Duloxetine Dosage: What You Need to Know About Dosing, Side Effects, and Alternatives

When you're prescribed duloxetine, a serotonin-norepinephrine reuptake inhibitor (SNRI) used to treat depression, anxiety, and chronic pain. Also known as Cymbalta, it works by balancing brain chemicals that affect mood and pain signals. But getting the dose right matters—too little won’t help, too much can cause side effects like dizziness, nausea, or even liver stress. It’s not a one-size-fits-all drug, and your doctor will adjust it based on your condition, age, and how your body responds.

Duloxetine is commonly used for major depressive disorder, a clinical condition marked by persistent sadness, loss of interest, and fatigue, and generalized anxiety disorder, a persistent state of excessive worry that interferes with daily life. It’s also prescribed for diabetic nerve pain, fibromyalgia, and chronic musculoskeletal pain. The starting dose for depression is usually 30 mg once daily, often increased to 60 mg after a week. For anxiety or pain, some people start at 30 mg, while others jump straight to 60 mg. Older adults or those with liver issues might stay on 30 mg long-term. Never change your dose without talking to your doctor—sudden stops can cause withdrawal symptoms like brain zaps, sweating, or irritability.

People often ask if duloxetine is better than other antidepressants like sertraline or venlafaxine. It’s not necessarily stronger, but it does have a unique edge for those dealing with both depression and physical pain. Unlike some SSRIs, it targets norepinephrine too, which helps with energy and pain signaling. But it’s not for everyone—people with uncontrolled high blood pressure, liver disease, or a history of mania should avoid it. And while it’s sometimes used off-label for stress incontinence or migraines, those uses aren’t FDA-approved and need careful monitoring.

What you’ll find below are real comparisons and practical guides from people who’ve used duloxetine—or switched away from it. You’ll see how it stacks up against other meds for pain and mood, what doses actually work in practice, how side effects play out over time, and what alternatives might be easier on your body. No fluff. Just what matters when you’re trying to feel better without losing your balance in the process.