COVID-19 antigen self-tests in stock here.

Jul 12, 2021
4 min read

Cymbalta and alcohol: risks and side effects

Cymbalta (duloxetine) is a serotonin-norepinephrine reuptake inhibitor (SNRI), an antidepressant approved to treat depression, anxiety, fibromyalgia, and chronic pain. You should limit alcohol while taking Cymbalta, as alcohol increases Cymbalta’s side effects and decreases its effectiveness at treating depression and anxiety. Like all antidepressants, Cymbalta may increase the risk of suicidal thoughts or behavior in children and young adults, especially when they first start taking it.

steve silvestro

Reviewed by Steve Silvestro, MD

Written by Tobi Ash, MBA, RN, BSN

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

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.

What is Cymbalta?

Cymbalta is the brand name for duloxetine (see Important Safety Information), 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.

What are the side effects of Cymbalta?

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.

Can you drink alcohol when taking Cymbalta?

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.

How does alcohol affect the body?

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). 

Dangers of drinking alcohol while taking Cymbalta

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.

Getting better 

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.

References

  1. Dhaliwal, J. S., Spurling, B. C., & Molla, M. (2020). Duloxetine. [Updated Jun 11, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549806
  2. National Alliance on Mental Illness (NAMI). (nd). Can I drink alcohol while taking antidepressants? Retrieved from https://www.nami.org/FAQ/Mental-Health-Medication-FAQ/Can-I-drink-alcohol-while-taking-antidepressants
  3. National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2014). Harmful interactions. National Institute of Health (NIH). Retrieved from https://pubs.niaaa.nih.gov/publications/Medicine/medicine.htm
  4. National Institute on Alcohol Abuse and Alcoholism (NIAAA). (nd-a) Overview: Alcohol consumption Retrieved from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking
  5. National Institute on Alcohol Abuse and Alcoholism (NIAAA). (nd-b). Alcohol’s effects on the body. National Institute of Health (NIH). Retrieved from https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body
  6. Patel, R. (2021). Alcoholic liver disease. [Updated Jul 26, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK546632/
  7. Qato, D. M., Manzoor, B. S., & Lee, T. A. (2015). Drug–alcohol interactions in older US adults. Journal of the American Geriatrics Society, 63(11), 2324-2331. doi: 10.1111/jgs.13787. Retrieved from https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.13787
  8. US Food and Drug Administration (FDA). (2019). Cymbalta. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/021427s052lbl.pdf