Eli Lilly’s antidepressant medication Cymbalta has become particularly notorious for exposing its users to the risk of painful and potentially dangerous withdrawal symptoms.

Cymbalta, or duloxetine, is one of a class of psychiatric medications called selective serotonin and norepinephrine reuptake inhibitors, or SSNRIs. First approved by the FDA in 2004, Cymbalta is now used to treat major depressive disorder and general anxiety disorder. It also has non-psychiatric applications as a treatment for fibromyalgia, other chronic muscle or joint pain, and pain associated with diabetic neuropathy.

Unfortunately, SSNRIs have been known since 2001 to lead to withdrawal symptoms, sometimes referred to as antidepressant discontinuation syndrome. In this regard, Cymbalta has earned a particularly bad reputation. The most dramatic of these symptoms is commonly described as “brain zaps,” the sensation of electrical shocks happening inside the head. The FDA-approved label for Cymbalta warns that discontinuation can lead to “dizziness, nausea, headache, paresthesia, fatigue, vomiting, irritability, insomnia, diarrhea, anxiety, and hyperhidrosis.” These Cymbalta withdrawal symptoms have been reported to last for several months in some cases.

For example, one patient reported having to stop taking Cymbalta abruptly due to a lapse in health insurance coverage between jobs. Right away, that patient began suffering seizures, brain zaps, mood swings, gastrointestinal symptoms, and body pain.

In a 2012 report, the Institute for Safe Medication Practices noted the frequency and severity of Cymbalta withdrawal symptoms and criticized the FDA-approved patient medication guide as being inadequate to warn patients about the risks of withdrawal. Early clinical studies of Cymbalta showed that abrupt discontinuation led to withdrawal in 44 to 50 percent of patients, and more than half of those cases did not resolve within one to two weeks. Symptoms of withdrawal in those trials included paresthesia, dizziness, changes in appetite and weight, and various psychiatric symptoms. In the first quarter of 2012, the FDA received 48 reports of withdrawal possibly related to Cymbalta, with reported symptoms including blackouts, nausea, tremors, and suicidal thoughts.

In October 2012, the FDA strengthened the warning label on Cymbalta packaging to give more detail about the effects of Cymbalta withdrawal. However, some say the new label misrepresents the frequency of withdrawal symptoms by stating they occur at a rate of “1% or greater,” despite the much more frequent occurrence of withdrawal symptoms in the earlier clinical studies.

No MDL for Federal Cymbalta Lawsuits

Over the past few years, Cymbalta withdrawal lawsuits have begun to trickle into the federal court system. Plaintiffs generally accuse Eli Lilly of understating the risks of withdrawal associated with Cymbalta.

In December 2014, the federal Judicial Panel on Multidistrict Litigation denied a request to consolidate 25 Cymbalta lawsuits into a single multidistrict litigation, or MDL, in the federal court for the Central District of California. The panel noted the lawsuits in question had progressed to various stages, making them hard to coordinate now. The panel also noted that there were only two different law firms representing all the plaintiffs, making informal coordination of pretrial matters more practical than consolidation. With this order by the panel, the 25 Cymbalta lawsuits will proceed individually.