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Thinking of starting an antidepressant? Simply, please do NOT.
Research shows that antidepressants are no better than placebo and can cause tremendous damage to the brain and body.
Antidepressants work by changing our brain chemistry and function. Considerable evidence shows that they are dangerous. The theory that depressed brains have a chemical imbalance has been proven to be false. Mounting evidence shows that antidepressants cannot treat depression effectively. Some of these drugs are also being prescribed for the pain of fibromyalgia or other neuropathic pain disorder. However, we are convinced the harmful effects of the drug are worse than the pain. Hence the group name Cymbalta Hurts WORSE!
We strongly recommend you do not take them. Find out for yourself. Ask questions. Read the information below and do other research.
Things to Ask Your Doctor:
- Do I really need this drug?
- What are the risks and benefits of taking this?
- Are there safer options?
- Is the data from a drug company-sponsored study?
- What is the underlying cause of my condition?
- Is this drug addressing the cause of my condition or only symptoms?
- What happens if I don’t take what you have suggested?
Large bodies of anecdotal information also carry scientific weight. The experience of our founding group, Cymbalta Hurts Worse, extends back to 2013. The group’s administrators and moderators have reviewed the posts of about 40,000 individuals desiring to cease taking brand name Cymbalta® or generic duloxetine. The collective opinion is that this drug is too dangerous in itself to be used for any therapy.
Why is Cymbalta/duloxetine so bad?
This drug is an SNRI. That stands for selective serotonin and norepinephrine reuptake inhibitor. Simply, it interferes with the body’s ability to absorb serotonin and norepinephrine. Some doctors mistakenly believe that this interference reduces depression and other problems. There is no certain evidence for this belief. We suggest the research proves (see our Authorities page) that this drug and other antidepressants work no better than a “placebo” or sugar pill. This is now coming to light.
The Inventor, Eli Lilly, ADMITS it is dangerous
The company who invented this drug, Eli Lilly, is forced to admit the quantity of horrific side effects in their formal product insert https://pi.lilly.com/us/cymbalta-pi.pdf
Since 2013, this group has seen all of these and more.
But don’t take their word for it
The Facebook group “Cymbalta Hurts Worse“, (CHW) over the last decade, has amassed, as of 2024, about 40,000 members. Hundreds of thousands of posts have provided the basis for the Gradual Taper that we describe in this site. Read posts from of the members on these subjects. No names or identifying info is included, and these are gathered at random over time. Click to go to that page:
From CHW: Symptoms
From CHW: Going “Cold Turkey”
From CHW: Bad Doctor Tapers
From CHW: Successful Gradual Tapers
Short Half-Life
Because this drug interferes with how the brain operates, it is unlike most of the other drugs you may be familiar with. For example, it is very quickly excreted from the body, about 50% in just 12 hours on average. That gives it a “half-life” that is one of the shortest of all the psychotropic drugs. This also means that you are on the verge of withdrawal every day.
“Cymbalta has one of the shortest half-lives (compared to many other leading antidepressants) and, thus, it would be expected to frequently cause withdrawal symptoms upon discontinuation.” —Joseph Glenmullen, MD, graduate of and clinical instructor in psychiatry at Harvard Medical School, and author of two books on the side effects of antidepressants: Prozac Backlash: Overcoming the Dangers of Prozac, Zoloft, Paxil and Other Antidepressants with Safe, Effective Alternatives and The Antidepressant Solution: A Step-by-Step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and “Addiction.”
This is why keeping a strict schedule of daily doses is critical, and some have even found relief splitting their dose in half, with one half in the morning and one half at night, 12 hours apart. Sadly, very few physicians understand the need for slow, gradual tapering, so we are here to support you. Many medical professionals propose very quick, large reductions and skipping days, both of which lead to horrible withdrawal effects. Read on for the solution.
Hyperbolic Effect
The effect of this drug on your body is hyperbolic, meaning that lower doses have a greater effect than higher doses. This is different from most drugs we know and use. We know that the effect of two doses of ibuprofen (such as Motrin) is about double that of one dose. But with Cymbalta/duloxetine, the receptors in your brain are changed, and it takes very little of the drug to do that. See the chart below on the effect of serotonin at various doses.
Diagram from Anders Sorenson, PhD: https://www.nature.com/articles/s41380-021-01285-w
And the more drug you take, the less the effect of the increased part of the dose. This is counterintuitive. Note that almost maximum effect is had at 60mg, and we cannot understand why an educated doctor would prescribe more, causing more side effects.
A smaller dose of 20mg achieves 70% of the effect, while tripling the dose to 60mg only increases the effect to 80%.
