IRFANA PARVEEN
By Irfana Parveen

B.Sc (Psychiatry Ward)

21 April 2022
Medically reviewed by
Sumayya Salam
Pharm D
Cymbalta and alcohol
Table of Contents

Duloxetine belongs to the class of serotonin-norepinephrine reuptake inhibitors or SNRI. It works by facilitating restoring certain natural chemical balances in the brain, such as that of serotonin and norepinephrine, which alcohol may disturb.

Cymbalta and alcohol interactions can be fatal or harmful. What should you know about the potential interaction between duloxetine and alcohol if you take Cymbalta? Cymbalta combined with alcohol may potentially harm or afflict the liver.

Numerous types of drugs do not combine well with alcohol, which can have side effects that are often fatal. It is neither safe nor recommended to take Cymbalta and alcohol together; therefore, avoid doing so. This article will look into greater detail regarding combining alcohol with Cymbalta.

What Is Cymbalta?

Cymbalta, known as duloxetine, is a serotonin-norepinephrine reuptake inhibitor (SNRI). SNRIs help to increase the activity of the brain neurotransmitters serotonin and norepinephrine.

Cymbalta treats many conditions, including Anxiety, depression, diabetic peripheral neuropathy, Fibromyalgia, and chronic musculoskeletal pain. Alcohol is a CNS depressant that slows down certain parts of the brain, resulting in reduced cognitive function.

People suffering from Anxiety or depression often consume alcohol for its calming effects to cope with the illness.

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What is Alcohol?

Alcohol is a psychoactive substance with addictive qualities that has been used for ages in many diverse cultures. In chemistry, "alcohol" refers to a class of organic molecules with a carbon atom bound to a hydroxyl group, which comprises an oxygen atom and a hydrogen atom. But in everyday speech, "alcohol" typically refers to ethanol, which chemists refer to as a particular molecule with the formula C2H5OH.

Alcohol is produced naturally when yeasts ferment sugars to make energy. Alcohol use is a contributing cause of more than 200 diseases, injuries, and other health issues.

How Does Cymbalta Work?

Duloxetine is an antidepressant that acts as a serotonin and norepinephrine reuptake inhibitor. Duloxetine (Cymbalta) prevents the reuptake of serotonin and norepinephrine. Additionally, it raises dopamine by influencing dopamine reuptake pumps, which boosts the brain's ability to diffuse dopamine. 

Furthermore, it lessens the symptoms of depression by reducing pro-inflammatory cytokines and increasing anti-inflammatory ones. This drug's capacity to alleviate pain is assumed to be due to its ability to inhibit sodium channels.

How Does Alcohol Work?

Alcohol slows down how well the central nervous system works. Alcohol can disrupt some messages that are trying to get to the brain. It affects a person's perceptions, emotions, mobility, vision, and hearing.

Alcohol can make someone feel more at ease or less worried in small doses. Intoxication results from the brain's alterations brought on by more alcohol. Overindulgent drinkers may stumble, become uncoordinated, and slur their words. They'll likely feel disoriented and confused. Intoxication can either make someone friendly and talkative or quite hostile and angry. It's advised against drinking while driving because it significantly slows reaction times.

Alcohol poisoning may occur on ingestion of excessive quantities of alcohol quickly. Typically, the first sign of alcohol poisoning is violent vomiting. It may lead to extreme tiredness, unconsciousness, breathing difficulties, dangerously low blood sugar, seizures, and even death.

Can You Drink Alcohol When Taking Cymbalta?

The effects of each drug vary. Avoid or limit alcohol consumption while taking Cymbalta. Alcohol and Cymbalta both have side effects that get worse when taken together. Drinking alcohol while taking Cymbalta can increase the risk of serious adverse effects or diminish the drug's effectiveness.

Eating grapefruit while taking the mood-related medications above can result in heart rhythm changes, excessive sleepiness, and other drug-specific effects.
Cymbalta's possible side effect is weight gain. During the first few months of taking medication, weight loss is also possible. Taking it for a prolonged period may cause weight gain. Making good lifestyle decisions will help you in controlling weight while taking Cymbalta.
Aside from worsening depression, drinking alcohol while taking Cymbalta raises the risk of liver damage, increases the risk of side effects, and decreases the drug’s effectiveness.

A Study on Alcohol and its Relation to Depression:

AIM: To review the links between alcohol use disorders (AUD) and major depression (MD) and to assess the evidence for a causal relationship between the two illnesses.

Method: the study used data from previous studies on AUD and MD from 1980 to the present. Random-effects models were used to derive estimates of the pooled adjusted odds ratios (AOR) for the links between AUD and MD among studies reporting an AOR.

