How to stop Cymbalta and start Effexor?
By
Dr Natalia Marceli Stephanes (PhD)
Author bio
Dr Natália Marcéli Stephanes PhD is a Pharmacist with expertise in Drugs Administration and Toxicity; Discovery of New Drugs; Cancer Treatment; Biochemical Analyzes and Hematological Analyzes. She writes and reviews content on these topics.
Dr Natália Marcéli Stephanes’ Highlights:
- Pharmacist at the Department of Health of Santa Catarina State, Brazil
- PhD with a focus on oncology treatment
- Years of experience in commercial pharmacy
- Bachelor, Master and PhD degrees in Pharmacy at the Federal University of Santa Catarina
Professional Experience:
From her undergraduate studies to her Master’s and Doctorate degrees in Pharmacy, Dr Natália Marcéli Stephanes has participated in numerous scientific studies in the field of oncology and onco-hematology at the University Hospital of the Federal University of Santa Catarina, Brazil. Her research has focused on understanding the molecular and biochemical bases of malignant neoplasms and investigating safer and more effective therapeutic alternatives.
Dr Natália Marcéli Stephanes has also served as an assistant professor of haematology for undergraduate students at the Federal University of Santa Catarina. Additionally, she held the position of professor of Hospital Pharmacy at the Qualificar Technical School in Brazil, where she developed instructional materials for use in the Pharmacy Postgraduate Program at the Leonardo Da Vinci University Center.
In addition to her academic experiences, Dr Natália Marcéli Stephanes possesses a strong expertise in commercial pharmacy, with in-depth knowledge of medications, their routes of administration, desired effects, adverse effects, and toxicity.
Currently, Dr Natália Marcéli Stephanes works as a Pharmacist at the Health Department of Santa Catarina State, where her role entails providing pharmaceutical scientific consulting services to judges.
Education:
- 2016 Bachelor in Pharmacy at the Federal University of Santa Catarina, Brazil
- 2018 Master in Pharmacy at the Federal University of Santa Catarina, Brazil
- 2023 PhD in Pharmacy at the Federal University of Santa Catarina, Brazil
The main publications of Dr Natália Marcéli Stephanes are:
Falchetti M ; Delgobo M, Zancanaro H, Almeida K, Das Neves RN, Dos Santos B, Stefanes NM, et al. Bishop Omics-based identification of an NRF2-related auranofin resistance signature in cancer: Insights into drug repurposing. Comput. Biol. Med [Internet]. 2023; 152:106347.
Feuser PM, Matos dos Santos PC, Cordeiro AP, Stefanes NM, Walter LO, Maioral MF, Santos-Silva MC, et al. Antineoplastic activity of free 4-nitrochalcone and encapsulated in poly(thioether-ester) nanoparticles obtained by thiol-ene polymerization in two human leukemia cell lines (Jurkat and K562). J Drug Deliv Sci Technol [Internet]. 2022; 67:102924.
Jacques AV, Stefanes NM, Walter LO, Perondi DM, Efe FL, Souza LFS, Sens L, et al. Synthesis of chalcones derived from 1-naphthylacetophenone and evaluation of their cytotoxic and apoptotic effects in acute leukemia cell lines. Bioorg. Chem [Internet]. 2021; 116:105315.
Duarte BF, Vieira DSC, Lisboa ML, Stefanes NM, Grando LJ, Santos-Silva MC. Características clínico-epidemiológicas de pacientes portadores de carcinoma de células escamosas de boca. Arquivos Catarinenses de Medicina. 2021; 50(2): 232–245.
Machado V, Jacques AV, Stefanes NM, Santos-Silva MC, Biavatti MW. Anti-leukemic activity of semisynthetic derivatives of Lupeol. Nat. Prod. Res. 2021; 35(22):4494-4501.
Bigolin A, Maioral MF, Stefanes NM, Mascarello A, Chiaradia-Delatorre LD, Nunes RJ, Yunes RA, et al. A novel sulfonamide derivative as a strong and selective apoptotic agent against hematological malignancies. Chem. Pap. 2020; 74:2965–2976.
Bigolin A, Maioral MF, Stefanes NM, Zatelli GA, Philippus AC, Falkenberg MB, Santos-Silva MC. Cytotoxic mechanisms of primin, a natural quinone isolated from Eugenia hiemalis, on hematological cancer cell lines. Anticancer Drugs. 2020; 31(7):709-717.
Maioral MF, Stefanes NM, Neufeldt PD, Chiaradia-Delatorre LD, Nunes RJ, Santos-Silva MC. Aldehyde biphenyl chalcones induce immunogenic apoptotic-like cell death and are promising new safe compounds against a wide range of hematologic cancers. Future Med. Chem. 2020; 12(8):673–688.
Perondi DM, Jacques AV, Stefanes NM, Maioral MF, Sens L, Pacheco LA, Cury NM, et al. A novel thiosemicarbazone as a promising effective and selective compound for acute leukemia. Anticancer Drugs. 2019; 30(8):p 828-837.
Rengifo AFC, Stefanes NM, Toigo J, Mendes C, Argenta DF, Dotto MER, Santos-Silva MC, et al. PEO-chitosan nanofibers containing carboxymethyl-hexanoyl chitosan/dodecyl sulfate nanoparticles loaded with pyrazoline for skin cancer treatment. Eur. Polym. J. 2019; 119:335-343.
