Edit %

Potential side effects (adverse events in fancy pharmaceutical talk) are often used as a rationalization to not take a medication. Many people will stop taking an otherwise working drug because of one or more relatively minor, or often temporary side effects. There may even be ways to counter or mitigate side effects.

It all comes down to a very important question: which sucks less?

There is no perfect drug. If you keep switching meds in the hopes of finding something with no side effect, or irrelevant side effects that don’t bug you as much, you could wind up treatment-resistant, and a med that worked before may work as well as it did the first time, if at all.

1.  Side Effects All Crazy Meds Have

No matter which neurological and/or psychiatric drug you take, you’ll probably get one or more of these side effects. These will usually be gone, or at least will diminish to the point where you barely notice it most of the time, within a week or two.

  • Headache
  • Drowsiness / fatigue - even when taking stimulants in some circumstances.
  • Insomnia, instead of or alternating with the drowsiness.
  • Nausea
  • Assorted other minor GI complaints (constipation, diarrhea, etc.)
  • Generally feeling spacey / out of it
    • Which can all add up to the ever-helpful “flu-like symptoms” listed as an adverse event on the PI sheet of practically every medication on the planet used to treat almost any condition humans and other animals could have.

All crazy meds can, and probably will affect your dreams as well. There is no way of telling if that will be good or bad, let alone if this side effect is permanent or temporary.

So don’t operate any heavy machinery and try to avoid driving the first couple of days. We always recommend starting a new med Friday night / Saturday morning (or whenever your day off is) so you have an idea of how it will affect you for the first week or two. Keep in mind: most side effects are usually temporary in nature.

2.  Cymbalta’s (duloxetine hydrochloride) Typical Side Effects

The usual for SNRIs - headache, nausea, dry mouth, sweating, urinary hesitancy (it is a med for urinary incontinence after all), sleepiness or insomnia, and diarrhea or constipation, weight gain, loss of libido and a host of other sexual dysfunctions. Most everything but the constipation, urinary hesitancy and weight gain, if any, will go away in a couple of weeks. Sexual dysfunction is a coin toss, although some women will get a sexual boost instead of a sexual dampening.
Most everyone gets at least one or two of these.

3.  Cymbalta’s (duloxetine hydrochloride) Uncommon Side Effects

Controlled narrow glaucoma (but you already have to be at risk for eye problems to start with), elevated liver serum (an annual liver panel with this med probably isn’t a bad idea), blurry vision, muscle cramps, weight loss.
You may or may not get one or more of these, so don’t be surprised either way.

4.  Potentially Dangerous Side Effects of Cymbalta (duloxetine hydrochloride)


If you have one or more of these, call your doctor ASAP. Or now. Or get the hell off of the Internet and go to the ER. NOW!

5.  Cymbalta’s Freaky Rare Side Effects

Retinal detachment. Excessive disturbing and disabling yawning. I guess they considered it “excessive and disturbing” because Lexapro wasn’t involved.
You won’t get these. Unless you already have and that’s why you’re here.

For all known side effects, see Cymbalta’s full US prescribing information. Or really indulge your paranoia by reading every PI sheet in the world we can find.
n.b. Reading the PI sheet for a drug you haven’t taken is an exercise in the fear of medications (pharmacophobia).

6.  Ways to Counter/Minimize/Deal with Some Side Effects

7.  Pregnancy Category

Pregnancy category is included here as it is a potential side effect that many people take into account when considering a medication. Exactly what do the pregnancy categories mean?

Pregnancy categories A, B, C, D, and X are used to quantify both risk and the risk-to-benefit ratio. They are relatively neutral when it comes to severity of birth defects.
The only difference between categories A and B is that the drug companies conducted human trials to get that A rating, while the B rating means there has been no reported birth defect of any kind since the drug has been on the market. With both A and B, no matter how much of either med researchers give to critters, the cute little babies are just fine. Until dissected to prove there is no problem.

Category X is fairly straight-forward. You take this drug while pregnant, possibly pregnant, or potentially pregnant, your kid will be born with three arms and a total of two fingers. There are also plenty of alternatives available. So unless you’ve tried everything else already, talk to your doctor about another med. In fact, if you’re a woman whose baby-making bits still work, you should ask your doctor why you’re taking this stuff instead of something else in the first place; or consider having all of your reproductive organs removed if nothing else worked, you’ve run out of options, and your condition isn’t popular enough for the drug companies to develop any new medications to treat it.

