Does Cymbalta contain Lithium? (+ 5 differences)

In this article, we will discuss whether Cymbalta contains Lithium. We will also discuss the differences between Cymbalta and whether these two medications can be taken together. Additionally, we will provide some general information to help you understand the factors your doctor might consider when choosing between Cymbalta and Lithium.

Does Cymbalta contain Lithium?

No, Cymbalta does not contain Lithium. Cymbalta belongs to a different class of medication called serotonin-norepinephrine reuptake inhibitors (SNRIs), while Lithium is a mood stabilizer with a different mechanism of action.

Cymbalta primarily contains duloxetine, which is the active ingredient in the medication. In addition to duloxetine, each Cymbalta capsule contains inactive ingredients, including enteric-coated pellets, lactose monohydrate,  titanium dioxide, triethyl citrate, povidone and hypromellose acetate succinate. (1)

On the other hand, Lithium itself is an element that is used in its compound forms in medications. Lithium-containing medications are prescribed to treat bipolar disorder, schizophrenia and mood swings. (2)

Although Cymbalta and Lithium target different conditions and work in distinct ways, both medications can affect the brain and nervous system, and combining them can increase the risk of side effects.

How is Cymbalta different from Lithium?

Cymbalta and Lithium are both medications used to treat mental health conditions, but they work in different ways and have different applications. Here are some key differences between Cymbalta and Lithium (1,2):

Mechanism of action

Cymbalta is an antidepressant classified as a serotonin-norepinephrine reuptake inhibitor (SNRI). This means it blocks the reuptake of both serotonin and norepinephrine. By inhibiting the reuptake of serotonin and dopamine in the synaptic cleft, Cymbalta increases their extracellular concentration, potentially enhancing neurotransmission and exerting beneficial effects on mood, emotional regulation and pain perception. 

Lithium functions as a mood stabilizer by modulating various neurotransmitters, including serotonin, norepinephrine, dopamine and glutamate. Lithium seems to help stabilize their levels and prevent extreme fluctuations, contributing to mood stabilization.

Lithium’s mechanism of action in treating mental conditions is still partially unknown, but research suggests it works through several complex and interlinked pathways, affecting many different brain chemicals and systems.

Target conditions 

Cymbalta is primarily used to treat major depressive disorder and generalized anxiety disorder. It is also prescribed for chronic pain conditions like fibromyalgia.

Lithium is mainly used for treating bipolar disorder,  including preventing future manic or depressive episodes. It may also be used for schizoaffective disorder and treatment-resistant depression.

Side effects profile 

Cymbalta’s side effects profile commonly includes nausea, dry mouth, fatigue, dizziness and sexual dysfunction. More serious side effects of Cymbalta, including serotonin syndrome, are possible, especially when combined with other medications. 

Lithium commonly causes side effects such as hand tremors, thirst, increased urination, weight gain and cognitive effects. Most serious side effects like kidney problems, thyroid dysfunction and neurological issues require immediate medical attention.

Dosage and administration

Cymbalta is usually taken once daily, either with or without food. Dosage adjustment may be needed based on individual response and potential side effects.

Lithium is often taken twice daily, and blood levels need regular monitoring to ensure a safe and effective dosage. 

Can you take Cymbalta and Lithium together?

Recent research provides strong evidence for combining Lithium with antidepressants, including Cymbalta, in treating resistant depression. A meta-analysis of 10 randomized controlled trials revealed that adding lithium to an antidepressant therapy significantly improved outcomes. 

While limited published data exists on combining Cymbalta with lithium, one report case describes a successful outcome after adding Lithium to Cymbalta treatment for 2 patients with severe, therapy-resistant depression.

This suggests the potential for exploring such combinations in future research, though caution and careful monitoring are crucial due to the lack of established safety and efficacy data. (3)

Whether or not you can take Cymbalta and Lithium together should be strictly determined by a healthcare professional. These medications can interact with each other and potentially increase the risk of serious side effects. Potential risks of combining Cymbalta and lithium include (4):

• Serotonin syndrome: Both Cymbalta and Lithium function by increasing the levels of serotonin in the brain. Taking them together can increase the risk of serotonin syndrome, a potentially life-threatening condition with symptoms like fever, confusion, agitation, muscle tremors and rapid heart rate.

• Kidney problems: Lithium can directly impair kidney functions and certain side effects of Cymbalta such as dehydration can exacerbate the risk of causing kidney dysfunction. 

• Electrolyte imbalances: Both medications can affect electrolyte levels like sodium and potassium, leading to problems such as muscle twitches, irregular heartbeat and confusion.

• Increased side effects: Combining these side effects can increase the frequency and severity of individual side effects like nausea, dizziness and tremors.

How to choose between Cymbalta and Lithium?

Choosing between Cymbalta and Lithium for your mental health treatment is a complex decision that should be made only by a qualified healthcare provider. Your healthcare provider can assess your circumstances and weigh the risks and benefits of each medication based on your specific needs and diagnosis.

Cymbalta and Lithium are both powerful medications with different mechanisms of action and target conditions, and the choice depends on several factors. Your healthcare provider will most likely consider the following factors when making the decision:

• Underlying conditions: Cymbalta is used for major depressive disorder, generalized anxiety disorder and chronic pain while Lithium is mostly used for treating bipolar disorder, schizoaffective disorder and treatment-resistant depression.

• Medical history: Existing medical conditions, allergies and interactions with other medications can influence the choice.

• Age and gender: Age and gender can sometimes play a role in medication selection.

• Past medication responses: If you have tried other medications, their effectiveness and side effects can help your doctor guide the decision.

• The severity of symptoms: The severity and type of symptoms can influence which medication might be more suitable to achieve the level of stabilization required.

• Individual preferences: Discuss your concerns and preferences with your doctor. Also, make sure you understand the potential benefits and risks of each medication.

• Cost and availability: Costs, availability of the medication and insurance coverage might also be a consideration.

• Monitoring requirement: Lithium often requires regular blood tests to monitor blood levels, which may influence the choice based on convenience and adherence (4).

In summary, based on my research, I can conclude that Cymbalta does not contain Lithium. Cymbalta and Lithium are two distinct medications for treating different conditions. Whether or not taking Cymbalta and Lithium together is safe and appropriate depends entirely on your individual circumstances. Choosing between Cymbalta and Lithium is a complex decision and should only be determined by a qualified healthcare professional.

References