Discontinuation and Tapering of Duloxetine (Cymbalta)

Tapering Strategy

• For patients who have taken duloxetine 20 mg daily for more than three weeks, a taper of 2–4 weeks minimum is recommended, using an alternating‑day schedule (e.g., 20 mg every other day for 1–2 weeks) before complete cessation. The FDA label also advises a gradual dose reduction over at least 2 weeks prior to full discontinuation. 1

Characteristics of Duloxetine Discontinuation Syndrome

• Duloxetine discontinuation syndrome presents similarly to that of other SSRIs and SNRIs, with common symptoms such as dizziness, paresthesias, and autonomic disturbances. 2

Switching to Another Antidepressant

• When transitioning from duloxetine to a different antidepressant (e.g., amitriptyline), a minimum washout period of 5 days after stopping duloxetine is advised to reduce the risk of serotonin syndrome. 3