EFFECT
05mg 40%
10mg 55%
20mg 70%
30mg 75%
40mg 78%
50mg 80%
60mg 82%
Obviously, it only takes a little to make a big difference. The same 10mg dose increase from 10 to 20mg causes a 15% increase in effectiveness, while going from 50mg to 60mg only has an increase of 2%! This is why doses of 90mg and 120mg do not seem to make sense.
Prescribed too often at too high dosages
According to ClinCalc, https://clincalc.com/DrugStats/Drugs/Duloxetine, the estimated number of patients on Cymbalta/duloxetine in the US alone as of 2021 was 4,444,533! That is about 1.34% of the population of the country at that time!
Even worse, antidepressants, in general, are very commonly prescribed:
Overall Usage: Data from the Centers for Disease Control and Prevention (CDC) suggests that during 2015-2018, 13.2% of adults aged 18 and over used antidepressant medications in the past 30 days. [1]
Age: Antidepressant use increases with age. The CDC data shows usage ranged from 7.9% among adults 18-39 years old to 24.3% for those 60 and over. [1]
Gender: Women are more likely to take antidepressants than men. During the same period, 17.7% of women and 8.4% of men reported using antidepressants. [1]
Race and Ethnicity: Antidepressant use varies by race and ethnicity. According to the CDC, in 2015-2018, non-Hispanic white adults had the highest usage (16.6%), followed by Hispanic adults (6.5%), non-Hispanic black adults (7.8%), and non-Hispanic Asian adults (2.8%). [1]
Education: Adults with at least some college education showed a slightly higher usage rate (14.3%) compared to those with a high school education (11.5%) or less (11.4%). [1]
Increased Usage: A study published in Pediatrics reported a significant increase in antidepressant prescriptions dispensed to adolescents and young adults (12-21 years old) between 2016 and 2022. The dispensed prescriptions grew by 46.1%. [2]
Here are some resources where you can find more details and up-to-date statistics:
- Centers for Disease Control and Prevention (CDC): https://www.cdc.gov/nchs/products/databriefs/db283.htm
- National Institute of Mental Health (NIMH): https://www.nimh.nih.gov/health/topics/depression
Over Dosed
We are shocked to see doses of 90mg and 120mg prescribed, as even the inventor, Eli Lilly, does not recommend such high doses. Since it is hyperbolic – see above – these excessive doses have no clinical value. According to Lilly, for most disorders for which it is designed, 60mg is the maximum effective dose. All from Lilly’s product insert https://pi.lilly.com/us/cymbalta-pi.pdf
Depressive Disorder
Fibromyalgia
General Anxiety Disorder
Neuropathic Pain
Note that all of these state that 60mg is the maximum effective dose. These high doses complicate to discontinuation as it takes much longer to taper down from them, and the symptoms can be more severe.
Stopping is Complicated
While publications soft-sell the complications, they do generally acknowledge that this is not a drug you should stop taking all at once. Every authority admits, even the original manufacturer, Eli Lilly, that a slow discontinuation is required to avoid harsh side effects. The formal documentation for Lilly Cymbalta https://pi.lilly.com/us/cymbalta-pi.pdf is very clear that quitting should be done using a slow taper method like we present on this site:
Lilly writes at length about the complications of stopping, and names it “Discontinuation Syndrome”:
Other authorities agree.
“It is best not to abruptly discontinue Cymbalta (duloxetine).” drugs.com
While most publications talk about weeks or months, we have found that for most people, this realistically is a matter of years.
“In a new study, researchers Jim van Os and Peter Groot found that when trying to discontinue antidepressant use, a process of hyperbolic tapering reduced the likelihood of withdrawal.”
https://www.madinamerica.com/2023/05/hyperbolic-tapering-off-antidepressants-limits-withdrawal/
According to a study published in the Journal of Affective Disorders, a pooled analysis of six of Eli Lilly’s clinical trials showed that 44% of patients discontinuing Cymbalta experienced withdrawal symptoms and that a significant percentage of those symptoms were moderate or severe. See Perahia, et al., “Symptoms Following Abrupt Discontinuation of Duloxetine Treatment in Patients with Major Depressive Disorder,” 89 J. of Affective Disorders 207-12 (2005). According to Dr. Glenmullen, an expert quoted above, “Based on Cymbalta’s half-life, one would expect the true risk of withdrawal to be more likely in the range between 66% and 78%“.
We recommend that a reverse hyperbolic tapering be performed, reducing the dose a set percentage from the previous dose every two weeks or more. This takes into account the increased reaction of the brain to changes at small doses. This chart is generated from the online calculators on this site.
Some uninformed physicians prescribe a rapid discontinuation by large drops in dosage, or skipping days. We have thousands of posts that detail the horrific side effects of this misguided approach.
The most dangerous times with serotonin-affecting drugs are when stopping, starting, changing doses up or down, or adding and taking away other drugs.