Rengifo AFC, Stefanes NM, Toigo J, Mendes C, Santos-Silva MC, Nunes RJ, Parize AL, et al. A new and efficient carboxymethyl-hexanoyl chitosan/dodecyl sulfate nanocarrier for a pyrazoline with antileukemic activity. Mater. Sci. Eng. C [Internet]. 2019; 105:110051.
Maioral MF, Stefanes NM, Bigolin A, Zatelli GA, Philippus AC, Falkenberg MB, Santos-Silva MC. Miconidine acetate, a new selective and cytotoxic compound with synergic potential, induces cell cycle arrest and apoptosis in leukemia cells. Invest. New Drugs. 2019; 37:912–922.
Srefanes NM, Toigo J, Maioral MF, Jacques AV, Chiaradia-Delatorre LD, Perondi DM, Ribeiro AAB, et al. Synthesis of novel pyrazoline derivatives and the evaluation of death mechanisms involved in their antileukemic activity. Bioorg. Med. Chem. 2019; 27(2):375-382.
Maioral MF, Bodack CN, Stefanes NM, Bigolin A, Mascarello A, Chiaradia-Delatorre LD, Yunes RA, et al. Cytotoxic effect of a novel naphthylchalcone against multiple cancer cells focusing on hematologic malignancies. Biochim. 2017; 140:48-57.
You can view some of Dr Natália’s work below and links to her professional profile below.
Research Gate: https://www.researchgate.net/profile/Natalia-Stephanes
Linkedin: https://www.linkedin.com/in/nataliamarceli/
How to stop Cymbalta and start Effexor?
The best way to switch from Cymbalta (Duloxetine) to Effexor (Venlafaxine) is to talk to your healthcare provider. Every individual is different and different switching strategies can be applied to them.
Cymbalta and Effexor both belong to the same class of antidepressants – serotonin-norepinephrine reuptake inhibitors (SNRIs) (1) – so it shouldn’t be that difficult to switch from one to another (2,3).
In general clinical practice, the best way to switch from one SNRI to another is by decreasing the dose of your current antidepressant, while starting the new one with the lowest effective dose. The dose of the older antidepressant keeps decreasing, while the new one settles in.
Some doctors may directly switch from Cymbalta to Effexor, but it’s not always a good option and depends on different factors, like your overall duration of treatment with Cymbalta, your current dose, and your symptoms of depression (4).
People who have been using Cymbalta for a long period of time can’t just stop using it altogether. Even though they are replacing it with Effexor, abrupt discontinuation of Cymbalta can trigger withdrawal symptoms.
This is why it’s best to taper one antidepressant off while introducing the new one to your body. Make sure you don’t try any such thing on your own and reach out to your healthcare provider if you wish to switch your antidepressant.
What reasons lead to Cymbalta withdrawal?
There are some reasons that can lead to the discontinuation of treatment with Cymbalta. These include:
Treatment completion
Once a patient has successfully completed their prescribed treatment duration or achieved the desired therapeutic goals, their healthcare provider may decide to discontinue Cymbalta.
Side effects
Some individuals may experience significant side effects while taking Cymbalta, such as nausea, dizziness, insomnia, or sexual dysfunction. If these side effects are intolerable or interfere with daily life, the medication may be discontinued.
Lack of effectiveness
In some cases, Cymbalta may not provide the desired relief from symptoms or improve the underlying condition. If the medication doesn’t work the way it should, your doctor may increase the dose if you can tolerate it. If that doesn’t work for some reason, alternative treatment options are considered.
Treatment plan adjustment
As a person’s medical condition or mental health status changes, their healthcare provider may need to adjust their treatment plan. This adjustment may involve discontinuing Cymbalta and trying a different medication or therapy approach.
What to expect when switching from Cymbalta to Effexor?
When switching from Cymbalta to Effexor, it’s important to be aware of potential changes and effects. The transition may vary from person to person, but some common experiences can be expected.
First, there may be an adjustment period as your body adapts to the new medication. You may notice changes in your mood, energy levels, and overall well-being. It’s possible to experience side effects such as nausea, dizziness, sleepiness, or headaches during this adjustment phase.
However, these symptoms are usually temporary and should subside over time. It’s crucial to communicate any concerns or unusual symptoms to your healthcare provider, who can provide guidance and support throughout the transition process.
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References
1.-
Sansone RA, Sansone LA. Serotonin-norepinephrine reuptake inhibitors: a pharmacological comparison. Innov Clin Neurosci. 2014 Mar;11(3-4):37-42. PMID: 24800132; PMCID: PMC4008300. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008300/
2.-
Dhaliwal JS, Spurling BC, Molla M. Duloxetine. 2023 May 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31747213. https://www.ncbi.nlm.nih.gov/books/NBK549806
3.-
Singh D, Saadabadi A. Venlafaxine. 2022 Oct 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30570984. https://www.ncbi.nlm.nih.gov/books/NBK535363
4.-
National Prescribing Service Limited. Guidelines for switching antidepressants. [Internet]. NPS MedicineWise; 2010. Available from: https://www.nps.org.au/assets/Products/Guidelines-switching-antidepressants_A3.pdf
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