Findings: According to the study, one disorder's presence doubled the second disorder's risk, with pooled AORs ranging from 2.00 to 2.09. According to new findings, the most likely causal relationship between AUD and MD is that AUD raises the risk of MD rather than vice versa.

Conclusion: the study found a causal linkage between the use of alcohol and major depression. It states that increased alcohol use increases the risk of major depression.

Study on Efficacy of Cymbalta (Duloxetine):

A systematic review was done following the 2009 Preferred Reporting Items (PRISMA) recommendations and the Joanna Briggs Institute Critical (JBI) Appraisals standards. The systematic analysis includes 85 studies that looked at the efficacy, safety, and tolerability of duloxetine. The studies were separated into subgroups based on the clinical condition and analyzed separately. Thus, the assessed outcomes show the usefulness of duloxetine in treating these clinical diseases in 32 studies of MDD, 11 studies of GAD, 19 studies of NP, 9 studies of FMS, and 14 studies of SUI.

This systematic review confirms that duloxetine's dual mechanism enhances the treatment of comorbid clinical problems, and it verifies duloxetine's efficacy, safety, and tolerability in short- and long-term treatments.

Is It Safe To Consume Alcohol and Cymbalta together?

Mixing anti-depressants and alcohol is not advisable. 

Cymbalta is a powerful anti-depressant. It can potentially cause significant harm to your health, especially when combined with other substances like alcohol.

Both alcohol and Cymbalta can cause liver damage and depression symptoms on their own. Combining them can amplify the adverse effects.

Effects of Mixing Alcohol and Cymbalta?

Taking alcohol with Cymbalta may intensify the effects of both drugs. Cymbalta and alcohol have similar effects on the brain's chemistry, so any adverse effects you encounter from either one are likely to be more severe when you combine the two than if you used either one alone.

Increased side effects

Combining Cymbalta and alcohol may worsen symptoms such as constipation, nausea, reduced appetite, headaches, dizziness, and insomnia.

Liver damage:

Alcohol can harm your liver, especially if you consume too much. Cymbalta has the potential to damage the liver as well. Drinking alcohol while taking Cymbalta may raise this risk, especially if you drink heavily. The signs of liver damage may include dark urine, jaundice, icterus (yellowing of the skin), itching, and pain in the upper right abdomen.

Escalates depression symptoms:

Mixing alcohol with Cymbalta increases the symptoms of depression. Although Cymbalta is a medication to treat depression and its symptoms, in some cases, Cymbalta can increase the symptoms of depression and Anxiety.

The symptoms include panic attacks, thoughts of suicide, irritability, sleep problems, and unexplained mood changes. Alcohol disrupts brain communication channels, affecting the brain's functions and causing mood and behaviour changes.

Alcohol can harm sleep quality, escalating depression. It can also intensify your Anxiety. It Is not advisable to consume alcohol over anti-depressants; however, Discuss with your doctor if you plan on drinking alcohol over Cymbalta. 

Side Effects Of Mixing Alcohol And Cymbalta

Common Side Effects Severe Side Effects
nausea worsening depression
headache liver damage
tiredness drowsiness
difficulty sleeping ​high blood pressure
dry mouth impaired judgment
constipation impairment of motor skills
diarrhoea fatigue
stomach pain vomiting
reduced appetite panic attacks

But alcohol use doesn't only make Cymbalta side effects worse. As you can see from the side effects listed above, alcohol's effects deteriorate when combined with Cymbalta.

Cymbalta for Alcohol Withdrawal?

Research done on Cymbalta suggests that the drug helps reduce anxiety-like behaviours and alcohol intake, which makes Cymbalta useful in the treatment of alcohol withdrawal. While Cymbalta could be helpful in this situation for some people, it can also have some side effects.

Some data suggest Cymbalta use may lead to increased alcohol cravings. Although these side effects have not been thoroughly researched, there are anecdotal reports of patients who took Cymbalta with alcohol and experienced increased intoxication and blackouts.

Never self-prescribe Cymbalta for alcohol withdrawal symptoms; it should only be taken as prescribed by a doctor. If you plan to stop your alcohol consumption, consult your doctor to see if Cymbalta can be used for the treatment.

Bottom Line Form Practical Anxiety Solutionss

When considering alcohol consumption, antidepressant users should use caution. Alcohol has a depressive effect on the brain and can make depression worse over time.

When used with alcohol, all antidepressants may have side effects. Alcohol may, in moderate circumstances, make antidepressants less effective. In extreme situations, taking drugs like Cymbalta can result in serious health issues, including liver damage. Cymbalta and alcohol can potentially harm the liver on their own. However, the risk increases when combined, especially if you consume numerous drinks at once. Discuss the potential dangers of drinking while taking antidepressants with your doctor.

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