Is Cymbalta (Duloxetine) An Effective Treatment For OCD?
Obsessive-compulsive disorder (OCD) is an anxiety condition that affects children, teens, and adults. At its core, OCD sufferers are worried or afraid (obsession) that they or someone they love will be harmed or killed if certain actions are not performed or rituals followed (compulsion). These individuals believe that the action or ritual must be repeated to ward-off danger.
And, although most OCD-sufferers know that their obsessions are unlikely to hurt themselves or others, the possibility of something terrible happening is enough to keep them from living happy and productive lives.
The exact cause of OCD is largely unknown at this time; however, studies indicate that biological (genetic) and environmental factors may contribute to its development and progression. Researchers have also found that when neurotransmitters (chemical messengers in the brain) become “blocked,” they are unable to properly communicate with other areas of the body.
Because these neurotransmitters (serotonin, dopamine, glutamate, and Y-aminobutyric acid (GABA)) are unable to transmit important messages to cells, tissues, and organs, mobility, planning, judgment, decision-making skills, and reason are “disrupted.” It is for this reason that many experts link OCD to “disrupted” neurotransmitter transmissions (triggered by biological/genetic and environmental components).
Researchers also suggest that OCD may also be linked to bacterial infections (i.e., PANDAS) or an anxious personality – in some cases. OCD may also be influenced by environmental triggers, such as trauma, the loss of a loved one, abuse, and/or chronic or excessive stress.
OCD is typically treated with therapy and medications, however, sometimes, OCD becomes “resistant” to conventional OCD treatments. When this occurs, a doctor is likely to take a different course of action when treating the condition. This course could involve taking “off-label” medications, like Cymbalta, to treat your OCD symptoms.
So, is Cymbalta an effective alternative for OCD? Possibly.
What is the BEST Way to Treat OCD?
Most researchers agree that the BEST way to treat OCD is with a combination of medication and therapy. More specifically, the best type of OCD therapy should involve cognitive-behavioral therapy (CBT), exposure-response and prevention (ERP) therapy, a type of CBT, acceptance and commitment therapy (ACT), grief therapy, trauma therapy, couples/marriage therapy, family therapy, individual therapy, and/or group therapy, along with lifestyle changes, self-help tools, and natural remedies.
The goal of OCD therapy is to change how a person “perceives” or “views” his or her intrusive thoughts, urges, fears, doubts, etc., with the hope that this change in mentality will lead to a change in behavior (i.e., continuously engaging in rituals and routines). Some OCD therapists also include exposing OCD-sufferers to their OCD triggers, so they become desensitized to them and they lose their power over them.
Once, a person becomes desensitized or immune to his or her OCD triggers, he or she will no longer feel the need to engage in compulsive behaviors, like counting, organizing, repeated in mantras or phrases, excessively cleaning and checking, etc. An OCD therapist may also encourage an OCD-sufferer to “accept” and “embrace” his or her fears, thoughts, doubts, urges, etc., and commit to the therapy process.
Thus, the ultimate goal of OCD therapy is to help individuals understand that their thoughts, fears, urges, etc., are unrealistic and unlikely to happen – even if he or she does not perform certain actions.
OCD medications may involve selective-serotonin reuptake inhibitors (SSRIs) like Celexa, Prozac, Zoloft, or Paxil; atypical antidepressants like Wellbutrin SR, Wellbutrin XL, Clomipramine, Remeron, Nefazodone, Trazodone, Viibryd, or Trintellix; serotonin-norepinephrine-reuptake inhibitors (SNRIs) like Effexor, Effexor XR, Cymbalta, Pristiq, Savella, or Fetzima; and/or antipsychotics like Risperdal, Zyprexa, or Seroquel.
The ultimate goal of medications is to increase the amount of serotonin, dopamine, and other hormones/neurotransmitters (how the brain communicates with various parts of the body) because people with OCD tend to have low hormone/neurotransmitter levels.
Note: Most OCD sufferers, who take SSRIs, start to see noticeable results within 4-8 weeks, however, others may take longer, such as a few months to experience an improvement in their OCD symptoms.
Are Medications Effective for OCD?
Yes, medications can be effective for OCD.
Although studies suggest that SSRIs are the most effective for OCD, other medications may be just as effective in certain situations. SSRIs, like Zoloft, Paxil, Prozac, Luvox, etc., are the “go-to” medications for OCD, especially for children, teens, and young adults, due to their effectiveness; Anafranil (clomipramine), an atypical antidepressant, has been used “off-label” for OCD symptoms for a longer period.
According to a 2005 study, people, who take Anafranil, or its generic form, clomipramine, may experience a 45% reduction in their OCD symptoms. Sometimes, Anafranil (clomipramine) is combined with an SSRI for people, who are struggling with treatment-resistant OCD. Cymbalta is also an effective OCD treatment for OCD sufferers, who do not respond well to other OCD medications.
