Does Cymbalta Increase Norepinephrine? (+3 Risks)

By Ivan Kahwa

Page last updated: 02/02/2024 | Next review date: 02/02/2026

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

Ivan Kahwa

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In this article, we will discuss whether Cymbalta increases norepinephrine levels. We will also discuss some research studies and

Does Cymbalta increase norepinephrine?

Yes, Cymbalta increases norepinephrine levels. Cymbalta is a serotonin-norepinephrine reuptake inhibitor. It works by increasing the levels of serotonin and norepinephrine (brain chemicals) in the brain (1).

This action of Cymbalta is believed to help in managing and treating depression, anxiety and certain types of pains.

The effects of antidepressants like Cymbalta vary among individuals because every person has a different response to medications, especially those meds which affect the brain chemistry.

What does research suggest?

There are several studies indicating the relationship between Cymbalta and norepinephrine. One study indicated that Duloxetine impacts serotonin and norepinephrine in a study with 12 men. It alters serotonin uptake, increases norepinephrine and has similar effects to a medication called desipramine. It affects heart rate and alters neurotransmitter levels (3).

Another study found that Duloxetine treats depression and nerve pain. It increases serotonin and norepinephrine levels in the brain starts working a few hours after taking it and stays in the body for about 12 hours (4).

The typical dose is 40-80 mg/day. It causes nausea, and mild blood pressure increase and is not good for kidney and liver patients (4).

What is the function of norepinephrine?

Norepinephrine is a neurotransmitter and hormone produced by the adrenal glands and some neurons in the central nervous system. It is involved in several functions in the body, including (2):

Stress response: Norepinephrine is a key component of the body’s “fight or flight response. When faced with a stressor norepinephrine is released, increasing heart rate and blood pressure and preparing the body to respond to the perceived threat.

Mood regulation: Norepinephrine aids in mood control in addition to its function in the stress response. It regulates alertness and arousal, and imbalances in this hormone are associated with mood disorders such as depression.

Cognitive function: Norepinephrine plays a role in cognitive processes such as attention, memory and learning. Optimal norepinephrine levels are necessary for these functions to work properly.

What are the symptoms of norepinephrine imbalance?

Symptoms of increased norepinephrine levels (2):

Anxiety
Irritability
Rapid heartbeat
Severe headache
Excessive sweating

Symptoms of decreased norepinephrine levels (2):

Depression
Low blood sugar
Low blood pressure
Memory problems
Irregular heartbeat

What are the potential benefits of increased norepinephrine levels?

The potential benefits of increased norepinephrine levels include (5):

Increased norepinephrine levels contribute to a sense of well-being and elevated energy levels.
Elevated levels of norepinephrine improve cognitive function and increase concentration.
Increased norepinephrine levels might increase blood pressure which helps in certain medical conditions.
Higher levels of norepinephrine improve alertness and wakefulness by activating the central nervous system.

It is important to note that not everyone using Cymbalta gets the same level of benefits. It is crucial to discuss your healthcare provider before taking any medication. they can assess your condition and guide you through the treatment.

What are the potential risks of increased norepinephrine levels?

Potential risks associated with increased norepinephrine include (5):

Norepinephrine is associated with flight or fight response and its heightened levels might exacerbate these feelings.
Norepinephrine is a vasoconstrictor and its elevated levels can cause high blood pressure leading to cardiac issues or other health problems.
Increased norepinephrine levels can interact with sleep patterns resulting in sedation or insomnia.
Higher norepinephrine levels can cause gastrointestinal issues such as nausea, constipation or diarrhoea and vomiting.
Norepinephrine imbalance can also cause attention deficit hyperactivity disorder (ADHD).

Always remember not everyone taking Cymbalta will experience these side effects and their intensity also varies from person to person. Follow your doctor’s guidance for safe and effective use.

What are alternatives to Cymbalta if it is not effective?

If Cymbalta is causing issues or is not effective in treating your condition, then antidepressants with minimal impact on norepinephrine could be taken. They include:

Selective serotonin reuptake inhibitors (SSRIs): These medications primarily affect serotonin levels and are commonly prescribed for treating depression and anxiety. These include:

Fluoxetine (Prozac)
Sertraline (Zoloft)
Escitalopram (Lexapro)

Adjunctive medications: Sometimes, medications with mood-stabilizing properties such as antipsychotics or anticonvulsants, might be used in combination with antidepressants.

Trazodone: Due to its sedative properties it is commonly prescribed as a sleep aid. However, it can be prescribed off-label for depression in combination with other antidepressants.

Psychotherapy: Cognitive behavioural therapy (CBT) or other forms of counselling can be useful either alone or in combination with medications.

Based on my knowledge and research, it is evident that Cymbalta increases norepinephrine levels. As a serotonin-norepinephrine reuptake inhibitor, it affects both serotonin and norepinephrine in the brain, leading to increased availability of these neurotransmitters. This action is a part of its mechanism for managing conditions like depression, anxiety and certain types of pain.