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From: Helen J (114.127.246.36)
Subject:         Can You Take Cymbalta & Xanax Together?
Date: August 16, 2009 at 3:21 pm PST

If you are experiencing Generalized Anxiety Disorder (GAD), or depression combined with an anxiety disorder, you may very well find yourself prescribed to both Cymbalta and Xanax simultaneously. Cymbalta and Xanax are two very different types of medication that are used for similar purposes.
One can certainly take Cymbalta and Xanax together, as there are no FDA contraindications listed on either product website. Still, it is important to understand how the two drugs work individually, and what possible side effects you may experience while taking the two in conjunction.

Cymbalta
Cymbalta is the trade name for duloxetine, which is a member of the selective SNRI (serotonin and norepinephrine reuptake inhibitor) family of drugs, generally classified as an antidepressant. According to the product website, Cymbalta's action of inhibiting the reuptake of these two neurotransmitters is effective in treating both depression and anxiety. Cymbalta, however, may take as long as four weeks to prove effective against anxiety--and that's where the Xanax comes in.
Xanax
Xanax, usually sold under the trade name Xanax XR or the generic chemical name alprazolam, is a potent benzodiazepine drug. Other members of this family include Valium (diazepam), Klonipin (clonazepam) and Ativan (lorazepam). Xanax is meant for short-term treatment of anxiety or panic attacks, and it doesn't take nearly as long as Cymbalta does to start working. In fact, the effects of Xanax in alleviating anxiety or panic attacks are usually apparent within as little as 15 to 20 minutes after ingestion with the instant release generic tablets, or within an hour to two hours with Xanax XR.
Combination
Many doctors prescribe Xanax along with Cymbalta to manage symptoms of anxiety and depression until the Cymbalta starts working. This can be very effective in controlling GAD or panic attacks. However, most physicians intend to titrate the Xanax dose down gradually--or "wean you off"--as the Cymbalta begins to work. This is because Xanax, unlike Cymbalta, is habit-forming, and if you miss a dose even by a few hours, you may experience some of Xanax's unpleasant withdrawal effects such as tremors, body pain and possible seizures. Your doctor will want to lower the dose gradually so you can safely come off the Xanax.
Side Effects
In some cases, Xanax is still prescribed in conjunction with Cymbalta on an as-needed basis to combat especially disabling anxiety attacks. According to Cymbalta's FDA-approved information sheet, there are no interactions with benzodiazepine drugs such as Xanax, although the two that were tested were Lorazepam (Ativan) and Temazepam (Restoril). Still, when using the Cymbalta and Xanax together, it is possible to experience increased side effects that the two have in common. As listed on their respective FDA product information sheets, two side effects that may occur or become amplified when Xanax and Cymbalta are taken together are drowsiness and decreased appetite. The amplification of side effects may be synergistic, meaning that the side effects can increase to an unpredictable level beyond the combined effects of each drug.
Warning
Xanax is highly addictive, and tolerance develops very rapidly. Do not stop taking Xanax or Xanax XR suddenly, as withdrawal symptoms are severe and can include seizure, coma, and in some cases, death.
If you are taking Xanax and Cymbalta, or either one by itself, avoid drinking alcohol. Especially with Xanax, alcohol can potentially cause overdose.

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