Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regards to prescription medication.
Cymbalta is a prescription medication commonly used to treat conditions related to depression, anxiety and chronic pain. It’s the brand name for a generic drug called duloxetine.
In this article we’ll review some of the published medical research on Cymbalta, and explain whether it’s likely to be effective as well as discuss some potentially serious side effects.
We’ll also provide some natural alternatives that may be safer options for long-term use.
Cymbalta works primarily by increasing circulating levels of serotonin and norepinephrine in the brain. Increased levels of these neurotransmitters can lead to improved mental health parameters in some patients, and it’s theorized that reduced levels of these neurotransmitters may cause certain mental disorders.
A research review of Cymbalta as a treatment for generalized anxiety disorder, which was published in the Adis Drugs journal, found that the drug was more effective for reducing anxiety than placebo. The review analyzed four different placebo-controlled studies on Cymbalta for improving mental health disorders.
The same four studies also measured patients’ depression levels, and Cymbalta was more effective than placebo for improving depression in all studies.
Another research review assessed Cymbalta’s efficacy for chronic pain management. In all three clinical trials analyzed, Cymbalta was more effective than placebo for reducing pain.
Cymbalta Side Effects
The reason many consumers are somewhat wary of prescription medication is these drugs tend to come with a significant side effect profile. Cymbalta isn’t as risky in regards to side effects as other anti-anxiety drugs like benzodiazepines in our opinion, but still has serious potential side effects.
The medical review on Cymbalta for pain that we linked above found that 16% of participants in the six Cymbalta and pain trials stopped taking the drug due to side effects. This is a high number in our opinion: nearly 1 in 5 patients suffered side effects so uncomfortable they had to discontinue use.
The review of Cymbalta for anxiety found that nearly 25% of patients taking it experienced nausea. Dry mouth, headache, constipation and dizziness were the next four side effects reported in order of frequency. Around 10-15% of participants reported each these effects.
Nearly all side effects were found to be higher in the patients taking Cymbalta than placebo, proving that Cymbalta caused the side effects.
One of the longer-term studies on Cymbalta for anxiety found that 11 out of 213 participants taking the medication suffered extremely severe side effects. That’s over 5%.
Here were the “serious adverse events” reported: acute alcoholic intoxication, alcohol dependency, anxiety, arrhythmia, cellulitis, cerebral hemorrhage resulting in death, depression, diverticulitis, mania, nephrolithiasis, two attempted suicides, one completed suicide, stress, and syncope.
These adverse events, in our opinion, are horrific for an anxiety drug. We tend to recommend exhausting lifestyle and supplemental options prior to pharmaceutical treatment for mental health disorders because the side effect profile can be so concerning.
Cymbalta contains a black box warning about suicidal thoughts and behaviors that may be associated with use of the drug.
The increased risk of suicidal thoughts was the same side effect that led us to not recommend Contrave in our review of the prescription weight loss medication.
Natural Alternatives to Cymbalta
As stated in the disclaimer at the top of the article, we don’t recommend altering use of any prescribed drug without a discussion with a doctor.
For patients considering Cymbalta but not currently taking it, we believe it may be worthwhile to talk to your doctor about the below-listed natural alternatives which we believe to be much safer, and which are shown to be effective in medical research for the following health issues that Cymbalta treats.
Supplements and prescription medications can have life-threatening synergistic effects like serotonin syndrome, so it’s important to speak with your doctor before starting any new supplement to ensure it won’t interfere with any prescription medications you may be taking.
Depression | St. John’s Wort
St. John’s Wort is a plant that’s been used medicinally for thousands of years. Most medical studies on it use a supplement standardized to 2-5% hyperforin and 0.3% hypericin, as these are the active chemical compounds.
A medical review of St. John’s Wort found that for mild and moderate depression it was as effective as prescription medication, and had a much safer risk profile. The studies only ranged to a maximum of 12 weeks, so we hope to see future medical research on St. John’s Wort that’s longer in duration.
Another meta-study on St. John’s Wort concluded the same: that its supplementation was as effective for depression as pharma drugs with less side effects.
Anxiety | Ashwagandha
Ashwagandha is a root native to India and its extract has been studied extensively as an anxiolytic. This means it can reduce anxiety. Most medical research on ashwagandha uses a supplement standardized to 1-5% withanolides, as this is the active chemical compound.
A study testing ashwagandha against placebo in stressed adults found that ashwagandha supplementation significantly reduced stress levels, improved sleep and improved quality of life overall.
A medical review published in the Journal of Alternative and Complementary Medicine analyzed five trials on ashwagandha for anxiety. It concluded that in all five trials ashwagandha supplementation reduced anxiety, and that none of the trials reported significant adverse effects.
Pain | Turmeric Extract With Black Pepper Extract
Turmeric is a spice that can be used in food, but its extract is used medicinally as an anti-inflammatory. Most medical studies on turmeric use an extract supplement standardized to 95% curcuminoids, which are the active chemical compounds.
Black pepper extract improves turmeric bioavailability by 2000% based on medical research, so we recommend this combination. Many supplements have both ingredients.
A medical review from 2016 found that turmeric extract at a dosage of 1000 milligrams(mg)/day was effective in reducing pain caused by arthritis. This review assessed 8 individual studies on the topic.
Another review which was more recent found that “Turmeric has consistently been demonstrated to produce analgesic [pain-relieving] and anti-inflammatory effects in animal models and in clinical trials”.
We don’t believe there is as strong evidence for turmeric’s role as a standalone pain supplement as there is for ashwagandha and St. John’s wort for their respective uses, but the early research is promising.