Anafranil (clomipramine) is a tricyclic antidepressant that is FDA-approved for the treatment of OCD. It is also FDA-approved for other mental health conditions, such as depression, bipolar disorder, etc. This medication is also used to treat “off-label” conditions, like chronic pain and panic attacks. Anafranil (clomipramine) works by balancing the number of hormones/neurotransmitters in the brain, and “restarting” or “restoring” hormone/neurotransmitter transmissions.
Prozac (fluoxetine) is a selective-serotonin reuptake inhibitor (SSRI) that is FDA-approved for acute or short-term OCD episodes. It is also FDA-approved for depression, panic attacks, bulimia, an eating disorder, and severe premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). Children (from the age of 8), along with teens and adults may benefit from taking this medication for recurrent and involuntary obsessions and compulsions.
Although Prozac is normally prescribed alone, a doctor may combine it with Zyprexa (olanzapine) for adult OCD-sufferers, who have not responded well to SSRIs on at least two occasions. Zyprexa is a medication commonly used to treat schizophrenia and other mental health conditions.
Luvox (fluvoxamine) is an FDA-approved SSRI designed to “balance” or increase the amount of serotonin and other hormones/neurotransmitters in the brain. This medication could help “quiet” intrusive thoughts, urges, mental images, emotions, fears, worries, etc., and reduce compulsive behaviors. According to researchers, Luvox may be a viable treatment for people suffering from OCD, panic attacks, depression, and post-traumatic stress disorder (PTSD).
Paxil (paroxetine) is another FDA-approved SSRI for the treatment of OCD and other mental health conditions, like depression, social anxiety, PTSD, PMS, PMDD, and menopausal hot flashes.
Zoloft (sertraline) is the “preferred” FDA-approved SSRI in people with mild-to-moderate OCD and depression symptoms. Low-dose Zoloft may reduce obsessions and compulsions, especially when combined with OCD therapy, like CBT, ACT, and ERP therapy.
Cymbalta (duloxetine) is an FDA-approved SNRI designed to “balance” and “restart” or “restore” stalled hormone/neurotransmitter transmissions in the brain. This medication is usually prescribed when conventional SSRIs have failed (i.e., treatment-resistant OCD). Cymbalta can also be used to treat chronic pain, back pain, arthritis, diabetes, or fibromyalgia. Studies suggest that Cymbalta is an effective treatment for moderate-to-severe OCD.
What is Cymbalta?
Cymbalta is a serotonin-norepinephrine reuptake inhibitor (SNRI). Duloxetine, the generic version of Cymbalta, targets neurotransmitters (chemical messengers in the brain) that have become “unbalanced.” Cymbalta is commonly used to treat clinical depression in adults, however, it is also used for anxiety conditions, such as OCD, social anxiety, panic attacks, general anxiety disorder (GAD), and PTSD in adults and children, who are over the age of 6.
This antidepressant is also prescribed for diabetic neuropathy (diabetes-related nerve pain), fibromyalgia or chronic muscle pain, arthritis or joint pain, lower back pain, and osteoarthritis in adults and children over the age of 12. Experts suggest that Cymbalta may also stabilize moods, reduce or eliminate insomnia, improve sleep quality, increase appetite, boost energy, and ease anxiety or nervousness.
Is Cymbalta FDA-Approved for OCD?
Yes, it is.
Cymbalta is FDA-approved for the following conditions:
- Chronic Pain
- Mood Disorders Like Depression or Bipolar Disorder
- Generalized Anxiety Disorder (GAD)
- Diabetic Neuropathy or Diabetic Nerve Damage
- Chronic Musculoskeletal Pain or Bone, Muscle, Tendon, and/or Ligament Discomfort
Children and Teens
- Generalized anxiety disorder (GAD) in children over the age of 6
- Fibromyalgia in children over the age of 12
Can I Take Cymbalta for My OCD Symptoms?
Yes, your doctor may prescribe Cymbalta for your OCD symptoms. The dosage heavily depends on your body chemistry, weight, your condition, severity and frequency of your symptoms, age, gender, etc.
(For Adults Between the Ages of 18 and 65)
For most adults, under the age of 65, who struggle with anxiety conditions like OCD and GAD, the beginning recommended dosage for Cymbalta is 60mg once a day.
For some OCD sufferers, it may be more beneficial to start with 30mg once a day for 1 week. This provides these individuals with an opportunity to adjust to the medication before increasing the dosage to 60mg once a day. Researchers have found that taking 120mg of Cymbalta for anxiety conditions, like OCD and GAD, is effective, however, there is no evidence that doses over 60mg are less effective than higher doses of Cymbalta.
Still, if the dosage is greater than 60mgs, it should be gradually increased by 30mg, once-a-day until the desired dose is reached. Your doctor must reexamine the dosage (i.e., the effects, benefits, and side effects) periodically to ensure it is the best course of action for your condition.
