Can Cymbalta and Xanax be used together? (3+ facts)

In this article, we will answer the question, “Can Cymbalta and Xanax be used together?” we will also look into the research studies on this combination along with the benefits of taking Cymbalta and Xanax together. We will also discuss the side effects associated with Cymbalta and Xanax and what to avoid while taking this combination. 

Can Cymbalta and Xanax be used together? 

Yes, Cymbalta and Xanax can be used together. This medication combination is commonly prescribed to individuals who are experiencing symptoms of both anxiety and depression. Anxiety and depression frequently occur together, and a combination of medication help mitigate symptoms of both anxiety and depression. (1)

Combination therapy is also used to treat major depressive disorder, where monotherapy is not useful. A combination of Cymbalta and Xanax is more effective in treating symptoms associated with anxiety and depression when compared to a single drug. (2)

Combination therapy is also associated with side effects. If you experience any unwanted side effects after taking Cymbalta and Xanax together, make sure you consult your physician and avoid sudden discontinuation of the drug, as it can cause withdrawal symptoms and worsen your condition. 

What is the benefit of using Cymbalta and Xanax together? 

Cymbalta (duloxetine) is an antidepressant belonging to a class of serotonin-norepinephrine reuptake inhibitors. Cymbalta acts by inhibiting the reuptake transporters of serotonin and norepinephrine, which increases the level of neurotransmitters such as serotonin, norepinephrine and dopamine in the brain. (3)

These neurotransmitters play an important role in regulating cognitive functions such as attention, memory, decision-making, reasoning, etc. A low level of serotonin can cause suicidal ideation in depressed patients, and dysfunction in norepinephrine can induce anxiety and mood disorders. (4) Antidepressants increase the level of these neurotransmitters, which helps alleviate the symptoms. 

Xanax (alprazolam) belongs to a class of benzodiazepines. It acts on the GABA-A receptors in the CNS. Benzodiazepines act on the alpha, beta and gamma subunits of GABA-A receptors; this enhances the action of GABA, which provides a calming effect on the nervous system. (5)

Xanax is used to treat psychiatric illnesses such as anxiety and panic disorders along with insomnia, premenstrual syndrome and depression. Whereas Cymbalta is used to treat depression, anxiety, fibromyalgia, peripheral neuropathy and chronic pain. (3,5)

Anxiety and depression have some similar symptomatology. A combination is used when monotherapy is not sufficient to treat the symptoms. The benefits of combination therapy include: (6)

• Rapid control of anxiety.
• Reduced drug-induced anxiety or agitation in an early stage of therapy.
• Better adherence to the therapy. 
• Improved control over anxiety episodes.

What does the research suggest?

Benzodiazepines have an enhanced effectiveness in treating anxiety. They have a rapid onset of action and have a good patient acceptance rate. Benzodiazepines are combined with an SNRI/SSRI for the short term, which provides rapid symptom relief at the beginning of the treatment. Benzodiazepines are then tapered as the SSRI/SNRI starts to show its effect. (6)

A combination of antidepressants with benzodiazepine has shown more effectiveness in treating symptoms of anxiety and depression in the early stages than antidepressant monotherapy. (2)

What are the side effects of taking Cymbalta and Xanax together? 

A combination of antidepressants and benzodiazepines can increase the risk of side effects. A case study reported 2 cases of suicidal ideation in patients treated with duloxetine and alprazolam together. (7)

With an increased dose, the risk of side effects also increases. Side effects associated with benzodiazepines include sedation, psychomotor impairment and rebound anxiety. (6)

The side effects experienced with the use of Cymbalta and Xanax vary among individuals. If you notice or experience any unwanted effects with the use of this combination, make sure you consult a physician for proper management.

Common side effects of Cymbalta: 

• Headache
• Drowsiness
• Fatigue
• Nausea
• Dry mouth
• Abdominal pain
• Weight loss
• Weakness
• Insomnia
• Dizziness
• Change in libido/erectile dysfunction
• Decreased appetite
• Tremor
• Diarrhea
• Seizures

Common side effects of Xanax: 

• Insomnia
• Tiredness
• Memory problems
• Poor balance and coordination
• Slurred speech
• Trouble concentrating
• Irritability
• Increased sweating
• Blurred vision
• Appetite changes
• Swelling of hands and limbs
• Muscle weakness
• Worsening depression 

If you notice a worsening of depression or suicidal ideation, consult your physician immediately. Avoid abrupt discontinuation of the drug, as it can cause withdrawal symptoms and worsen your condition. 

What to avoid while taking Cymbalta and Xanax?

Xanax and Cymbalta can interact with other drugs, herbal supplements, and alcohol, which can lead to an increased concentration of the drugs in the body, causing severe side effects. Here are a few things to avoid while taking Xanax and Cymbalta together. Consult your physician before taking any OTC medication. 

• Alcohol
• Monoamine oxidase inhibitors 
• Opioids 
• Stimulants like amphetamines
• Grapefruit/grapefruit juice
• Caffeine
• Herbal supplements, especially St. John’s wort
• Antibiotics such as ciprofloxacin
• OTC medication such as aspirin, tramadol, Benadryl, etc. 

In my experience as a pharmacist, Cymbalta and Xanax can be taken together to treat the symptoms of depression and anxiety more effectively. This combination is usually used to treat comorbid anxiety and depression, which provides rapid relief from the symptoms. However, the effect of antidepressants and benzodiazepines varies among individuals. 

If you are experiencing worsening depression or anxiety, seek immediate medical help and avoid sudden discontinuation of the drug, as it can worsen your condition. 

References