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Cymbalta (duloxetine) for anxiety: What you need to know

Cymbalta (duloxetine) for anxiety: What you need to know

Cymbalta is a brand name for duloxetine, a medication that’s been approved by the FDA since 2004 to treat depression and anxiety, as well as other conditions.

Reviewed by:
Divya Khosla, MD
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February 23, 2024
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Key takeaways

If you’ve been diagnosed with an anxiety disorder, or believe you may have one, there are a few different medications that doctors may prescribe. One common treatment option is Cymbalta.

Whether you’re already taking Cymbalta for anxiety or you think you might benefit from taking it, this guide will tell you what you need to know about how Cymbalta works, how long it takes to work, and the side effects you should look out for.

What is Cymbalta and how does it work?

Cymbalta is a brand name for duloxetine, a medication that’s been approved by the FDA since 2004 to treat depression and anxiety, as well as other conditions. Other brand names for duloxetine include Irenka and Drizalma Sprinkle. Regardless of what it's called duloxetine (Cymbalta) is a serotonin and norepinephrine reuptake inhibitor (SNRI)—a type of medication that works by balancing chemicals in your brain called neurotransmitters. One of them is serotonin, which helps regulate mood and promotes good feelings. The other is norepinephrine, which helps with alertness and energy levels.  

Typically, after these neurotransmitters do what they’re supposed to, nerve cells reabsorb—or “reuptake”—them. SNRIs like Cymbalta block, or inhibit, that reuptake, keeping the serotonin and norepinephrine active in your brain, which can help you feel better emotionally.

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What conditions does Cymbalta treat?

Cymbalta can help regulate chemical imbalances or a serotonin deficiency, and it has been clinically proven to treat a variety of mental health disorders, including

If you have one of these conditions, or think you might, talking to a doctor is the right place to start. You can take our free online assessment to get matched with a psychiatrist to help get a diagnosis and/or treatment.

Off-label uses

Doctors also prescribe duloxetine for off-label uses. If a doctor prescribes a drug for an off-label use, it’s because the drug has shown some success as a potential treatment for a specific condition despite not being the primary use for that drug. For Cymbalta, these include:

  • Chemotherapy-induced peripheral neuropathy
  • Stress urinary incontinence
  • Osteoarthritis pain
  • Panic disorder (PD)
  • Social phobia or social anxiety disorder

How long does it take Cymbalta to work?

If you’re taking duloxetine for anxiety or depression, it usually takes between 2-4 weeks to begin noticing the effects. It can take up to 4-6 weeks to see the maximum benefits of a particular dose of Cymbalta. (If you’re using it for nerve pain, it may take longer to work.) This varies from person to person and the exact dosage of Cymbalta prescribed. Like many other antidepressants, it may not work right away. But that’s no reason to skip out on treatment.  

Even if you don’t notice its effects, stopping antidepressant medications, like Cymbalta, can lead to withdrawal symptoms or cause serotonin syndrome, which can have serious affects on your health. Keep in contact with your psychiatrist and let them know if your symptoms aren’t improving. They can help with adjust dosage adjustments or changes to your medication.  

Potential side effects of Cymbalta

Like any medication, Cymbalta and other duloxetine products may cause side effects. Most people (90%) have no side effects or very minor ones, which can be resolved by adjusting the dose with your doctor.  

Common side effects

These are typically short-lived and improve with time. They can also be treated if they persist.

  • Difficulty sleeping
  • Headaches
  • Dizziness
  • Blurred vision
  • Constipation
  • Diarrhea
  • Nausea or vomiting
  • Increased blood pressure
  • Urinary retention
  • Dry mouth
  • Sweating
  • Tiredness or drowsiness
  • Diminished appetite and weight loss
  • Diminished interest in sex, or sexual dysfunction, including difficulty maintaining an erection or reaching orgasm  

Serious side effects

In rare cases, you may experience more adverse effects from taking this medication.You should call 911 or go to the ER right away if you experience any of the following:

  • Seizures
  • Yellowing in the whites of your eyes, which may be a sign of liver issues
  • Hypomanic symptoms like hallucinations, bursts of sudden anger or euphoria, excitement, extreme agitation or irritability and  restlessness  
  • Worsening suicidal thoughts or thoughts of self-harm

Some people are allergic to duloxetine and, in extreme cases, it’s possible to have a serious allergic reaction. If you’re having trouble breathing, breaking out into hives, or feeling a tightness in your throat, go to the ER right away.

Cymbalta vs. other medications

Other common SNRIs used to treat anxiety and depression include Pristiq (desvenlafaxine) and Effexor (venlafaxine). These medications come in different doses, have slightly different side effects, and can be used to treat different symptoms. For instance, Pristiq, and Effexor may raise your blood pressure while duloxetine may worsen existing liver problems. If you’re worried about any specific side effects or have allergies, always remember to tell your doctor. They’ll guide you through your options based on any concerns you have.