It’s the meds that are categories C and D are difficult. C means animals gave birth to mutants when given anywhere from sub-therapeutic to ridiculously high amounts of the medication in question, and there have been reports of human birth defects that may be due to taking the med. Sometimes the data from the field are so vague (e.g. all or almost all the women were taking at least one other medication), and the critters didn’t spawn Roger Cormanesque offspring on anything lower than 50 times the maximum human dosage, that it’s pushing a C+ to B-. The important thing is category C meds are first-line drugs while category D meds are usually second- or third-line drugs. Let’s compare Lamictal (lamotrigine), Topamax (topiramate), and Depakote. Lamictal is fairly safe. It looks like an overall 2-3% rate of birth defects, and the animal tests show a slight increase in the risks for low birth weight, low folate levels, and miscarriage. Category C, easy.
It’s a different story with Topamax. From the Topamax PI sheet:

Pregnancy registry data suggest that there may be an association between the use of TOPAMAX™ during pregnancy and congenital malformations (e.g., craniofacial defects, such as cleft lip/palate, hypospadias, and anomalies involving various body systems). This has been reported with topiramate monotherapy and topiramate as part of a polytherapy regimen.

And that doesn’t even get into the animal tests - that section of the PI sheet reads like a bad X-Files Fringe script - or the increased risk of low fetal body weight or miscarriage due to metabolic acidosis and other side effects that can affect the mother. So why is Topamax category C instead of category D?

  • Because Topamax is a one-pill wonder for so many women with migraines and/or full-on, flopping-around-like-a-fish-out-of-water generalized seizures.
  • It doesn’t make them fat.
  • There aren’t enough reports of problems to figure out what the exact risk is. By now there would either be enough instances of problems to know what the chances of birth defects or miscarriage are, or that the odds are Topamax is safe. It’s just not 97.something percent or better safe like Lamictal.

Category D means you can still consider taking the drug, but you probably want to try another one first if you might be getting pregnant. Category D meds may still be first-line drugs, but they’re usually meds that used to be one of the first things prescribed but are now second or third line. Depakote is one. Why is Depakote is category D?

  • Because the birth defects happen fairly often - 11% of the time for something serious.
  • They’re pretty bad, like spina bifida and needing a liver transplant at birth.
  • Depakote isn’t as good as Topamax when it comes to migraines.
  • It makes people fat. Along with other side effects that are worse than what you’d get from Topamax, Lamictal, and most other first-line meds prescribed for epilepsy, bipolar, and migraines.
  • But Depakote is still a reliable med for epilepsy, bipolar, and migraines, and it’s side effects suck less than desperation meds like Felbatol (felbamate) and Sabril (vigabatrin).

Thus Topamax has a risk-to-benefit ratio that makes it category C, while Depakote’s is category D: there are better meds out there, but we know that Depakote works and that sucks a lot less than taking nothing.

For more information, see the Federal Regulations covering PI sheets and the FDA’s Summary of Proposed Rule on Pregnancy and Lactation Labeling. They’re both remarkably clear for legal / bureaucratic documents.


Date created 05 Apr 2011 - 15:24 Page Creator: JerodPoore Last edited by:

Cymbalta Expanded Side Effects is copyright 2011 JerodPoore

Page design and explanatory material copyright © 2004 - 2011 Jerod Poore. All rights reserved.

Almost all of the material on this site is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, and 2011 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and the following disclaimer, I’m usually cool with it.

All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you.
The information on Crazy Meds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else.
Know your sources!
Nobody on this site is a doctor, therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. Some doctors tend to get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication*. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away.
Crazy Meds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
All brand names of the drugs listed in this site are the trademarks of the companies named on the PI/SPC sheet associated with the medication, sometimes on the pages about the drugs, even though those companies may have been acquired by other companies who may or may not be listed in this site by the time you read this. Or the rights to the drug were sold to another company. And any or all of the companies involved may have changed their names.
Crazy Meds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Firefox.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices or in all dimensions of reality.

*While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

‘Everything is true, nothing is permitted.’ - Jerod Poore


dimension