PLEASE: never stop, start or add medications or supplements to your health or mental health care regimen without first checking for interactions or other problems and thoroughly researching the substance.
Doctors, Ignorance, and Common Misinformation
Seemingly, doctors know very little about the horrific side effects from fast tapers. While everyone is different, we believe that most people will suffer withdrawal symptoms that are proportionally bad relative to the speed of quitting.
Part of the blame goes to Eli Lilly, the manufacturer of Cymbalta and patent holder, whose FDA-approved labeling for the drug is inaccurate and misleading. They were sued for failing to warn patients and doctors just how dangerous and difficult it is to discontinue Cymbalta/duloxetine.
This 2013 deposition of Dr. Glenmullen, MD, graduate of and clinical instructor in psychiatry at Harvard Medical School specializing in antidepressants, fully explains – in 13 pages of double-spaced, plain English – what the problem is. If you read no other authorities on withdrawal symptoms, READ THIS:
https://www.baumhedlundlaw.com/documents/pdf/drglenmullendeclarationsupportofcymbaltaclasscert.pdf
According to Dr. Glenmullen, from the document linked above:
“Since entering the market, Lilly’s label for Cymbalta has failed to provide accurate and/or sufficient information about the frequency, severity, and duration of those symptoms caused by stopping the ingestion of Cymbalta (i.e., Cymbalta withdrawal). With regard to frequency of Cymbalta withdrawal, Cymbalta’s labeling gives the impression that the likelihood of experiencing withdrawal symptoms is an uncommon side effect. It suggests that the frequency of Cymbalta withdrawal is low, approximately 1%. This characterization, however, is misleading and belied by the clinical data. Lilly’s six double-blind placebo controlled clinical trials of Cymbalta, involving a combined total of 1,113 patients, found approximately 44% of users experienced withdrawal symptoms. In a separate open label clinical trial involving 1,279 patients, approximately 51% of patients experienced withdrawal symptoms. … the true percentage is likely much higher.”
It is already more than TEN years since this early research: QuarterWatch Report on Cymbalta Withdrawal, which found evidence of a high number of withdrawals in a large percentage of those studied. In the Conclusions, we read, “The prescribing information … does not provide realistic schedules for dose tapering or a clear picture of the likely incidence of these reactions.”
Has anything changed for the better? Yes. We have more research, more support groups, more awareness – but apparently the same ignorance and lack of care from professionals.
We have collected innumerable posts from the Facebook group Cymbalta Hurts Worse‘s 40,000 members explaining how their doctor had them stop Cymbalta/duloxetine in a matter of weeks, only for them to start having horrible withdrawal symptoms. Many of these members did not recover for years. Typical posts:
“I have been tapering off 30mg. GP has said to take a tablet once every 2 days for 10 days. Then once every 3 days for 10 days, then possibly once every 4 days for 10 days depend how im feeling. My specialist said it’s totally out of your system by the third day so you shouldn’t need to take it.
Well I tried that I am up to 1x every 3 days and the third day is just horrible, the brain zaps are way worse not to mention the rest of my symptons. This is horrible”
“I tried the every other day method of withdrawal, as advised by my PCP. The brain zaps and other symptoms were unbearable. Fortunately, I found this group and followed a safe taper.”
“Before I found this group, I had been tapering off per my psych’s instructions. I went down from 60mg/day to 20mg in just 3 months, since he said I was doing fine. I felt fine. But after he told me to do 20mg every other day, like… I freaked out. I went back to 20mg daily and have been doing so the last 2 months. But I feel like this delayed tidal wave of withdrawal hitting me now. The worst part for me is how I go from 0 – 100 enrage mode in 2 seconds, I have just like flipped out and felt like I’m not in control of myself so many times… I stopped hanging out with people because I feel like I’m a monster. I can’t drink alcohol anymore because it intensifies this monster so much… I really want to wean off this drug because I feel like a slave.”
We hear these testimonials over and over and over. And they are the reason we documented the Gradual Taper method and provide the online calculators to manage the dosage reductions.
Do your own research
We trust doctors to tell us what we should do. Many of us – or even most – expect our doctors to know everything. We let them tell us what medications to take, to increase or decrease, to come off them in a certain way.
We can research for ourselves on the Internet but some of us don’t trust this. We probably all struggle to know what sources can be trusted. When we do our own research, we often find conflicting information.
We are all born unique. This is the case: at birth we already have different chemistry, strengths and weaknesses. As we grow older, our bodies and minds change from our experiences, physical, mental and emotional.
We must each play an active role in any discussion with a doctor regarding medication. We can – and should – do our own research.
Informed consent
This link is to an eBook written by MIA Blogger and psychiatrist Stuart Shipko, MD. It is a short book and inexpensive.
Reading the reviews will also prove helpful in validating our own experiences.
