,” says Saltz.

Gastrointestinal symptoms like nausea, diarrhea, constipation, and heartburn are not as rare as overdose or death, but they’re obviously not as serious, either. Other milder symptoms include headaches, dry mouth, loss of appetite, and night sweats. “We try to figure out if they can be managed over time. They can go away, but they don’t always,” says Saltz.

One last word of warning: Be sure to let your doctor know if you have a family or personal history of bipolar disorder, because antidepressants may increase your likelihood of becoming manic. “If you experience periods of time of where you feel highly agitated and irritable or overly confident and sped up, ask your doctor,” says Saltz. “It’s not that you wouldn’t be prescribed an antidepressant, but you really want to be cautious. You’d be checked more frequently and might be put on a mood stabilizer instead.”