Does Cymbalta cause high triglycerides? (5+ tips)

In this article, we will answer the question “Does Cymbalta cause high triglycerides”. We will also discuss the research on this side effect, factors influencing triglyceride levels, tips to manage triglycerides while on Cymbalta, steps to be taken if Cymbalta causes high triglycerides, and alternative medications in the event of Cymbalta causing high triglycerides.

Does Cymbalta cause high triglycerides?

Cymbalta does not cause an increase in triglycerides. It is not a listed side effect on the official label of the medication. The studies on this particular link are scarce and a strong association between Cymbalta and high triglycerides is still under debate.

Triglycerides are fats that are essential for life. They are involved in multiple biochemical mechanisms in our body. However, an excessive intake can result in their deposition in the body and blood vessels leading to multiple disorders.

Anti-depressants in general have been associated with an increase in the levels of triglycerides and cholesterol. Therefore, one must be careful and monitor their lipid parameters while on Cymbalta. Since studies trying to find a link between Cymbalta and high triglycerides are few, there is a possibility that Cymbalta might be increasing the levels of triglycerides in some patients. 

Cymbalta is the brand name for the prescription drug duloxetine and belongs to the class of selective serotonin-norepinephrine reuptake inhibitors. It is used for the treatment of depression, anxiety, and chronic pain.

What does the research say?

Clinical studies measuring multiple parameters of patients with depression have been conducted to understand the correlation between anti-depressants and triglyceride levels. These studies used various tests for their assessment such as patient questionnaires, blood tests, and mental illness parameters. It was concluded that an increase in the levels of triglycerides was associated more with the depressive symptoms of the patient rather than the anti-depressants themselves (1).

One of the studies reported that the state of depression leads to unhealthy behavior (i.e., lack of physical activity, consumption of alcohol) which may contribute to an increase in the levels of triglycerides. However, a direct link between anti-depressants and particularly Cymbalta was not found (2).

Weight gain is usually associated with an increase in the levels of triglycerides and cholesterol. However, Cymbalta is considered a weight-neutral anti-depressant and thus is not even indirectly linked to increasing triglyceride levels.

It is thus a particularly good choice for patients with pain along with depression accompanied by a cardiovascular disorder since it does not increase the risk of a cardiovascular event.

What factors influence triglyceride levels in Cymbalta users?

Studies have found that an increase in the levels of triglycerides might be associated with the mental health status of an individual.

Factors such as below may contribute to high triglyceride levels (3):

• Excessive smoking
• Excessive consumption of alcohol-Both alcohol and Cymbalta affect the liver, damaging it over prolonged use
• Diet high in sugar, saturated fat, and simple carbohydrates
• Sedentary lifestyle
• Obesity
• Lack of physical activity associated with depression or chronic pain.
• High blood sugar

High triglycerides can over a period cause disorders such as metabolic syndrome, stroke, angina, cardiac arrest, and many more, further complicating the health status of a mental health patient.

I can hypothesize a factor about the duration of the prescription of anti-depressants. Depression if not treated properly is a life-long disorder and even with therapy and medical interventions, it takes a long time for a patient to come out of it.

Doctors continue prescribing higher doses of anti-depressants for a longer period due to the fear of recurrence, lack of safety concerns, and low frequency of proactive medication review. They prescribe higher doses with the intent that it would bring greater efficacy and decide to increase or switch the medication after 8-10 weeks. However, studies have shown that higher doses lack greater efficacy and the onset of action is usually within 1-2 weeks (4).

This leads to fluctuating levels of the drug which highly impacts the mental status of a patient and their daily lifestyle. If this happens frequently, there is always a probability that the patient may be in a depressive state longer than intended and switch to an unhealthy lifestyle leading to changes in levels of triglycerides, sugar, and cholesterol.

What tips to follow to manage triglyceride levels?

We are aware that a lack of motivation or a healthy drive for life is affected in patients with depression or chronic pain. Some patients fall prey to binge eating under duress. However, lifestyle modifications mentioned below may help patients cope with their triglyceride levels:

• Undergo regular counseling with a professional counselor. Try to voice your worries and events causing you anxiety.
• Consider a few physical therapies to relieve stress such as walking, cycling, and yoga. Even meditation can help a lot.
• Follow diet changes such as avoidance of sugar, alcohol, and whole wheat-based food. Eat food with fewer carbohydrates and less saturated fats.
• Check your eating portions.
• Don’t skip meals and drink lots of water.
• Quit smoking.
• Join mental health support-based groups where patients share their experiences and learn from each other to overcome their issues.

Cymbalta interacts with multiple drugs and natural herbs and it is important to give a complete medical history to your doctor before starting the treatment as it may serve as a critical factor affecting the dynamics of the medication.

If ultimately nothing is working out, patients can consult with their healthcare provider and consider taking statins to lower their triglyceride levels.

What to do if Cymbalta causes an unexplained increase in triglycerides?

The most important thing is to consult your healthcare provider. They will have your medical history and will try to understand the factors causing high triglyceride levels and advise measures and treatment plans accordingly. 

The doctor may stop giving you Cymbalta, taper the dose or recommend an alternative anti-depressant.  Once a suitable measure is taken, a correlation can be established between the medication and levels of triglycerides.

Also, do not abruptly discontinue Cymbalta without your doctor’s approval as it may harm your health. Do not shift to other anti-depressants without consultation with a physician.

Get your blood reports done and self-evaluate if any sudden lifestyle changes might have led to an unexplained rise in triglyceride levels.

What are the alternatives to Cymbalta if it increases triglycerides?

Many alternative medications are available for patients in the event of Cymbalta causing an increase in the levels of triglycerides. The doctor will decide on the switch depending on the condition of the patient being treated, patient history, other medications prescribed, and the response of the patient to the new medication. The few alternatives listed below have been found not to increase triglyceride levels:

• Escitalopram
• Sertraline
• Fluoxetine
• Venlafaxine

These drugs help in treating anxiety and depression independent of any metabolic effects on the patients (5).

Conclusion:

According to my perspective and the data available, Cymbalta is not directly associated with causing an increase in the levels of triglycerides. However, patients taking the medication must monitor their vital and biochemical parameters and keep open communication with their doctor.

They should strive to maintain a healthy lifestyle to avoid any potential side effects associated with mental health status as well as medication.

References