Panic Disorder Treatment Cymbalta (Duloxetine) for Panic Disorder Uses, How It Works, Side Effects, and Precautions By Katharina Star, PhD 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. Learn about our editorial process Updated on July 10, 2023 Learn more." tabindex="0" data-inline-tooltip="true"> Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Peter Dazeley / Getty Images Table of Contents View All Table of Contents Uses How It Works Side Effects Precautions When Taking Trending Videos Close this video player 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: Eating disorders Obsessive-compulsive disorder (OCD) Post-traumatic stress disorder (PTSD) Sexual disorders 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: ConstipationDecreased appetiteDrowsinessDry mouthExcessive sweatingFatigueNausea 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. Panic Disorder Treatment Options 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. C. Freire R, Machado S, Arias-Carrion O, E. Nardi A. Current pharmacological interventions in panic disorder. CNS Neurol Disord Drug Targets. 2014;13(6):1057-1065. doi:10.2174/1871527313666140612125028 Muscatello MRA, Zoccali RA, Pandolfo G, et al. Duloxetine in psychiatric disorders: Expansions beyond major depression and generalized anxiety disorder. Front Psychiatry. 2019;10:772. doi:10.3389/fpsyt.2019.00772 Strawn JR, Prakash A, Zhang Q, et al. A randomized, placebo-controlled study of duloxetine for the treatment of children and adolescents with generalized anxiety disorder. 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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 Sobieraj DM, Martinez BK, Hernandez AV, et al. Adverse effects of pharmacologic treatments of major depression in older adults. J Am Geriatr Soc. 2019;67(8):1571-1581. doi:10.1111.jgs.15966 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. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Helpful Report an Error Other Submit