(For Older Adults Over the Age of 65)
The recommended beginning Cymbalta dosage for older adults with OCD or GAD is 30mg once a day for two weeks before increasing the dosage to 60mg once a day. If needed, the dosage can be gradually increased (by 30mg increments) to120mg once a day.
(For Children Between the Ages of 7 and 17)
The recommended beginning Cymbalta dosage for children and teens with OCD or GAD is 30mg once a day for two weeks before increasing the dosage to 60mg once a day. If needed, the dosage can be gradually increased to 60mg once a day. Some pediatric OCD sufferers may be prescribed more than 60mg once a day for their symptoms. In this situation, the dosage should be gradually increased by 30 mg once a day until the desired dosage is reached. The maximum Cymbalta dosage for children and teens is 120mg once a day.
When Can I Expect to See Results If I Take Cymbalta for My OCD Symptoms?
It typically takes 6-8 weeks to reap the full benefits of Cymbalta for OCD. However, you may see a mild improvement in your sleep quality, energy, and/or appetite a week or two after beginning the medication. Depressed mood, fatigue, loss of interest in activities, mental confusion, intrusive thoughts, fears, urges, emotions, and compulsive behaviors may take the complete 6-8 weeks to improve or resolve. Chronic pain usually improves in a couple of weeks after beginning Cymbalta for OCD.
Can I Take Cymbalta for OCD While Pregnant?
It is not recommended, however, in some cases, it may be prescribed for OCD symptoms – with caution.
Cymbalta is not recommended, in general, for pregnant women, primarily because its effects are not fully understood at this time. Thus, there is a chance that this antidepressant could cause spontaneous abortion or harm to your growing fetus (i.e., genetic abnormalities and/or developmental delays). So, if you are pregnant or trying to conceive, inform your doctor of your pregnancy or plans to become pregnant.
Can I Breastfeed While on Cymbalta for My OCD Symptoms?
It is not recommended, however, in some cases, it may be prescribed for OCD symptoms – with caution.
Studies indicate that Cymbalta can transfer to an infant or toddler through the mother’s breastmilk, however, no significant adverse effects were found. There have been reports of irritability, sleepiness, and feeding problems in breastfed infants and toddlers, who have been exposed to Cymbalta through their mother’s breastmilk. Thus, if you are breastfeeding or plan to breastfeed in the future, inform your doctor of your current situation or future plans.
Does Cymbalta Come with Side Effects? If So, What Are They?
Yes, Cymbalta does come with side effects.
Mild side effects have been reported with Cymbalta.
Cymbalta’s mild side effects include:
- Sleepiness or Drowsiness
- Fatigue or Low Energy
- Gastrointestinal Distress – Nausea, Abdominal Pain, Constipation, or Diarrhea
- Dry “Cotton” Mouth
- Suicidal Ideation – Thoughts and Attempts
- Liver Damage – i.e., Upper Right Stomach Pain, Intense Itching, Dark-Colored Urine, and/or Jaundice (“Yellowing” of the Skin and Eyes)
- Eye Problems and Changes in Vision
- Allergic Reaction
- Fainting, Lightheaded, or Dizziness Upon Standing
- Sudden Changes in Blood Pressure
- Serotonin Syndrome
- Low Sodium Levels – i.e., Headaches/Migraines, Mental Confusion, Distorted or Magical Thinking, Memory Issues, Muscle Weakness, and/or Unsteadiness
- Painful or Difficult Urination
- Severe Skin Reactions
- Excessive Bleeding and Bruising
- Poor Appetite
- Male and Female Sexual Dysfunction
- Profuse Sweating
- Accelerated Heartrate or Chest Flutters
- Mania – i.e., Racing Thoughts, Extreme Happiness or Joy, Giddiness, Endless Energy, Insomnia or Sleeplessness, Risk-Taking Behaviors, Agitation, and/or Excessive Talking
Note: In most cases, these side effects are short-lived. In the majority of cases, these side effects can be easily managed so you can continue taking Cymbalta for your OCD symptoms. However, if your obsessions and compulsions worsen or persist past 8 weeks, consult your doctor for guidance. But do not abruptly stop taking Cymbalta unless your doctor instructs you to.
Consult your doctor immediately if you experience a sudden change in your mood, personality, behavior, thought processes or if your depression, OCD, or anxiety symptoms worsen. Or, if you start to have a hard time falling and staying asleep at night, or begin to have panic attacks, or become aggressive, agitated, impulsive, restless, hyperactive, talkative, and/or suicidal.
Could Cymbalta Cause Long-Term Effects in Some OCD-Sufferers?
Yes, it could.
Although rare, Cymbalta can cause long-term health – in some OCD sufferers.
