Cymbalta (Duloxetine Hcl)

Cymbalta Review

Like many medicines, Cymbalta works to treat more than one condition. Cymbalta has been approved by the FDA for both the treatment of depression and the management of pain associated with diabetic peripheral neuropathy. Cymbalta (an SSNRI) targets two chemicals, serotonin and norepinephrine, that are believed to play a role in how the brain and body affect mood and pain.

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Cymbalta Drug Class and Mechanism

When serotonin and norepinephrine are released from nerve cells (neurons) in the brain they are reabsorbed into the nerve cells through reuptake. Duloxetine works by preventing serotonin, norepinephrine, and to a lesser extent dopamine from being reabsorbed into the nerve cells in the brain, specifically on the 5-HT and NE and D2 receptors respectively. Serotonin and norepinephrine in the brain and spinal cord are believed to mediate core depression symptoms and to help regulate the perception of pain. Disturbances of serotonin and/or norepinephrine may explain the presence of both the emotional and physical symptoms, including painful physical symptoms, of depression. Based on pre-clinical studies, duloxetine is a balanced and potent reuptake inhibitor of serotonin and norepinephrine. While the mechanism of action of duloxetine is not fully known, scientists believe its effect on both emotional symptoms and pain perception is due to increasing the activity of serotonin and norepinephrine in the central nervous system (CNS). Duloxetine is also used to treat nerve pain in the feet, legs, or hands due to nerve damage caused by poorly controlled diabetes. Duloxetine is thought to enhance the nerve signals within the central nervous system which naturally inhibit pain. Duloxetine is not effective for the numbness or tingling, nor is it effective for the other complications of diabetes. It does not treat the underlying nerve damage, but can help reduce the pain.

Cymbalta Uses

Take duloxetine exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you. Take each dose with water. Cymbalta capsules should be swallowed whole and should not be chewed or crushed, nor should the contents be sprinkled on food or mixed with liquids. Duloxetine may be taken with or without food. Try to take duloxetine at the same time each day. Do not stop taking Cymbalta without first talking to your doctor. It may take several weeks before you start feeling better. It is important to take duloxetine regularly to get the most benefit. Your doctor may want to perform tests or schedule appointments to monitor your treatment with duloxetine.

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Cymbalta Side Effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects which are known to be associated with this medicine. Simply being listed here does not mean that all people using this medicine will experience these (or any other) side effects.

Nausea, somnolence, insomnia, and dizziness are the main side effects, reported by about 10 to 20 percent of patients.

In a trial for mild major depressive disorder (MDD), the most commonly reported treatment-emergent adverse events among duloxetine-treated patients were nausea (34.7%), dry mouth (22.7%), headache (20.0%) and dizziness (18.7%), and except for headache, these were reported significantly more often than in the placebo group:

Dry mouth
Headache
Insomnia
Sleepiness or somnolence
Dizziness or Orthostatic hypotension
Fatigue
Vivid nightmares
Increased sweating
Decreased appetite and weight loss
Blurred vision
Paresthesia (relates to "brain shivers or brain zaps")
Disturbances of the gut, such as nausea, constipation, diarrhea, indigestion, vomiting
Tremor
Anxiety, nervousness, agitation
Palpitations
Decreased sex drive or difficulty achieving orgasm
Impotence or delayed ejaculation
Hot flashes
Taste disturbances
Difficulty passing urine
Increase in blood pressure or heart rate
Cold hands or feet
Jaundice
Inflammation of the liver or hepatitis
Depersonalization
Hypomania
Weight gain or loss

Cymbalta Pregnancy

Cymbalta Overdose

There is limited clinical experience with duloxetine overdose in humans. In clinical trials, cases of acute ingestions up to 3000 mg, alone or in combination with other drugs, were reported with none being fatal. However, in postmarketing experience, fatal outcomes have been reported for acute overdoses, primarily with mixed overdoses, but also with duloxetine only, at doses as low as approximately 1000 mg. Signs and symptoms of overdose (mostly with mixed drugs) included serotonin syndrome, somnolence, vomiting, and seizures

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