Does Cymbalta cause shortness of breath? (1+ facts)

In this article, we will discuss whether Cymbalta causes shortness of breath, how it causes SOB, factors that affect SOB, and precautions to take while consuming Cymbalta.

Does Cymbalta cause shortness of breath?

Cymbalta can cause shortness of breath (SOB), which is a rare side effect. Drug response can differ from person to person, and not all individuals may experience all of the potential side effects.

The medication guide for Cymbalta mentions yawning, throat stiffness, cough, and oropharyngeal pain as respiratory-related side effects experienced by patients while taking Cymbalta.

You may develop shortness of breath while taking Cymbalta. However, shortness of breath can also be caused by other underlying conditions. It is important to know the cause of SOB before treating it. Make sure you visit your physician for a proper evaluation and avoid abrupt discontinuation of Cymbalta, as it can cause withdrawal symptoms and worsen your condition. 

What does the research suggest? 

There are no research studies indicating Cymbalta-induced shortness of breath. However, Cymbalta can cause other respiratory problems such as oropharyngeal pain, throat stiffness, coughing, and yawing. (1)

A case study reported a 32-year-old man who was being treated with duloxetine (Cymbalta) experienced flu-like symptoms such as chills, cough, and fever, which did not subside even after being treated with antibiotics. Upon further investigations, he was diagnosed with eosinophilic pneumonia, which resolved after discontinuing duloxetine treatment. This concluded that Cymbalta caused eosinophilic pneumonia in the patient, causing flu-like symptoms. (2)

A study by Rosenberg et al. reported that selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) used in elderly patients are associated with the risk of lung diseases. Hence, it is recommended to monitor for any pulmonary symptoms in elderly patients who are taking duloxetine. (3)

How can Cymbalta cause shortness of breath? 

Cymbalta is an antidepressant which belongs to the class of SNRI. Cymbalta acts by increasing the levels of neurotransmitters such as serotonin, norepinephrine and dopamine in the brain by inhibiting their reuptake. These neurotransmitters play an important role in mood, memory, attention, etc. An increase in these neurotransmitters helps treat symptoms of depression and anxiety disorders. (4)

Research studies conducted about the effect of serotonin on the respiratory system concluded that serotonin plays a role in the control of breathing, and an increase in serotonin can cause changes in breathing, such as shortness of breath. (5)

Cymbalta also acts on the neurons of the dorsal horn in the spine, which helps reduce pain signals from reaching the brain and helps treat pain in fibromyalgia and chronic pain. (4)

What are the factors contributing to SOB while taking Cymbalta? 

Shortness of breath can be caused by various reasons, and it is important to get evaluated for any underlying cause for SOB before treating it. Here are some factors that can contribute to SOB while taking Cymbalta.

• Allergic reactions: Allergy to specific medication can manifest as shortness of breath and other symptoms. If you are allergic to Cymbalta, stop taking it immediately. 
• Interaction: Cymbalta may interact with other medications, which may enhance the effect of the drug and increase the risk of side effects. 
• Underlying conditions: Any preexisting respiratory and cardiovascular conditions, such as asthma, COPD, pulmonary embolism, etc, can contribute to SOB
• Panic attacks: When Cymbalta is not well-tolerated, or if its effectiveness is reduced while treating anxiety, it may cause a panic attack, which can result in shortness of breath.
• Infection: bacterial or viral infection can contribute to SOB.
• Anemia: Reduced haemoglobin in the body can decrease the oxygen-carrying capacity of the blood, which can cause SOB
• Environmental factors: Pollution, smoke, and reduced oxygen levels at higher altitudes can contribute to SOB.

How to manage Cymbalta-induced SOB?

If you are experiencing shortness of breath after taking Cymbalta, consult your healthcare provider for further management. Avoid abrupt discontinuation of the drug because of the side effects, as it can cause withdrawal symptoms and worsen your condition. 

Your physician may either reduce your dose or switch to another antidepressant. Changes in your treatment regimen should be done only under the guidance of a qualified physician to avoid unwanted side effects. 

Get a thorough medical evaluation to determine the cause of SOB, which may include physical examination, medical history review and some imaging studies if needed. If you are experiencing unwanted side effects after taking Cymbalta, which is interfering with your day-to-day activities, you can consider other alternative antidepressants to treat your illness, such as 

• SSRI: citalopram, fluoxetine, sertraline, paroxetine.
• SNRI: venlafaxine, milnacipran, levomilnacipran.
• Tricyclic antidepressants: amitriptyline, desipramine, imipramine.
• Atypical antidepressants: bupropion, mirtazapine, nefazodone, trazodone.

If you are taking Cymbalta to treat fibromyalgia, you can use pregabalin as an alternative to treat symptoms of fibromyalgia. (6) You can consider other non-pharmacological therapies, such as cognitive behavioural therapy, physical therapy and psychotherapy, along with medications to help treat your illness effectively. 

What safety measures should be taken while using Cymbalta?

• Do not make any change in your dose without a physician’s guidance
• Do not discontinue your medication suddenly, as it may cause withdrawal symptoms.
• Cymbalta can cause suicidal thoughts in some individuals in the early stages of treatment, and you may experience mood swings or worsening of depression. Monitor for any unwanted changes in your behaviour. 
• Attend regular follow-ups to monitor your progress and make the necessary adjustments to your regimen. 
• Avoid alcohol as it may intensify certain side effects of Cymbalta and also decrease its effectiveness.
• Be aware of the other side effects of Cymbalta and monitor them; Cymbalta may cause serotonin syndrome; if you are experiencing confusion, hallucination, seizures, changes in blood pressure, fever, tremors, etc, seek medical help immediately. 
• Be cautious while handling machinery, as Cymbalta can cause dizziness or drowsiness. If you are experiencing dizziness or drowsiness, you can shift the medication from morning to night.
• Keep Cymbalta in a cool, dry place away from sunlight and moisture, as these can cause chemical degradation of the drug and decrease its effectiveness.  

What are the potential side effects of Cymbalta? 

The side effects of Cymbalta can vary among individuals, and not all individuals will experience these side effects. If you notice any of these side effects, make sure you consult your physician before making any changes to your treatment. The common and serious side effects of Cymbalta include: 

• Headache
• Drowsiness
• Fatigue
• Nausea
• Dry mouth
• Abdominal pain
• Weight loss
• Insomnia
• Dizziness
• Constipation
• Tremor
• Diarrhea
• Erectile dysfunction/change in libido
• Seizures
• Serotonin syndrome
• Suicidal thoughts
• Hepatotoxicity
• Mania
• Syncope
• Decreased sodium level

In my experience, Cymbalta may cause SOB, but the incidence is very low. I would recommend you get a thorough medication evaluation to find the cause of SOB before making any changes to your regimen. 

If SOB is caused by Cymbalta, your physician may adjust your dose or suggest another antidepressant. Avoid self-medicating and abrupt discontinuation of Cymbalta. 

References