Tapering and Stopping Cymbalta (Duloxetine) Guidelines

Introduction to Tapering

The Centers for Disease Control and Prevention recommends beginning with a reduction of approximately 10% of the original dose per week as a reasonable starting point, with slower tapers (10% per month or less) for patients on Cymbalta long-term 1, 2
Tapering plans should be individualized based on current dose, duration of treatment, and patient response, according to the Centers for Disease Control and Prevention 1

For standard capsules, consider alternating day dosing in the final stages of tapering, as suggested by the American Academy of Sleep Medicine 3
The American Academy of Sleep Medicine also notes that withdrawal symptoms typically appear within days of dose reduction and may last 1-3 days per step 3

Consider supportive medications to manage specific symptoms, such as short-term use of trazodone for anxiety or irritability, as recommended by the Mayo Clinic 4
The American Academy of Sleep Medicine suggests using sleep hygiene measures and possibly short-term sleep aids for sleep disturbances 3
The Mayo Clinic recommends appropriate symptomatic treatments for gastrointestinal symptoms 4

Pause tapering and restart when the patient is ready if withdrawal symptoms become severe, as advised by the Centers for Disease Control and Prevention 1, 2
Successful tapering may require several weeks to months, especially after long-term use, according to the American Academy of Sleep Medicine 3
The American Academy of Sleep Medicine also suggests considering cognitive-behavioral therapies during tapering to increase rates of successful discontinuation 3
The Mayo Clinic recommends discussing with patients that withdrawal symptoms are not necessarily a sign that they need to continue the medication long-term 4

Avoid tapering too quickly, which increases withdrawal risk, as warned by the Centers for Disease Control and Prevention 1
Do not mistake withdrawal symptoms for recurrence of the original condition, as cautioned by the Mayo Clinic 4
The Mayo Clinic also notes that protracted withdrawal may occur months after discontinuation, with symptoms including dysphoria, irritability, and insomnia 4

If symptoms of the original condition worsen significantly during tapering, seek additional help, as recommended by the Centers for Disease Control and Prevention 1