Cymbalta and alcohol: risks and side effects

You've been prescribed Cymbalta (duloxetine) to treat depression, anxiety, or chronic pain, and you're wondering if you can have an alcoholic drink while on this medication. Learn about Cymbalta, common and serious side effects, and how Cymbalta and alcohol interact.

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Cymbalta is the brand name for duloxetine, a type of antidepressant called a serotonin-norepinephrine reuptake inhibitor (SNRI). The U.S. Food and Drug Administration (FDA) approves it to treat symptoms of depression, anxiety disorder, fibromyalgia, chronic pain, and nerve pain. Some healthcare providers also prescribe it off-label to treat chronic fatigue syndrome, neuropathy caused by chemotherapy, and stress-related urinary incontinence (Dhaliwal, 2021). 

As an SNRI, Cymbalta works by inhibiting or preventing your brain from rapidly absorbing the chemical messengers serotonin and norepinephrine. This helps to stabilize your mood, decrease anxiety, and can help with chronic pain conditions. SNRIs like Cymbalta don't add any additional neurotransmitters to your brain or nervous system. Instead, they keep the neurotransmitters that are already there around for more extended periods (Dhaliwal, 2021).

Your healthcare provider will evaluate your medical history and symptoms, underlying health conditions, along with other medications and supplements you take before prescribing this medication for you.

All medications have side effects, and Cymbalta is no exception.

Common side effects of Cymbalta are dizziness, dry mouth, constipation, headache, nausea, increased sweating, and drowsiness. 

Severe side effects rarely happen but can include abdominal pain, bleeding, bruising, swelling, chest pain, jaundice, dark urine, panic attack, trouble breathing, or worsening depression (Dhaliwal, 2021).

If you’re experiencing bothersome side effects, speak with your healthcare provider so they can help you make changes to your medication if necessary.

Suppose you've taken antidepressants before and had an alcoholic drink (or two) and felt fine. In that case, you may think that you can mix Cymbalta with alcohol. However, each medication is different. In general, it's recommended to limit or avoid alcohol while taking Cymbalta.

Cymbalta and alcohol each have side effects, which intensify when you combine them.

You may want to see how Cymbalta affects you first before having a drink. If you experience some side effects of Cymbalta, you may not be able to tolerate the combined impact of alcohol and Cymbalta. 

According to the National Institute of Health (NIH), alcohol consumption has serious consequences for your mental and physical health (NIAAA, nd-b).

It interferes with your brain’s communication pathways, making it harder to think clearly. It can even change the way your brain looks and works. In addition, alcohol affects the quality of your sleep. These interruptions can change your mood and behavior. If you already have depression or anxiety, drinking alcohol may worsen your symptoms (NIAAA, nd-b).

Alcohol intake also affects your heart and liver, causing high blood pressure and increasing the risk of stroke, cirrhosis (hardening of the liver), and liver disease. It can also cause arrhythmias (irregular heartbeats) and cardiomyopathy (drooping and stretching of your heart muscles) (NIAAA, nd-b). 

Alcohol affects women and older people differently than young men. 

• Biologically born women are at higher risk for alcohol damage than men. This is because alcohol mixes with body water and is distributed to all the muscles. Women’s bodies have less water than men’s bodies, so alcohol is more concentrated in their bodies (NIAAA, 2014).

• Older people typically take more medications than younger people. Aging also slows down the liver and the body’s ability to metabolize alcohol. These risk factors make it more dangerous for an older person to take Cymbalta and drink alcohol (Qato, 2015). 

Some people may feel relaxed when drinking. Still, drinking alcohol while taking Cymbalta can decrease the effectiveness of the medication, or increase or cause dangerous side effects (NAMI, nd).

Increased side effects 

Combining Cymbalta and alcohol can worsen constipation, low appetite, dizziness, headaches, nausea, sleepiness, or insomnia (NIAAA, 2014).

Decreased effectiveness

Cymbalta and alcohol both affect your mood. If you take the two together, you can decrease the effectiveness of Cymbalta, worsening your anxiety and depression. This can cause sleep problems, irritability, unexplained mood changes, panic attacks, and even thoughts of suicide (NIAAA, 2014).

Liver damage

Both Cymbalta and alcohol are metabolized in and affect the liver. Using these two substances together can cause liver damage (NIAAA, 2014). 

The FDA says that Cymbalta is not recommended for people who regularly drink alcohol. If you already have liver problems, whether from alcohol use or other issues, your body won’t metabolize Cymbalta effectively (FDA, 2019).

Warning signs of liver damage include (Patel, 2021):

• Abdominal pain

• Dark urine

• Exhaustion

• Itching

• Nausea

• Vomiting

• Yellowing of the skin or eyes 

If you take Cymbalta and have any of these symptoms, contact your healthcare provider or seek medical advice immediately.

If you enjoy a glass of wine or drink socially and are prescribed Cymbalta, talk to your healthcare provider. Your healthcare provider may make recommendations on how much alcohol you can have based on your physical and mental history and health (NIAAA, 2014)

If you’re feeling well on Cymbalta and want to reduce drinking alcohol, speak to your healthcare provider about cognitive-behavioral therapy or other treatments to help you stop drinking.

Follow your healthcare provider’s instructions while on Cymbalta to start feeling better.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

July 12, 2021

Written by

Tobi Ash, MBA, RN, BSN

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.