Can Cymbalta cause brain zaps? (3+ studies)

In this article, we will answer the question “Can Cymbalta cause brain zaps?”. We will discuss what research has to say, how to manage Cymbalta-induced brain zaps and what to do if brain zaps do not subside while on Cymbalta therapy. 

Can Cymbalta cause brain zaps?

Yes, Cymbalta (Duloxetine) can cause brain zaps in individuals. This side effect can occur at the start of treatment as well as at discontinuation. Most people experience brain zaps during the withdrawal from Cymbalta. The side effects of any medication, including Cymbalta, can vary from person to person so the brain zaps may not be experienced by everyone on Cymbalta 

Cymbalta is an antidepressant medication, belonging to the class of serotonin and norepinephrine reuptake inhibitors (SNRIs). It inhibits the reuptake of two of the most important mood-regulating neurotransmitters in the brain. It is approved by the FDA for depressive conditions, fibromyalgia, musculoskeletal pain and diabetic peripheral neuropathic pain (DPNP) (1,2).

Brain zaps are electric shock-like sensations experienced by some people when they stop taking antidepressants, but can also happen at the initiation of, or during the treatment. This side effect is mostly seen with selective serotonin reuptake inhibitors (SSRIs) and SNRIs. Some people also describe these as ‘brain shivers’ because they feel that their brain is shivering. 

How does Cymbalta cause brain zaps?

The role of Cymbalta in causing brain zaps has not yet been understood. The mechanism through which this phenomenon happens is still under research. However, these side effects can be due to changing serotonin levels within the brain.

Cymbalta works by increasing the levels of serotonin and norepinephrine in the brain. The increased levels can improve mood and exert the intended therapeutic effect. If there is an abrupt change in the levels of serotonin during Cymbalta treatment or at withdrawal, some individuals may experience brain zaps. One possible mechanism also links lateral eye movements to brain zaps and proposes that both these side effects could be contributing to each other (3,4).

Along with brain zaps, Cymbalta may cause weight loss or gain, somnolence, gastrointestinal side effects and upset stomach with nausea, vomiting and diarrhoea. Keep in mind that each individual is different and everyone may not respond to Cymbalta equally. However, if you feel any such uncomfortable sensation immediately contact your healthcare provider for guidance.

What does research say?

Many research studies have been published that report the occurrence of brain zaps or shock-like sensations when SSRI and SNRI therapy is discontinued.

A study monitoring the side effects of Duloxetine reported two cases of patients, both of whom experienced shock-like sensations at the initiation of therapy. Both patients recovered from this side effect once Duloxetine was discontinued (5).

Another study assessing the adverse reactions of patients undergoing treatment of depression with Duloxetine stated that shock-like sensations were a symptom of the discontinuation syndrome, and were experienced by many individuals coming off Duloxetine therapy (6).

A case study of a 29-year-old woman who was given Duloxetine 60mg for the treatment of a major depressive episode states that shock-like sensations were experienced by the patient a the start of treatment and also after Duloxetine discontinuation. To manage her symptoms, Fluoxetine was introduced to her regimen and was given for more than three months (7).

A research study assessing the ADR reports by consumers concluded that many Duloxetine consumers experienced and reported electric shock-like sensations with Duloxetine therapy. Most reports were of patients undergoing Duloxetine discontinuation (8).

What other conditions can cause brain zaps?

Although research indicates the use of SSRIs and SNRIs is mostly associated with brain zaps in individuals, medications are not always responsible for these zaps. There are a few other conditions that can trigger zaps or electric shock-like sensations in the brain (4):

• Insomnia
• Anxiety
• Caffeine
• Alcohol
• Fatigue
• Headaches
• Excess sound or noises
• Bright lights

You should always consult your doctor if you are experiencing brain zaps so that your doctor can assess your situation and find the exact cause of your brain shivers.

How to manage brain zaps while on Cymbalta?

Brain zaps are a self-resolving side effect, which will resolve when the underlying cause has been eliminated. If they are due to antidepressant therapy, they will resolve a few weeks after discontinuation of the medication. But if there is something else causing this side effect, then that specific cause has to be addressed.

Unfortunately, there is not much that could be done to manage brain zaps while on Cymbalta or any other antidepressant. There are a few things that have helped some people in managing this side effect (3):

• Omega-3 fatty acids
• Magnesium
• Vitamin B-complex preparations

However, there is not much scientific evidence supporting these remedies and they may not work for everyone experiencing this side effect.

What to do if Cymbalta-induced brain zaps do not subside?

If you feel your symptoms are getting worse instead of improving, you should consult a healthcare provider and talk to them about your condition. Your healthcare provider may assess your symptoms and find out the underlying cause of your symptoms. 

If your symptoms get extremely uncomfortable and Cymbalta is the cause, your doctor may change your dosage or even medication, if required. But if the zaps are not due to Cymbalta, your healthcare provider may recommend a full workup of the possible cause.

Although Cymbalta is not a controlled substance, it does require a prescription. So, please do not make amends to your dosage or medication without a proper prescription.

To the best of my knowledge and research, Cymbalta does cause brain zaps or electric shock-like sensations in the brain. This side effect normally occurs as a part of the discontinuation syndrome when Cymbalta is discontinued, but can also occur at the start of and even during treatment. Other conditions like insomnia, headaches or fatigue can also be responsible for brain zaps. Some people have benefited from supplements like omega-3, magnesium and vitamin B-complex, but is advised that you should consult a doctor for a personalised plan.

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