Cymbalta is a prescription medication that can help alleviate symptoms of depression, anxiety, and chronic pain.
Many people starting Cymbalta also have insomnia, or difficulty sleeping.
Poor sleep can have adverse effects on your physical health, and it can also make it difficult to find joy in daily life activities, a common goal for many people seeking treatment for mental health conditions.
In this article, I’ll describe how Cymbalta works, how it may affect your sleep, and some strategies that may help to improve your sleep while taking Cymbalta.
I’ll also tell you some signs that you should talk to your doctor.
What is Cymbalta?
Cymbalta is a type of medication called a serotonin and norepinephrine reuptake inhibitor, or SNRI.
SNRIs work by affecting chemicals in the brain known as neurotransmitters.
These neurotransmitters (serotonin and norepinephrine) can help regulate mood, stress, and even pain perception.
Because Cymbalta works by affecting two specific neurotransmitters, it can also be referred to as a dual reuptake inhibitor or dual-acting antidepressant.
What does it treat?
Cymbalta is often prescribed to treat major depressive disorder, or MDD.
It can also be prescribed to treat:
- Generalized anxiety disorder (GAD)
- Chronic pain, including fibromyalgia, arthritis, and diabetic neuropathy
It can take between 2-8 weeks for Cymbalta to start taking effect.
Some mild side effects can occur during that period, including nausea, dizziness, fatigue, dry mouth, and insomnia.
Many of these side effects will resolve on their own, but not always.
To ensure you’re reducing the risk for side effects as much as possible, take Cymbalta exactly as directed by your provider.
Don’t take Cymbalta more or less frequently than recommended by your provider, and don’t double up on doses.
If you feel that you need to adjust your Cymbalta dose, don’t do so on your own.
Talk to your prescriber before making any changes.
Cymbalta and Insomnia
Unfortunately, insomnia is a common side effect experienced by some people who take Cymbalta.
Roughly 10% or more of patients taking Cymbalta report insomnia.
Insomnia can mean difficulty falling asleep, difficulty staying asleep, waking up earlier than desired, or waking up and still feeling tired.
There are many possible causes of insomnia, but if you’re experiencing signs for the first time after starting medication, it’s possible that you have Cymbalta-induced insomnia.
Insomnia can also be a side effect of Cymbalta withdrawal and discontinuation.
If you’re experiencing signs of insomnia or any other bothersome side effects while taking Cymbalta, reach out to your provider for guidance and help.
How to Sleep While Taking Cymbalta
During the first few weeks on a new antidepressant like Cymbalta, it’s helpful to let your provider know if new symptoms or side effects emerge, including insomnia.
In some cases, your provider may recommend waiting to see if your insomnia resolves on its own as you continue the medication.
If not, they may recommend one of the following alternatives.
Slowly increase dosage
When starting a new antidepressant, it’s common for your provider to start you at a lower dose and gradually increase the dosage until you reach the recommended therapeutic amount (usually 60 mg per day).
However, if you start to experience new side effects like insomnia as the dosage increases, your provider may recommend slowing the dose increase to minimize side effects and give your body time to adjust to the medication.
Reduce dosage if needed
Your provider may recommend reducing your dosage or discontinuing the medication altogether.
Higher doses of Cymbalta can exacerbate insomnia and other sleep disturbances, which is why your provider may recommend lowering the dosage if you’re still able to reap the therapeutic benefits of the medication.
Otherwise, stopping the medication may be the best option for you.
In that case, do not stop taking Cymbalta abruptly or suddenly.
It’s crucial that you work with your provider to gradually taper off of Cymbalta to avoid experiencing withdrawal symptoms.
Establish a routine
One way to support getting adequate, quality sleep is to establish a regular sleeping routine.
Going to bed at the same time every night (within one hour of variation) and waking up at the same time each day (also within one hour of variation) can help get your circadian rhythms into a reliable pattern.
Avoiding screens for at least an hour before bed can also help, as can sleeping in a cool room.
Relaxation techniques including deep breathing exercises, imagery, and others, can also help your mind and body relax before bed.
Use sleep aids
Over-the-counter (OTC) sleep aids have become a popular resource in recent years for people hoping to get good, consistent sleep.
Melatonin, when taken at typical doses of 1-5 mg nightly, is safe to use while taking Cymbalta.
Evidence suggests that melatonin supplements can help some people to improve total sleep time, sleep quality, and sleep latency (how long it takes to fall asleep).
Melatonin may also be particularly helpful in treating chronic insomnia in people aged 55 and older.
However, some supplements can cause adverse reactions when taken with Cymbalta and should be avoided, including St. John’s wort.
Check with your provider or pharmacist before adding any OTC sleep aid or supplement to your routine to be sure it will not have an adverse interaction with Cymbalta.
Avoid caffeine or exercise before bed
Regular exercise can support a healthy sleeping schedule, but exercising right before bedtime may impair the quality of your sleep.
Though there’s little evidence to suggest that you need to avoid exercising in the afternoon or evening (in fact, some research suggests that afternoon workouts can yield the best performance in some athletes), make sure that the end of your workout occurs at least 60-90 minutes before bedtime.
Though the rate at which you metabolize caffeine can vary depending on the individual, one study found that consuming caffeine even six hours before bedtime can reduce sleep time by one hour.
When to See a Doctor
For most people, Cymbalta can be a safe and effective treatment option for depression, anxiety, or chronic pain.
But if you’re experiencing insomnia or any other bothersome side effects while taking the medication, reach out to your provider to discuss whether adjusting the dose or switching to another antidepressant may help.
Reach out to your provider if you experience any of these rare, but serious, symptoms:
- Severe dizziness
- Hives, or a red or purple rash with blistering or peeling
- Itching or swelling, particularly of the mouth, face, or throat
- Trouble breathing
Additional signs that the medication may not be working appropriately can include these serious side effects:
- Panic attacks
- Worsening mood
- Feeling agitated, impulsive, aggressive, restless, or hyperactive
- Thoughts of suicide
If you experience any of the above symptoms, talk to your provider as soon as possible.
If you’re having a mental health emergency, call 911 or go to the nearest emergency room. You can also get free 24/7 support from a suicide and crisis expert by calling or texting 988. If you’d prefer to chat online, you can chat with a suicide and crisis expert by visiting the Lifeline Chat.
How K Health Can Help
Think you might need a prescription for Cymbalta (Duloxetine)?
K Health has clinicians standing by 24/7 to evaluate your symptoms and determine if Cymbalta is right for you.
Get started with our free assessment, which will tell you in minutes if treatment could be a good fit. If yes, we’ll connect you right to a clinician who can prescribe medication and have it shipped right to your door.
Frequently Asked Questions
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
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