SSRIs are another class of antidepressant that can also help with anxiety. They’re prescribed more often because they tend to be less likely to cause side effects than some SNRIs. Common SSRIs include Celexa (citalopram), Lexapro (escitalopram), Prozac (fluoxetine), Paxil (paroxetine), and Zoloft (sertraline).

Related article: Cymbalta vs Lexapro

Your psychiatrist will help you choose between the different types of anxiety and depression medication. Some medications have interactions, and a health care provider will take that into account when discussing your treatment options. Make sure to tell them about any medical conditions you may have and whether you’re pregnant or breastfeeding to narrow down treatment options to what is best in your situation.

Is Cymbalta good for depression and anxiety?

Cymbalta is an antidepressant that can effectively regulate your serotonin and norepinephrine levels to help minimize your anxiety symptoms and get you on your way to feeling better. If you’re struggling with anxiety and think Cymbalta can help with your symptoms of depression or anxiety, reach out to a medical health professional. Talkiatry can help connect you with a licensed psychiatrist to help you get a diagnosis and treatment plan. The first step is completing our short free online assessment to schedule your first visit.  

The information in this article is for informational and educational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

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Frequently asked questions

Does Talkiatry take my insurance?

We're in network with major insurers, including:

  • Aetna
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Even if your insurer isn't on the list, we might still accept it. Use the insurance eligibility checker in our online assessment to learn more.

Can I get an estimate of my visit cost?

The best way to get a detailed estimate of your cost is to contact your insurance company directly, since your cost will depend on the details of your insurance.  

For some, it’s just a co-pay. If you have an unmet deductible it could be more.  

Call the number on your insurance card and ask about your plan’s coverage for outpatient psychiatric services.

How does Talkiatry compare to face-to-face treatment?

For most patients, Talkiatry treatment is just as effective as in-person psychiatry (American Psychiatric Association, 2021), and much more convenient. That said, we don’t currently provide treatment for schizophrenia, primary eating disorder treatment, or Medication Assisted Treatment for substance use disorders.

What kind of treatment does Talkiatry provide?

At Talkiatry, we specialize in psychiatry, meaning the diagnosis and treatment of mental health conditions. Your psychiatrist will meet with you virtually on a schedule you set together, devise a treatment plan tailored to your specific needs and preferences, and work with you to adjust your plan as you meet your goals.

If your treatment plan includes medication, your psychiatrist will prescribe and manage it. If needed, your psychiatrist can also refer you to a Talkiatry therapist.

What's the difference between a therapist and psychiatrist?

Psychiatrists are doctors who have specialized training in diagnosing and treating complex mental health conditions through medication management. If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.  

Other signs that you should see a psychiatrist include:  

  • Your primary care doctor or another doctor thinks you may benefit from the services of a psychiatrist and provides a referral    
  • You are interested in taking medication to treat a mental health condition  
  • Your symptoms are severe enough to regularly interfere with your everyday life

The term “therapist” can apply to a range of professionals including social workers, mental health counselors, psychologists, professional counselors, marriage and family therapists, and psychoanalysts. Working with a therapist generally involves regular talk therapy sessions where you discuss your feelings, problem-solving strategies, and coping mechanisms to help with your condition.

Who can prescribe medication?

All our psychiatrists (and all psychiatrists in general) are medical doctors with additional training in mental health. They can prescribe any medication they think can help their patients. In order to find out which medications might be appropriate, they need to conduct a full evaluation. At Talkiatry, first visits are generally scheduled for 60 minutes or more to give your psychiatrist time to learn about you, work on a treatment plan, and discuss any medications that might be included.

Divya Khosla, MD

Dr. Divya Khosla, MD, is a board certified Adult Psychiatrist and board eligible Child and Adolescent Psychiatrist. She received her undergraduate degree from Case Western Reserve University in Cleveland, Ohio, and her medical degree from Ross University, completing all of her clinicals in Maryland, D.C., and NYC. She completed her adult psychiatry residency at The Ohio State University in Columbus, Ohio. Then she returned to the east coast, where she completed her child and adolescent psychiatry fellowship at Nassau University Medical Center in East Meadow, New York.

Dr. Khosla has participated in a variety of innovative academic clinical research, and has presented research at annual national meetings of the American Psychiatric Association. Her robust clinical experience with varying demographics at different clinical sites around the country has allowed her to treat patients in an evidence-based way, tailoring treatment to an individual’s specific needs.

Although Dr. Khosla’s practice focuses on medication management, she also implements supportive therapy and motivational interviewing in sessions to allow for a more comprehensive approach to treatment. Her clinical interests include depression, bipolar disorder, anxiety disorders, post-traumatic stress disorder, panic disorder, and ADHD.

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