Does Cymbalta cause dystonia? (+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 about Cymbalta-induced dystonia. We will also discuss the research studies linking Cymbalta use and dystonia. Additionally, we will explore the factors that may increase the risk of dystonia while taking Cymbalta and the management tips for Cymbalta-induced dystonia.
Does Cymbalta cause dystonia?
Yes, Cymbalta does cause dystonia. However, it is not a commonly reported side effect of Cymbalta but individual responses to Cymbalta may vary, and some patients can develop dystonia after using Cymbalta.
Cymbalta is a serotonin and norepinephrine reuptake inhibitor antidepressant medication. It increases the concentration of these neurotransmitters in the brain. The elevated levels of serotonin and norepinephrine are responsible for the therapeutic effects of Cymbalta which may include the management of depression, anxiety, fibromyalgia, and chronic pain (1).
Cymbalta has a good safety profile with mild to moderate side effects. The frequently reported side effects of Cymbalta may include nausea, vomiting, dizziness, drowsiness, fatigue, headache, and dry mouth. However, some individuals may also report rare adverse effects of Cymbalta such as hallucinations, hepatotoxicity, and dystonia (2).
What does research suggest?
According to research, Cymbalta-induced dystonia may result from its impact on serotonin levels in the brain, influencing dopamine levels and disturbing the balance with acetylcholine. This disruption, especially through serotonin receptors inhibiting dopaminergic pathways, is thought to contribute to the development of acute dystonia associated with Cymbalta (4).
Research indicates that Cymbalta-induced dystonia can manifest within a few hours to several months of treatment initiation. A specific case study reported dystonia occurring after a single dose of Cymbalta prescribed for anxiety disorder within 2 days. Importantly, the dystonia resolved upon discontinuing the medication (5).
In another research study, an elderly woman reported experiencing dystonia after using Cymbalta for 1.5 years to manage her depression. Despite discontinuing the medication, the dystonia persisted (3).
What factors can influence Cymbalta-induced dystonia?
Several factors may increase the risk of developing Cymbalta-induced dystonia. These factors may include (6):
Family history: Individuals with a family history of dystonia and other movement disorders are at higher risk of developing dystonia while taking antidepressant medications like Cymbalta.
Age and gender: According to research, children under the age of 18 are more vulnerable to developing dystonia, and this risk decreases as they grow older. Additionally, males are at a higher risk of developing dystonia when taking Cymbalta, compared to females.
Use of alcohol: The risk of adverse effects of Cymbalta including dystonia, increases with the concomitant use of alcohol. Healthcare providers recommend not consuming alcohol with antidepressant medications including Cymbalta, to avoid unwanted side effects.
Medication history: The use of Cymbalta with other medications such as antipsychotics increases the risk of dystonia and dyskinesia. It is important to discuss your medication history with your healthcare provider to prevent drug interaction and subsequent adverse effects.
Underlying medical conditions: Individuals with a history of movement disorders, including dystonia, are more susceptible to the development or worsening of dystonia when using Cymbalta.
What to do if Cymbalta causes dystonia?
If you experience unintended muscle contractions that cause abnormal recurrent movements or any other symptom of dystonia after taking Cymbalta, it is important to consult your healthcare provider immediately.
Your healthcare provider will assess your condition to identify the actual cause of your symptoms. If it is related to Cymbalta, they may make changes to your treatment plan accordingly. In cases where the symptoms of dystonia are not severe and the benefits of therapy outweigh its risks, dosage adjustments of Cymbalta may be done.
However, if dystonia remains persistent after lowering the dosage and is affecting your quality of life, then your healthcare provider may recommend an alternative medication to Cymbalta that is equally effective but with a lower risk of developing dystonia.
In addition to medication changes, your healthcare provider may also recommend exercises designed to enhance muscle strength and flexibility. They might suggest lifestyle modifications to avoid triggers and manage stress, which can contribute to the exacerbation of dystonia.
What are alternatives to Cymbalta if it causes dystonia?
Some alternative antidepressants to Cymbalta are equally effective in managing medical conditions including mental disorders and fibromyalgia for which Cymbalta is prescribed. However, they may have a lower incidence of dystonia compared to Cymbalta. These alternatives include:
- desvenlafaxine
- zolpidem
- Pregabalin
- milnacipran
- benzodiazepines for anxiety
It’s important to note that while these medications may generally have a lower risk of dystonia as compared to Cymbalta, individual responses vary, and adverse effects can occur in some individuals.
In my opinion, based on my knowledge and experience, SSRI medications, including Cymbalta, have the potential to induce dystonia. While it is not frequently reported as a side effect of Cymbalta in clinical settings, instances of dystonia may occur rarely, particularly in individuals with specific risk factors.
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References
1.-
Dhaliwal JS, Spurling BC, Molla M. Duloxetine. 2023 May 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31747213. https://pubmed.ncbi.nlm.nih.gov/31747213/
2.-
Dhaliwal JS, Spurling BC, Molla M. Duloxetine. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549806/
3.-
Chen PY, Lin PY, Tien SC, Chang YY, Lee Y. Duloxetine-related tardive dystonia and tardive dyskinesia: a case report. Gen Hosp Psychiatry. 2010 Nov-Dec;32(6):646.e9-646.e11. doi: 10.1016/j.genhosppsych.2010.04.009. Epub 2010 Jun 3. PMID: 21112461. https://pubmed.ncbi.nlm.nih.gov/21112461/
4.-
Karakaş Uğurlu G, Onen S, Bayındırlı D, Cayköylü A. Acute dystonia after using single dose duloxetine: case report. Psychiatry Investig. 2013 Mar;10(1):95-7. doi: 10.4306/pi.2013.10.1.95. Epub 2013 Feb 8. PMID: 23483133; PMCID: PMC3590439. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3590439/
5.-
Siddiqui SH, Memon NA, Shanker R. Drug-induced movement disorder and confusion associated with duloxetine. BMJ Case Rep. 2018 Mar 28;2018:bcr2016216746. doi: 10.1136/bcr-2016-216746. PMID: 29592972; PMCID: PMC5878391. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878391/
6.-
van Harten PN, Hoek HW, Kahn RS. Acute dystonia induced by drug treatment. BMJ. 1999 Sep 4;319(7210):623-6. doi: 10.1136/bmj.319.7210.623. PMID: 10473482; PMCID: PMC1116493. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1116493/
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