Dr. Shipko’s Informed Consent for SSRI Antidepressants
“I am writing this eBook to share the key information that I discuss with patients in consultation, before starting or stopping a serotonin reuptake inhibitor (SSRI) antidepressant.”
Stuart Shipko, MD
He continues, “Informed Consent is not intended to be a comprehensive book about these drugs; rather, it duplicates the information that I typically provide to my patients when I see them in consultation. If you are contemplating starting or stopping an SSRI antidepressant, then you will find this information helpful.”
What you could ask your doctor
When doctors say this … ask this.
Here are some practical steps we can take. Reading the blog will also make us more likely to question what we are told. This is not about conspiracy theories. It is about not simply accepting what we are told.
Take responsibility for what we do. It is all too easy just to accept every piece of information as a fact. Have courage! Ask questions, evaluate how well your doctor really knows the facts.
The doctor may stutter, stare into space or tell you to stop reading the Internet conspiracies.
Compiled by Bobby Fiddaman, Author, blogger, researcher. https://fiddaman.blogspot.com
“Antidepressants help many people.”
How many? How do they help them? Describe, in detail, how they act on the brain and, furthermore, how that action helps “lift” depression, anxiety etc.
(Ed: How many do they harm? How does that happen?)
“After overcoming depression some find coming off antidepressants quite difficult.”
Some? How many exactly, what are the figures? In any event, how does one know one has overcome “depression” if the antidepressants are designed to make consumers feel like they aren’t depressed?
(Ed: Describe, in detail, what “difficult” means when trying to come off.)
“When trying to stop you may find your depression returns.”
How do you know this? How do you know whether it’s a return of the depression or whether it’s a side effect of withdrawal?
“If you’ve had one episode of depression, it’s best to stay on your antidepressants for six months to a year after you feel better.”
Antidepressants are supposed to treat depression, not prevent it. Should I take headache medicine even though I don’t have a headache?
“Most people don’t have troublesome side effects when coming off antidepressants, but some do.”
Figures, what are the figures? Is this statement based on 8- to 1- week clinical trials or is it based on the post-marketing surveillance of these drugs?
(Ed: Does it include patients who have tried for years and years to come off the drug?)
“Most people said that their symptoms lasted up to six weeks.”
Define “most”. What are the figures?
(Ed: Online peer support group evidence suggests thousands of people suffer for years and years. What symptoms did they have?)
“Ask your friends and family for support and maybe take some time off work.”
Those same friends and family will not know anything about drug withdrawal – yes, they may spot signs of suicidality but (they) won’t make the connection that it could be the drug causing the suicidal feelings – they will assume, just as many doctors do – and say – that it’s the ‘underlying illness’.
(Ed: What about those of us without that close support? With no family near us? Parents who have responsibility for their children?)
“Reduce your dose slowly, this helps to reduce symptoms.”
Symptoms of what? How slowly? Where’s the guidance here?
(Ed: Cymbalta/duloxetine should be reduced no faster than 5% of the most recent dose, holding for at least 2 weeks between drops. This is VERY slow, gradual, and hyperbolic.)
“Keep a diary of your symptoms and doses.”
Have you ever tried writing when going through severe withdrawal? I could barely lift a pen, let alone write.
“Be prepared to stop the reduction or increase the dose as necessary.”
Why? Is this due to the drug causing the symptoms or a return of the illness?
(Additional questions added by the editor. You can ask your own, of course.)
Turn the tables, folks. Your doctor has a duty to inform you.
Why To Never Ever Take Cymbalta
Cymbalta has a long list of serious potential side effects.
On average, it takes 2-4 years to safely taper off even if on the lowest manufactured dose of 20 mgs. A GRADUAL TAPER is essential to avoid the horrendous disabling withdrawals that can otherwise last for years.
The cut-off point for just stopping is 2-3 weeks after starting the drug, after which it is not safe to stop without tapering gradually. If for some reason you could not take Cymbalta/duloxetine, you would be forced to go cold turkey and risk having those horrendous withdrawals disable you for years.
For this reason alone you should never consider taking it.
Many people in online support groups have suffered permanent damage: vision, liver and hearts all damaged by Cymbalta/duloxetine. People have had to be put on blood pressure meds and be treated for diabetes because of it.
Many doctors, psychiatrists and pharmacists still don’t know about these dangers, nor do they know how to safely taper off the drug. That is why this website and peer support groups exist.
Many people who went off Cymbalta/duloxetine on their doctor’s advice are stuck with PAWS: Protracted Acute Withdrawal Syndrome.
Doctors think this is the miracle drug. It’s not. It’s a nightmare.
This website encourages you to seek natural alternatives to treat depression, anxiety and pain. You will have dodged a bullet by never taking Cymbalta/duloxetine.
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