Does Cymbalta cause aggression? (5+ factors)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will discuss whether Cymbalta causes aggression, what research suggests, what factors can contribute to cymbalta-induced aggression, what to do if you are experiencing aggression as a side effect of Cymbalta, and what are the nonpharmacological strategies to control Cymbalta-induced aggression.
Does Cymbalta cause aggression?
Yes, Cymbalta may cause aggression in some patients who are using it for the treatment of their mental health conditions. It is one of the less common side effects of Cymbalta, and individual responses to this medication can vary. (1)
Cymbalta (duloxetine) is a serotonin-norepinephrine reuptake inhibitor. It is primarily used to treat major depressive disorder, generalized anxiety disorder, fibromyalgia, diabetic neuropathic pain, and chronic musculoskeletal pain.
However, Cymbalta-induced aggression can also occur in the initial phase of therapy and may subside within a few weeks as the body adjusts to the medication.
How does Cymbalta cause aggression?
Cymbalta inhibits serotonin and norepinephrine reuptake, both responsible for mood regulation. The changes in these neurotransmitters impact behavior, including the potential for increased aggression.
It’s important to note that antidepressants, including Cymbalta, can affect individuals differently, and the possibility of experiencing side effects varies among users. (1,7)
What does research suggest?
Aggression can be influenced by various factors, and research that directly links Cymbalta to aggression is limited, but individuals who reported increased aggression while using Cymbalta cannot be ignored because antidepressants, in general, have the tendency to cause aggression and irritability. (2)
Some studies have reported increased irritability and aggression in individuals taking SNRIs, including Cymbalta, for the treatment of major depressive disorder. Postmarketing surveillance of Cymbalta resulted in reports of aggressive behavior in patients who were using it to treat certain mental disorders and chronic pain. (1,3)
A meta-analysis focusing on aggression induced by serotonin and serotonin-norepinephrine reuptake inhibitors concluded that in children and teenagers taking SSRIs or SNRIs, the risk of aggression doubled. However, more research is required to form a causal link between Cymbalta and aggression. (4)
What factors can contribute to Cymbalta-induced aggression?
Several factors may contribute to the emergence of aggression as a side effect of Cymbalta:
- Individual differences: Genetic, biological, and psychological factors unique to each individual can influence how the body responds to Cymbalta and may make you more prone to experiencing side effects, including aggression.
- Dosage: The dosage and frequency of Cymbalta can impact the likelihood of aggression. Higher doses can increase the risk of side effects, including aggression.
- Duration of use and treatment phase: The duration and phase of Cymbalta treatment may impact the likelihood of aggression. The body needs time to adjust to the new medication, and in this initial phase, aggression can occur. Long-term treatment with Cymbalta can also increase the risk of aggression.
- Drug interactions: Concomitant use of Cymbalta with other medications can impact how your body reacts to Cymbalta and increase the risk of side effects, including aggression.
- Underlying mental conditions: The presence of coexisting psychiatric conditions like bipolar disorder may contribute to changes in behavior when taking Cymbalta and increase the risk of experiencing aggression as a side effect.
- Age: Children and adolescents are more susceptible to experiencing aggression as a side effect of Cymbalta. (4)
What to do if you are experiencing Cymbalta-induced aggression?
If you are taking Cymbalta and experiencing aggression, it is crucial to consult your healthcare provider. Your doctor will assess your condition and recommend appropriate actions according to the severity of your situation. These recommendations include:
Lowering the dosage: Your healthcare provider may suggest lowering the dose as it can mitigate the side effects and make your treatment more comfortable.
Alternative antidepressant: If lowering the dose does not resolve the aggression, your doctor might explore other antidepressants that have a low probability of causing aggressive behavior.
What are some non-pharmacological strategies to control Cymbalta-induced aggression?
For individuals experiencing aggression as a side effect of Cymbalta, there are nonpharmacological strategies that may help manage these symptoms:
- Therapy and stress management: Psychotherapy, such as cognitive-behavioral therapy (CBT) and parent management training (PMT), can be valuable for managing anger and aggressive behaviors. Stress management techniques like mindfulness can also help reduce aggression. (5,6)
- Lifestyle modifications: Eliminating factors from your lifestyle that can cause aggression can be helpful in managing aggression. Regular exercise and adequate sleep may positively impact mood and behavior and, as a result, reduce aggression.
From my perspective, the research on the causal link between Cymbalta and aggression remains unclear; monitoring any behavior changes and reporting them to your healthcare providers is essential so that they can decide to continue, adjust, or discontinue Cymbalta.
Therapies like cognitive-behavioral therapy and stress management techniques should also be considered to manage aggression non-pharmacologically.
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References
1.-
Highlights of prescribing information of Cymbalta by The U.S. Food and Drug Administration, Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022516lbl.pdf
2.-
Healy, D., Herxheimer, A., & Menkes, D. B. (2006). Antidepressants and Violence: Problems at the Interface of Medicine and Law. PLoS Medicine, 3(9). https://doi.org/10.1371/journal.pmed.0030372
3.-
Tsutsui-Kimura I, Ohmura Y, Yoshida T, Yoshioka M. Milnacipran affects mouse impulsive, aggressive, and depressive-like behaviors in a distinct dose-dependent manner. J Pharmacol Sci. 2017 Jul;134(3):181-189. doi: 10.1016/j.jphs.2017.06.004. Epub 2017 Jun 27. PMID: 28694090. https://pubmed.ncbi.nlm.nih.gov/28694090/
4.-
Sharma, T., Guski, L. S., Freund, N., & Gøtzsche, P. C. (2016). Suicidality and aggression during antidepressant treatment: Systematic review and meta-analyses based on clinical study reports. The BMJ, 352. https://doi.org/10.1136/bmj.i65
5.-
Sukhodolsky, D. G., Smith, S. D., McCauley, S. A., Ibrahim, K., & Piasecka, J. B. (2016). Behavioral Interventions for Anger, Irritability, and Aggression in Children and Adolescents. Journal of Child and Adolescent Psychopharmacology, 26(1), 58-64. https://doi.org/10.1089/cap.2015.0120
6.-
Carlson LE, Speca M, Patel KD, Goodey E. Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology. 2004 May;29(4):448-74. doi: 10.1016/s0306-4530(03)00054-4. PMID: 14749092. https://pubmed.ncbi.nlm.nih.gov/14749092/
7.-
AHFS Patient Medication Information [Internet]. Bethesda (MD): American Society of Health-System Pharmacists, Inc.; c2019. Duloxetine; [updated 2022 Mar,15; reviewed 2018 Jul 5; cited 2020 Jul 1]; [about 5 p.]. Available from: https://medlineplus.gov/druginfo/meds/a604030.html
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