Does Cymbalta make you hyperactive? (3+ reasons)

In this article, we will discuss the reasons why Cymbalta causes hyperactivity. We will also talk about some research findings on Cymbalta-induced hyperactivity and mania. Additionally, we will discuss the factors that can contribute to Cymbalta-induced hyperactivity and ways to manage the side effects associated with Cymbalta. 

Does Cymbalta make you hyperactive? 

Yes, Cymbalta can make you hyperactive. Cymbalta is an antidepressant belonging to the class of serotonin-norepinephrine reuptake inhibitors (SSRIs), which help treat symptoms of depression, anxiety and chronic pain. Depression is associated with decreased energy levels, and Cymbalta can increase energy levels in individuals. (1)

It has been observed that Cymbalta can lead to the activation of mania and hypomania in adults, paediatrics and patients with psychiatric and non-psychiatric illnesses. (2) Mania is characterised by symptoms like enhanced talking, rapid speech, insomnia, increased thoughts, and agitation, which resembles hyperactivity. (3)

If you notice any behavioural changes or unwanted signs, make sure you consult your physician and avoid sudden discontinuation of the drug, as it can cause withdrawal syndrome and worsen your condition. 

Why does Cymbalta make you hyperactive?

Cymbalta acts by inhibiting the reuptake transporters of serotonin and norepinephrine, which increases the level of neurotransmitters such as serotonin, norepinephrine and dopamine in the brain. These neurotransmitters play an important role in regulating mood, memory, sleep cycle, attention, energy levels, focus and other cognitive functions. (4,5)

When the level of these neurotransmitters in the brain increases, it can cause an individual to become hyperactive. However, the effect of Cymbalta differs from person to person, and not all individuals may experience hyperactivity. Individuals with depression who have depressed moods, less energy and lack motivation may benefit from this treatment. 

Cymbalta can cause hyperactivity if you have underlying bipolar or hyperactivity disorders. Cymbalta is not approved to treat symptoms of bipolar, and one should exercise caution when using Cymbalta as it can exacerbate mania. (2)

What does the research suggest? 

Cymbalta-induced hyperactivity is a rare side effect. A case study by Feras et al. reported that duloxetine (Cymbalta) induced hypomania episodes in a 41-year-old female who was diagnosed with co-morbid fibromyalgia and chronic fatigue syndrome. She had been treated with antidepressants such as venlafaxine and trazodone, which was discontinued because of inefficacy and intolerance. (6)

She then started with a monotherapy of duloxetine 30mg/day, which showed improvement in the early stage of treatment. Two weeks into the treatment, she developed insomnia, hyperactivity and sexual arousal; after six weeks, she had a manic episode with psychotic symptoms, following which duloxetine was discontinued, and olanzapine was added to her treatment. (6)

Case reports by Peritogianis et al. showed a 61-year-old female with a history of depression had a hypomania episode after three days of duloxetine therapy. A study by De Dios and Ezquiaga reported a 58-year-old man who developed manic syndrome after four months of 60mg duloxetine therapy. (6,7)

What are the factors contributing to Cymbalta-induced hyperactivity? 

Hyperactivity can be caused by various factors. Here are some factors which can contribute to hyperactivity while taking Cymbalta.

Individual variability: The response to Cymbalta varies between individuals. As the genetic makeup and metabolism vary among individuals, you may experience hyperactivity if you are sensitive to the drug. 

Dosage: Hyperactivity can sometimes be dose-related, and an increased amount of duloxetine can lead to increased energy levels, excitation, increased speech, and insomnia. 

Drug interaction: Some drugs, such as NSAIDs, amphetamines, tramadol and other antidepressants, can interact with Cymbalta and increase its concentration in the body, leading to an increased risk of side effects, including hyperactivity. 

Serotonin syndrome: An increased dose of Cymbalta or concomitant use of Cymbalta with monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs) can increase the level of serotonin and causes serotonin syndrome, which can cause hyperactivity and manic episodes.

Underlying condition: The presence of psychiatric illnesses such as bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), schizophrenia, etc., can be amplified with the use of Cymbalta and contribute to hyperactivity and mania episodes. Other conditions, such as hyperthyroidism, can lead to an increase in energy levels, restlessness, and hyperactivity. 

Withdrawal symptoms: An abrupt discontinuation of Cymbalta can cause a sudden decrease in the level of neurotransmitters, leading to withdrawal symptoms, which can worsen your condition.

Stimulants: Ingestion of certain medications such as amphetamines, opioids, and excessive amounts of caffeine-containing beverages can cause an increase in energy level and hyperactivity 

How to manage Cymbalta-induced hyperactivity? 

If you are experiencing symptoms of hyperactivity or mania, such as enhanced talkativeness, insomnia, rapid speech, racing thoughts, and agitation while taking Cymbalta, consult your physician for a proper evaluation and management.

If you are on a high dose of Cymbalta, your physician may taper the drug to a low dose. If the side effects do not subside after dose adjustment, Cymbalta can be slowly tapered and discontinued over a few days. 

Consult your physician to address underlying mental health conditions. If you have bipolar disorder or ADHD you may need a different therapy to treat your symptoms. Get a proper evaluation of your mental health to find out the cause of the side effects. 

Consult your physician before taking any OTC medication. Avoid caffeinated beverages as they can increase the symptoms of hyperactivity. Maintain a proper sleep schedule as sleep deprivation can exacerbate hyperactivity. Opt for a healthy lifestyle, and drink enough water as it helps eliminate Cymbalta’s toxic metabolites and reduces the risk of side effects.

Monitor for any other side effects that may be caused by Cymbalta, such as headache, drowsiness, fatigue, nausea, vomiting, dry mouth, weight loss, insomnia, tremors, suicidal thoughts, agitation, etc. (1)

In my experience, Cymbalta can cause hyperactivity and, if not treated, can cause mania episodes. I recommend you consult your physician if you are experiencing any symptoms of hyperactivity or mania. Avoid abrupt discontinuation of the drug, as it can worsen your condition. 

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