Can you take Mirtazapine and Cymbalta together?

In this article, we will discuss the concomitant use of Mirtazapine and Cymbalta. We will discuss some research studies and shed light on the potential dangers of combining these two medications. 

Can you take Mirtazapine and Cymbalta together?

You can take Mirtazapine (Remeron) and Duloxetine (Cymbalta) together if your healthcare provider has prescribed this combination. Mirtazapine and Cymbalta are antidepressants, which belong to two different classes of drugs (1,2).  

However, they both affect your excitatory neurotransmitters to work against the symptoms associated with depression. Antidepressant combinations are carefully prescribed, as they are not for everyone. 

So, never take another antidepressant while you’re already being treated with one without consulting your doctor. Taking an extra antidepressant does not always give additive benefits. Sometimes, it just increases the risk of side effects. 

What does research suggest?

There is limited research on the combination of Mirtazapine and Cymbalta. However, some research studies have discussed them. 

One research study indicated that the combination of Mirtazapine and Cymbalta can be considered for the management and treatment of severe depression (3). 

However, this combination can sometimes lead to drug-induced hypomanic episodes, potentially affecting mental well-being significantly. The study concluded that this combination may have a role for specific patients but should be approached carefully (3).

Another research study indicated that combining Mirtazapine and Duloxetine can be beneficial in treating treatment-resistant depression. It can lead to improved treatment outcomes and may also have a positive impact on sexual function (4).

What are the potential risks of taking Mirtazapine and Cymbalta together?

Combining Mirtazapine and Cymbalta can have potential risks. One rare but dangerous risk is serotonin syndrome. This can happen when there’s too much serotonin in the brain. It’s more likely to occur if the doses aren’t properly adjusted or if there’s an interaction between the two drugs.

Signs and symptoms associated with serotonin syndrome include: (5)

  • Excessive sweating 
  • Fever with chills
  • Confusion
  • Restlessness and fatigue
  • Headache, which often feels like your head is pounding
  • Changes in blood pressure and/or temperature
  • Shivering and goosebumps

Furthermore, both Mirtazapine and Cymbalta can also cause some common side effects. These may include nausea, dizziness, drowsiness, and changes in appetite. Combining them may increase the chances of experiencing these side effects.

Additionally, it’s important to note that both Mirtazapine and Cymbalta are antidepressants. Taking two antidepressants at once might not be well-tolerated by everyone, even if the doses are adjusted. 

It’s crucial to work closely with your doctor to monitor how your body responds to this combination and to discuss any concerns or side effects with your healthcare provider.

Always follow your doctor’s guidance when it comes to medication combinations, and don’t hesitate to reach out to them if you have any questions or experience any unusual symptoms.

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

To ensure the proper use of Mirtazapine and Cymbalta together, the following points are important (1,2):

  • Always follow the instructions provided by your healthcare provider. 
  • Take each medication exactly as prescribed by your doctor. Do not alter the dosages on your own, as adjusting the doses without medical guidance can lead to complications.
  • Mirtazapine and Cymbalta may interact negatively with alcohol or certain substances, so combined use should be avoided.
  • Keep an eye out for the potential side effects associated with this combination and reach out to your doctor if anything concerns you.
  • A balanced diet, regular exercise, and good sleep hygiene can complement your medication regimen. These lifestyle factors can contribute to your overall well-being.

Remember, safe and effective use of medications is the most important key to achieving the best possible therapeutic outcome. 


In this article, we have discussed the concomitant use of Mirtazapine and Cymbalta. We have also discussed some potential risks associated with their use and how you can ensure proper use if your doctor has prescribed this combination. 

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Meagher D, Hannan N, Leonard M. Duloxetine-mirtazapine combination in depressive illness: The case for Limerick ‘rocket fuel’. Ir J Psychol Med. 2006 Sep;23(3):116-118. doi: 10.1017/S0790966700009782. PMID: 30290515. Available from:


Ravindran, Lakshmi N MD*†; Eisfeld, Beata S. BSc(Hons)*; Kennedy, Sidney H. MD, FRCP(C)*†. Combining Mirtazapine and Duloxetine in Treatment-Resistant Depression Improves Outcomes and Sexual Function. Journal of Clinical Psychopharmacology 28(1):p 107-108, February 2008. | DOI: 10.1097/JCP.0b013e318160d609. Available from:


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