For instance, a serious side effect of Cymbalta is long-term liver damage or failure, however, this is also rare. Drinking alcohol while taking Cymbalta for OCD could exacerbate liver damage or liver failure. Some studies suggest that it is safe to take Cymbalta for your OCD symptoms for up to 6 months. However, a 2009 study found that people with anxiety conditions, like OCD, can safely take Cymbalta for their OCD symptoms for up to 12 months.
Does Cymbalta Come with a Black Box Warning?
Yes, it does.
Cymbalta does come with a “black box” warning (issued by the FDA) informing the public that this antidepressant could cause suicidal thoughts and behavior – in some people (children and people under the age of 25).
Once you begin taking Cymbalta for your OCD symptoms, self-monitor for changes in your mood, behavior, thought processes, personality, and/or emotions. If you experience any changes in your thoughts or demeanor, contact your doctor immediately.
Note: Thousands of Cymbalta lawsuits have been filed over serious and life-threatening side effects and complications.
I Take Other Medications for My OCD – Could They Interact with Cymbalta?
It is possible.
Nonsteroidal anti-inflammatory drugs (NSAID) like aspirin, ibuprofen, naproxen, Excedrin, Advil, Aleve, Motrin, etc., may interact with Cymbalta. Moreover, taking NSAIDs with Cymbalta could lead to excessive bruising or bleeding. Some prescription and over-the-counter medicines (OTC), and vitamins, minerals, and herbal supplements could also interact with Cymbalta altering its effectiveness and safety. Inform your doctor and pharmacist of any OTC or prescription medications you are talking about, along with vitamins, minerals, or herbal supplements you are taking (i.e., CBD).
What Will Happen If I Suddenly Stop Taking Cymbalta for My OCD Symptoms?
Well, if you suddenly stop taking Cymbalta for your OCD symptoms, you run the risk of experiencing Cymbalta or OCD withdrawal symptoms. The best way to stop Cymbalta is by “weaning off of it.” In other words, slowly reducing your Cymbalta use over 2-4 weeks is the best course of action, if you and your doctor decide to stop the medication.
“Weaning off of Cymbalta can prevent you from experiencing withdrawal symptoms like headaches/migraines, anxiety, depression, dizziness, nausea, and/or a reemergence in intrusive thoughts, fears, urges, emotions, etc., and compulsive behaviors. Never suddenly quit Cymbalta “cold turkey” without consulting your doctor first.
Why do I need to contact my doctor before stopping Cymbalta?
Cymbalta interacts with your brain to treat conditions, like OCD, anxiety, depression, and pain. This medication “balances” serotonin and norepinephrine in your brain. It can take several weeks for your body to adjust to Cymbalta’s “stabilizing properties.” During the “weaning process” and once you are completely off of Cymbalta, you may experience unpleasant withdrawal symptoms, such as dizziness (the most common withdrawal symptoms, accounting for approximately 12% of former Cymbalta users).
Note: Understand that slowly discontinuing Cymbalta may not prevent all withdrawal symptoms. So, contact your doctor if these symptoms increase or persist after you stop taking Cymbalta for your OCD symptoms.
What Are the Most Common Cymbalta Withdrawal Symptoms?
According to studies, Cymbalta doses, ranging from 40mg to 120mg, per day, for 8-9 weeks, can lead to withdrawal symptoms – in some people. More specifically, researchers found that when Cymbalta was suddenly stopped, 44% of the Cymbalta users experience withdrawal symptoms.
The most common Cymbalta withdrawal symptoms are (in order):
- A “Pin-and-Needles” Sensation or a Burning Feeling on Your Skin
- Hyperhidrosis (Profuse Sweating)
- Mental Confusion
- Emotional Lability
- Tinnitus (Ringing or Noises in the Ears)
How Long Could Cymbalta Withdrawal Symptoms Last?
According to researchers, approximately 65% of Cymbalta withdrawal symptoms resolved within seven days of stopping the medication. Fortunately, most Cymbalta users only experienced mild-to-moderate withdrawal symptoms. The highest incidences of Cymbalta withdrawal symptoms were reported in people, who took the highest dosage of the medication (120mg).
Are There Natural Ways I Can Treat My OCD Symptoms?
Lifestyle changes, such as getting proper sleep, consuming a healthy diet, and getting plenty of exercise, along with natural remedies like vitamins, minerals, or herbal supplements or CBD, and self-help tools, like Impulse Therapy, an online OCD treatment program that utilizes cognitive-behavioral techniques and provides unlimited support, resources, and guidance, hypnosis, and OCD therapies, like cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), and exposure and response prevention (ERP) therapy, etc., can help you better manage your OCD symptoms – without medications.
Note: Keep in mind, that medications are always considered the last resort – when therapy and natural treatments have failed to work. With the right treatment and support, you can wrangle your OCD symptoms back under control.
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