How to Sleep While Taking Cymbalta

Yes, Cymbalta can affect sleep. And can cymbalta make you tired? Also yes. Feeling tired and sleepy or having trouble sleeping are common side effects of Cymbalta. 

You may wonder, how is it possible that one medication can produce opposite side effects? Well, medications can cause different side effects for different people. Additionally, when a medication affects the functioning of the sleep-wake center in the brain, you can see a range of disturbances, including both difficulty sleeping at night and fatigue during the day.

These side effects can be temporary, but that doesn't mean they aren’t uncomfortable or disruptive while they’re happening.

Nine percent of those taking Cymbalta report having insomnia or trouble falling or staying asleep.

On the other hand, if you’re having trouble starting or maintaining activities, difficulty concentrating, or a combination of the two, you may be experiencing fatigue as a side effect of Cymbalta. However, if the fatigue was present before starting Cymbalta, it’s more likely to be a symptom of anxiety or depression, which frequently cause fatigue.

There are many reasons why you may be experiencing insomnia. But if you’re having trouble sleeping after starting the medication, you may have Cymbalta insomnia. Trouble sleeping or insomnia can also be an adverse effect of Cymbalta withdrawal.

This is because Cymbalta and other SNRIs prevent your brain cells from reabsorbing serotonin and norepinephrine, which keep the brain active when awake.

Norepinephrine and serotonin also suppress rapid eye movement (REM) sleep, the deeper sleep state that sets in about 90 minutes after falling asleep.

Since Cymbalta helps keep more serotonin and norepinephrine in your system, you may feel more energized and have trouble falling asleep.

Adequate sleep promotes mental and physical well-being, so let’s discuss ways to address Cymbalta-induced insomnia.

1. Keep track of side effects

Whenever you start a new medication, it’s always wise to keep track of side effects and to let your healthcare provider know if any new ones emerge.

For the first few weeks on Cymbalta, pay attention to your sleep — and if you’re having trouble falling or staying asleep.

A healthcare professional may recommend waiting to see if the side effect resolves itself on its own. If your insomnia doesn’t go away, they may suggest trying a sleeping pill or a different medication or treatment for your depression.

2. Consider dosage

When starting a new antidepressant, you’ll typically be prescribed a lower dosage, and your healthcare provider may gradually increase it until reaching the recommended amount. You should take the same dose for at least 7 days before increasing the dosage.

One single patient trial found that higher dosages of Cymbalta might make insomnia worse.

If you start experiencing insomnia after increasing your dosage, your provider may choose to wait for the side effects to subside and for your body to adjust before increasing the amount of medication again. Your prescriber may also reduce your Cymbalta dosage or have you taper off to reduce withdrawal effects if insomnia persists.

3. Try appropriate sleep aids

If you’ve been having insomnia since starting Cymbalta, certain sleep aids can help. For example, some research has shown that melatonin makes it easier to fall asleep and establish better sleeping patterns.

Melatonin is safe to use with the typical dosage of 1mg to 5mg nightly. However, using melatonin while taking Cymbalta can increase side effects of dizziness, drowsiness, confusion, and difficulty concentrating. 

Keep in mind that other sleep-related over-the-counter supplements and medications can have adverse effects when taken with Cymbalta. These include:

• St. John’s wort
• Antidepressants like MAOIs (including phenelzine)
• Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
• Blood thinners
• Some migraine medications (like naproxen) and other painkillers (like tramadol)
• High blood pressure medications

Make sure to let your healthcare provider know about any other medications you are taking or will take — including melatonin — before starting a Cymbalta prescription to treat anxiety or depression.

4. Change your Cymbalta schedule

If you notice that you’re feeling either fatigued or more alert and energized after taking your Cymbalta dose, you may want to change your dosage schedule.

Cymbalta can be taken at any time of day, but it should be taken at the same time every day for the most effective results.

If you currently take Cymbalta at night but are having trouble sleeping, talk to your healthcare provider about taking it first thing in the morning instead.

5. Avoid caffeine

While many of us turn to coffee to beat the afternoon slump, caffeine comes back with a vengeance when you’re trying to sleep. Caffeine blocks the chemical adenosine, which signals our body to become drowsy and sleep to rebuild energy levels.

Try to eliminate that post-lunch cup of coffee or switch to a drink with lower levels of caffeine, such as green tea. You can also try stretching or walking around the block for an energy boost that won’t mess with your sleep.

6. Practice good sleep hygiene

A promising way to ensure you get a good night’s rest is to have good sleep hygiene. Some tips include:

• Keep a set bedtime and wake-up time (even on the weekends)
• Avoid large meals too close to bedtime
• Limit or stop screen time at least 30 minutes before bed
• Take time to unwind from the day

Establishing a routine before your head hits the pillows will help you sleep better at night.

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If you and your doctor decide that Cymbalta isn’t the right treatment option, there are other alternatives you can consider. We’ll highlight a few below. Keep in mind that these medications come with side effects, too. 

Other SNRIs

As we’ve mentioned, Cymbalta is an SNRI. These antidepressants are often prescribed to treat chronic pain, depression, and anxiety. Aside from Cymablta, there are a few different types of SNRIs, including:

• Venlafaxine (Effexor®)
• Desvenlafaxine (Pristiq®)
• Levomilnacipran (Fetzima®)

The side effects of other SNRIs are similar to those of Cymbalta.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Unlike SNRIs, SSRIs only act on serotonin. They’re also some of the most common types of antidepressants for depression and anxiety treatment. Some examples include:

• Escitalopram (Lexapro®)
• Paroxetine (Paxil® and Seroxatr®)
• Sertraline (Lustral and Zoloft®)
• Fluoxetine (Prozac®)

Tricyclic Antidepressants (TCAs)

Emerging in the mid-20th century, TCAs were some of the first antidepressants developed. Some examples are:

• Imipramine (Tofranil®)
• Clomipramine (Anafranil®)
• Nortriptyline (Pamelor®)

Tricyclic antidepressants tend to cause more side effects than other antidepressants, so they aren’t typically prescribed as the first line of defense.

Norepinephrine and Dopamine Reuptake Inhibitors (NDRIs)

Bupropion (Wellbutrin® and Zyban®) belongs to a class of prescription drugs called NDRIs. These are often used to treat depression and aid in smoking cessation.

Researchers think bupropion works by affecting norepinephrine and dopamine, chemicals in the brain that impact mood, motivation, and more.

Though it is an alternative to Cymbalta, it may also have a side effect of insomnia.