Can you take Celexa and Cymbalta together? (3+ side effects)

In this article, you will read about the topic: “Can you take Celexa and Cymbalta together?”. You will also know about the side effects and potential risks of combining Celexa and Cymbalta. Furthermore, we will discuss how to ensure proper use of Celexa and Cymbalta.

Can you take Celexa and Cymbalta together?

Yes, you can take Celexa and Cymbalta together only when your physician prescribes the combination. Your physician will carefully analyse your needs and adjust the dose.

Celexa and Cymbalta combination taken without a physician’s guidance can cause potential harm.

Celexa (citalopram) is a selective serotonin reuptake inhibitor (SSRI). Celexa inhibit the CNS reuptake of serotonin by inhibiting the serotonin transporters, in turn increasing the level of serotonin that helps to treat mood disorders, depression and anxiety (1)

Cymbalta (duloxetine) is a serotonin and norepinephrine reuptake inhibitor (SNRI) which increases dopamine levels in the brain by blocking the norepinephrine transporters. An increase in dopamine levels results in the feeling of well-being.

Cymbalta (duloxetine) also help treat chronic and neuropathic pain by acting on noradrenergic and serotonergic neurons. (2)

What are the benefits of combining Celexa and Cymbalta?

Combining Celexa and Cymbalta includes benefits such as enhanced efficacy in treating major depressive disorder, reduction in relapse of the symptoms, and treating treatment-resistant depression.

In the beginning stage of depression, monotherapy (single-drug therapy) is used because the symptoms are mild and can be treated easily. If you are having severe depression or you do not respond to monotherapy, combination therapy is planned with proper dose adjustment.

A study has shown that combination therapy with SSRI and SNRI antidepressants is more effective and preferable than monotherapy. (3)

If you have severe depression or your symptoms persist even after monotherapy, consult your physician for further management. Dosing antidepressants is very important and should not be done without a physician’s guidance.

What does research suggest?

Combination therapy with antidepressants belonging to a different class enhances the drug’s efficacy, safety and tolerability compared to monotherapy. A study found that combining other antidepressants with duloxetine resulted in an improved response. (4)

The approach of combination therapy in treatment-resistant depression has shown positive results. Combination therapy from the beginning enhances the remission of symptoms when compared with monotherapy. (5,6)

However, the action of antidepressants varies from person to person, and each individual responds differently to the medications. If your symptoms are not subsiding, talk to your physician.

What are the potential drug interactions between Celexa and Cymbalta?

Celexa and Cymbalta both medications increase serotonin levels, and an overdose of this medication can cause a rise in serotonin levels, which leads to serotonin toxicity.

Serotonin toxicity can be harmful. Symptoms of serotonin toxicity range from mild to fatal. These symptoms usually appear within 24 hours after overdosing or combination therapy. (3,7)

 Symptoms of serotonin syndrome include:

• Mild hypertension
• Tachycardia
• Mydriasis
• Diaphoresis
• Shivering
• Tremor
• Myoclonus and hyperreflexia
• Diarrhea
• Vomiting
• Disorientation
• Restlessness
• Hyperactive bowel sounds
• Mild agitation
• Pressured speech
• Increased blood pressure
• Delirium
• Muscle rigidity
• Fever which can rise up to 41 degrees Celsius

Complications include seizures, metabolic acidosis, renal failure, acute respiratory distress syndrome, respiratory failure, coma and death. (7)

How to ensure the proper use of Celexa and Cymbalta together?

Do not continue taking Celexa if you are hypersensitive to the drug. If you develop any rash, puffy eyes, swollen salivary glands or nodes, immediately seek medical help.

Cymbalta is an FDA pregnancy category C drug, which means it can cause damage to fetal development. Be careful if you are pregnant or trying to conceive, and talk with your physician.

Cymbalta can pass into breastmilk; if you are breast-feeding your infant, a small amount of Cymbalta can be transferred. Monitor for behavioural changes, sleep disturbance, feeding changes, growth and neurodevelopment in your infant. (7)

Do not stop taking your medication. If you want to stop your medication, talk to your physician. Your physician will taper your dose over a few weeks and discontinue your medication.

Discontinuing medication abruptly can cause withdrawal symptoms, including flu-like symptoms, insomnia, nausea, dizziness, vertigo, light-headedness, and sensory disturbances like tingling, burning, and anxiety. (8)

What are the alternatives to Celexa and Cymbalta combination treatment?

In some individuals, monotherapy is ineffective, and combination therapy with Celexa or Cymbalta or with any other antidepressants can cause side effects. There are several alternatives that can be considered.

Always consult with your healthcare provider before starting any alternative therapies. Your physician will analyse and provide you with the most beneficial psychotherapy. Here are some of the alternative therapies for depression:

• Cognitive behavioural therapy: CBT is a widely used form of psychotherapy for depression; it identifies an individual’s negative thought patterns and behaviours and helps develop adaptive ways.
• Interpersonal therapy: This helps improve your interpersonal relationship and communication skills and also helps address conflicts, grief and situations contributing to depression.
• Psychodynamic therapy: Helps explore how unconscious thoughts and past experiences may influence an individual’s depressive symptoms and enhances self-awareness.
• Behavioural therapy: This therapy encourages you to engage in social and positive activities, which counteracts depression’s tendency of isolation and inactivity.
• Supportive therapy: This therapy offers emotional support for expressing your feelings.

Conclusion

You can take Celexa and Cymbalta together. Research has found that combination therapy is effective in treating depression. Look out for symptoms of serotonin toxicity.

References