Cymbalta (duloxetine) is commonly used to treat depression and generalized anxiety. The drug belongs to a class of antidepressant medicines known as serotonin and norepinephrine reuptake inhibitors (SNRIs). In some cases Cymbalta may be prescribed to treat pain due to diabetic neuropathy and fibromyalgia.
History of Cymbalta
In August 2004, the U.S. Food and Drug Administration (FDA) approved duloxetine for the treatment of depression under the brand name Cymbalta. Shortly afterward, Cymbalta became the first and only officially indicated drug in the United States for the management of pain from diabetic peripheral neuropathy. In February 2007, Cymbalta got approval from the FDA for the treatment of generalized anxiety.
How Does Cymbalta Work?
Cymbalta inhibits the reuptake of serotonin and norepinephrine in the central nervous system. It also increases dopamine by acting on dopamine reuptake pumps, thus increasing the diffusion of dopamine in the brain. It also decreases pro-inflammatory cytokines and increases the anti-inflammatory ones, which assist in relieving depression symptoms. The pain-relieving properties of this drug are thought to be due to the blocking of sodium channels.
- What are the normal dosages for this medication?
- Major depression: A normal dose of this drug for patients over 18 is 60 mg once daily.
- Generalized anxiety: In adults over 18 years of age, an initial dose of 30 mg daily is administered, which can be increased to 60 mg; the maximum dose should not exceed 120 mg.
- Diabetic neuropathy: The dose for diabetic neuropathy is 60 mg once daily but should not exceed 120 mg daily. Cymbalta should be discontinued of there is no response and the treatment should be reviewed every three months.
- How does my body process this drug?
Cymbalta is absorbed in the gastrointestinal tract and has a moderate bioavailability (about 50%). The onset of action is after about 2 hours and it reaches a maximum plasma concentration after about 6 hours. This medication is metabolized in the liver. If taken with food, this drug may not reach peak concentration for about 10 hours. It has a half-life of 12 hours after which it is excreted in the urine (70%) and feces (30%).
- Is it safe to use this drug if I am pregnant or become pregnant during treatment?
Cymbalta should be used with great caution during pregnancy and should be only used if the potential benefits outweigh the risk. This question should be carefully considered by you and your doctor before reaching a decision.
- What are some ways to get the most out of my treatment with this drug?
Cymbalta is prescribed for several mental health conditions that are often effectively treated with psychotherapy. If you are prescribed this drug for depression or anxiety, consider finding a qualified therapist or counselor to help with your mental health treatment. While psychotropic medication can be great for dulling or relieving debilitating symptoms, it cannot teach a person positive coping methods, self-care strategies, or help someone understand what they are experiencing better. Connecting with a therapist and building a good therapeutic relationship may help improve a person’s quality of life and result in a better mental health outcome than treatment with medication alone.