Is Long-Term Use of Cymbalta Safe for Anxiety Patients?

Can Qianyoujie be taken long-term?

Hello, Pharmacist Lu: I am an anxiety disorder patient.
I have previously taken Lexapro and Effexor.
Now my doctor has prescribed Cymbalta (Duloxetine) 60 mg, to be taken once daily.
However, I saw in the leaflet that when mice were given 11 times the dosage, it increased the incidence of malignant tumors, which makes me very anxious.
Since anxiety itself can lower immunity, will taking Cymbalta make it easier for me to develop cancer? If I take it continuously for many years, will it increase my cancer risk? Can I go back to taking Effexor? Are Lexapro and Effexor considered safer options? Additionally, my liver enzyme levels are sometimes elevated, with ALT/GPT at 50 and r-GT at 35.
Will taking Cymbalta have any impact on this?

PIJA, 30~39 year old female. Ask Date: 2007/01/06

Dr. Lü Shuhui reply Pharmacology

Dear P I J A,
Thank you for your message.
You mentioned that you have switched from taking St.
John's Wort and Seroquel to Cymbalta.
It is important to note that in the clinical trials prior to the approval of Cymbalta in 2002, there were no reports of life-threatening overdose cases.
Therefore, you can take this medication with confidence under your physician's guidance.
Additionally, you mentioned that your ALT (SGPT) and AST (SGOT) levels are somewhat unstable.
I recommend that you share your lab reports with your attending physician for further evaluation and to schedule regular blood tests to monitor these values.
Thank you for your message, and I wish you all the best.
Sincerely,
Pharmacist, Taoyuan Rehabilitation Hospital

Reply Date: 2007/01/06

More Info

Cymbalta (Duloxetine) is a medication commonly prescribed for anxiety and depression, and it is also used to treat chronic pain conditions. As a patient with anxiety, it's understandable to have concerns about the long-term use of this medication, especially regarding its safety and potential side effects, including the risk of cancer.

Long-Term Use of Cymbalta
Research indicates that Cymbalta can be effective for managing anxiety disorders. It works by inhibiting the reuptake of serotonin and norepinephrine, which helps improve mood and reduce anxiety symptoms. While some studies have raised concerns about the long-term safety of various medications, including potential links to cancer, it is essential to contextualize these findings. The studies often involve animal models and may not directly translate to human outcomes.
The specific concern you mentioned regarding increased cancer risk in rodents at high doses does not necessarily imply a similar risk in humans. Regulatory agencies, including the FDA, evaluate the safety of medications based on extensive clinical trials and post-marketing surveillance. Currently, there is no conclusive evidence linking Cymbalta to an increased risk of cancer in humans when used at prescribed doses.

Safety Profile and Side Effects
Cymbalta is generally well-tolerated, but like any medication, it can have side effects. Common side effects include nausea, dry mouth, fatigue, and dizziness. In some cases, it may affect liver function, which is particularly relevant for you since you mentioned elevated liver enzymes (ALT/GPT). It is crucial to monitor liver function regularly while on this medication, especially if you have pre-existing liver issues. If your liver enzymes remain elevated, your healthcare provider may consider adjusting your dosage or switching to a different medication.

Alternatives: Prozac and Lexapro
You asked about the safety of returning to Prozac (Fluoxetine) or Lexapro (Escitalopram). Both of these medications are also SSRIs (Selective Serotonin Reuptake Inhibitors) and are commonly prescribed for anxiety and depression. They have their own safety profiles and side effects, but they are generally considered safe for long-term use as well. The choice between Cymbalta, Prozac, and Lexapro should be based on your specific symptoms, response to the medication, and any side effects you may experience.

Recommendations
1. Consult Your Doctor: It’s essential to have an open discussion with your healthcare provider about your concerns regarding Cymbalta, especially in light of your anxiety and elevated liver enzymes. They can provide personalized advice based on your medical history and current health status.

2. Monitor Your Health: Regular check-ups and blood tests to monitor liver function and overall health are vital while on any long-term medication.

3. Consider Therapy: In addition to medication, cognitive-behavioral therapy (CBT) or other forms of psychotherapy can be beneficial for managing anxiety. This approach can help address the underlying issues contributing to your anxiety and may reduce your reliance on medication.

4. Lifestyle Modifications: Incorporating stress-reducing practices such as mindfulness, exercise, and a balanced diet can also support your mental health and overall well-being.

In summary, while long-term use of Cymbalta is generally considered safe for anxiety patients, it is crucial to monitor your health closely and maintain an open line of communication with your healthcare provider. If you have concerns about cancer risk or liver function, discussing these with your doctor will help you make an informed decision about your treatment options.

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