Cymbalta (Duloxetine) for Panic Disorder

Uses, How It Works, Side Effects, and Precautions

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Updated on July 10, 2023

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Antidepressants are a common treatment for panic disorder. They help by reducing panic attack symptoms and anxiety. Cymbalta (duloxetine) is one type of antidepressant that's prescribed for people diagnosed with this disorder.

If your healthcare provider wants you to take Cymbalta for panic disorder, it's beneficial to learn more about this drug. Here we share important information about Cymbalta, its potential side effects and precautions, and more.

The Most Important Things to Know About Cymbalta

Serious side effects such as hallucinations and abdominal swelling can occur when taking Cymbalta, requiring immediate medical attention.
Cymbalta may increase your risk of suicidal thoughts or behaviors.
You should not take Cymbalta within 14 days of taking a monoamine oxidase inhibitor (MAOI) or if you have uncontrolled narrow-angle glaucoma.

Uses for Cymbalta

Cymbalta belongs to a category of antidepressants called serotonin and norepinephrine reuptake inhibitors (SNRIs). Originally, SNRIs were used to treat mood disorders like depression and bipolar disorder. However, these drugs also have anti-panic properties, making them another option for treating panic disorder.

There is also some evidence that Cymbalta may be an effective treatment for borderline personality disorder (BPD) and schizophrenia, with mixed findings regarding its ability to help treat:

Other studies have found benefits of Cymbalta for anxiety. For instance, one study involving children and teens with generalized anxiety disorder (GAD) reported that duloxetine helped improve symptoms and remission rates. Another study found positive effects for treating social anxiety disorder (SAD).

The U.S. Food and Drug Administration (FDA) has also approved Cymbalta to treat several pain-based conditions, namely diabetic peripheral neuropathy, fibromyalgia, and chronic musculoskeletal pain.

How Cymbalta Works

Neurotransmitters are naturally occurring chemicals in the brain which are responsible for relaying messages that impact many bodily functions. It is thought that imbalances in certain neurotransmitters can lead to depression and anxiety disorders.

Cymbalta works to bring balance back to the neurotransmitters serotonin and norepinephrine, both of which are connected to panic disorder. Serotonin is involved in regulating functions including mood and sleep, while norepinephrine regulates the fight-or-flight stress response and reactions to anxiety.

Cymbalta restores balance by preventing brain cells from quickly absorbing these neurotransmitters. This helps bring equilibrium back, which subsequently helps to alleviate anxiety, lessen panic attacks, and improve mood.

Side Effects of Cymbalta

All prescribed medications have the potential for side effects and Cymbalta is no exception. Common side effects of Cymbalta include:

Constipation
Decreased appetite
Drowsiness
Dry mouth
Excessive sweating
Fatigue
Nausea

Because side effects vary from one person to the next, you may experience some, none, or all of these. Typically, these side effects will subside over time as your body adjusts to taking Cymbalta. Consult your physician if you experience side effects that don’t seem to go away or if they become worse.

Serious Cymbalta Side Effects

Serious allergic drug reactions can also happen when taking Cymbalta. Seek emergency medical treatment if you experience abdominal swelling, confusion, hallucinations, peeling or blistering of the skin, or difficulty breathing or swallowing.

Precautions for Cymbalta

Before you start taking a new medication, it's important that you understand its risks. Here are a few of the precautions associated with Cymbalta.

Suicidal Thoughts and Actions

The U.S. Food and Drug Administration (FDA) requires that a warning be placed on SNRIs and other antidepressants. Known as a black box warning, this statement indicates that these medications can potentially increase the risk for suicidal thoughts and actions.

Children, teens, and young adults have been found to be especially at risk. That said, anyone taking SNRIs should be monitored for a decline in mood and/or suicidal thoughts, especially if they are in one of these at-risk age groups.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Alcohol Consumption

Drinking alcohol while taking Cymbalta is not recommended. Alcohol consumption can increase the toxicity of Cymbalta, potentially impacting its effectiveness and leading to more serious side effects.

Drug Interactions

Drugs that may interact with Cymbalta include:

Blood thinners
Certain antidepressant medications
Migraine medications
Monoamine oxidase inhibitors (MAOIs)
Nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and other pain medications

Tell your healthcare provider about all other over-the-counter and prescription medications you're taking or plan to start. This includes any vitamins, supplements, or herbal products as many of these can interact with Cymbalta.

Special Populations

If you are pregnant or nursing, consult your physician before taking Cymbalta as it's possible to pass this medication to the fetus. Older adults should also discuss taking Cymbalta with their prescribing doctor as they may be at greater risk for experiencing side effects with this drug.

When Taking Cymbalta

Don’t expect Cymbalta to immediately resolve your symptoms of panic disorder. You may notice improvements within the first days to weeks; however, it can take up to two months to experience the drug's full effects. So, you may need to give your medication some time before deciding if it's working for you.

Also, don't suddenly stop taking Cymbalta as you may experience uncomfortable discontinuation symptoms. Symptoms of discontinuation syndrome include dizziness, upset stomach, nausea, vomiting, diarrhea, headaches, anxiety, and sleeping difficulties.

If you need to stop taking this drug, talk to your healthcare provider first as they can gradually decrease your dose to help avoid Cymbalta withdrawal symptoms.

Summary

This article does not cover all possible scenarios, such as potential severe side effects, overdose, and contraindications associated with Cymbalta. Always consult your healthcare provider or pharmacist about any questions and/or concerns you may have about your prescription.

13 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

National Institute of Mental Health. Panic Disorder: When Fear Overwhelms.
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Esler M, Alvarenga M, Barton D, et al. Measurement of noradrenaline and serotonin metabolites with internal jugular vein sampling: An indicator of brain monoamine turnover in depressive illness and panic disorder. Front Psychiatry. 2022;13:818012. doi:10.3389/fpsyt.2022.818012
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Fornaro M, Anastasia A, Valchera A, et al. The FDA "black box" warning on antidepressant suicide risk in young adults: More harm than benefits? Front Psychiatry. 2019;10:294. doi:10.3389/fpsyt.2019.00294
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Additional Reading

Silverman HM. The Pill Book (15th Edition).

By Katharina Star, PhD
Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness.

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