Generic name: Duloxetine
Cymbalta is an antidepressant medication. It has been approved for use in treating symptoms of depression and generalized anxiety disorder (GAD). It is also used to treat fibromyalgia and diabetic neuropathy. Cymbalta is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI). Serotonin is a neurotransmitter in the brain and depression has been linked to the inability to create enough serotonin. Norepinephrine is another neurotransmitter linked to depression. Cymbalta targets both serotonin and norepinephrine, unlike SSRIs, which only target serotonin. Both of these neurotransmitters can impact mood. The medication works to block the neurotransmitters from reentering the nerves, allowing more of the neurotransmitters to remain active.
Clinical trials have shown Cymbalta to improve mood, increase appetite and allow for better sleep. It can also increase energy and decrease nervousness.
Generally, this medication is started at a low dose and increased in increments, as needed. It should not be stopped except under the advise of a doctor. When stopping this medication, you can experience withdrawal symptoms and is often tapered off rather than suddenly stopping.
For many people, benefits of the medication can be felt after one to two weeks, however, the full benefit of the medication may take up to four weeks of continuous use. If you continue to feel depressed, or if your depression worsens, you should talk with your doctor.
Before Taking this Medication
As with all antidepressants, children and adolescents can experience an increase in suicidal thoughts and depression when taking this medication, especially when first beginning the medication or when dosage has been increased. You should talk with your doctor about this and be aware of the signs of depression and suicidal thoughts in order to help your child or teen while taking this medication. If you see a worsening of depression, contact your doctor immediately.
There are also a number of health conditions that may require an adjustment to your dosage. Therefore, you should tell your doctor if you have any of the following conditions:
- Liver or kidney disease
- Seizure disorders, such as epilepsy
- Bleeding or blood clotting disorder
- History of suicidal thoughts
- History of substance abuse
In addition, you should let your doctor know if you have taken medications that can thin blood (aspirin, ibuprofen or heparin), water pills, and high blood pressure medications.
Your doctor will decide if this medication is right for you, if you need medical tests to determine if you can safely take this medication or if your dosage needs to be adjusted based on your medical history.
Cymbalta should not be taken at the same time as a monoamine oxidase inhibitor (MAOI). If you are currently taking a MAOI, you will need to stop it at least 14 days before beginning Cymbalta. In addition, this type of medication should not be taken for at least 5 days after stopping Cymbalta.
Other medications, including over the counter medications can impact the effectiveness of Cymbalta. Before using any of the following, consult your physician:
- Cold or allergy medications
- Narcotic pain medication
- Pain/arthritis medication
- Sleeping aids
- Muscle relaxers
- Seizure medications
Certain medications should be avoided when taking Cymbalta. These include:
Although the medications listed here can cause interactions and should not be taken with Cymbalta, it is important to discuss all medications you may be taking with your doctor to avoid any serious interactions.
There are a number of common side effects with the use of Cymbalta. Many of these should lessen or disappear after a few weeks of taking the medication. If they do not disappear or worsen, you should contact your doctor:
- Stomach problems, such as nausea, constipation, or loss of appetite
- Fatigue, drowsiness or dizziness
- Dry mouth
- Increased sweating
- Blurred vision
- Increased yawning
Although many people take this medication without experiencing serious side effects, you should be aware of conditions that would require you to contact your doctor immediately:
- Changes in mood (suicidal thoughts, high energy/nervousness)
- Tremors or shaking
- Sexual side effects (decreased interest or inability to perform sexually)
- Difficulty urinating or changes in the amount of urine produced
- Weight loss
There are also more serious side effects that are rare, but may occur and would require you to contact your doctor right away:
- Stomach pain or vomiting that looks like coffee grounds
- Stools that are bloody, black or tarry or dark urine
- Bruising or bleeding more easily
- Muscle weakness
- Yellowing of eyes or skin
- Extreme tiredness
- Heart palpitations or pounding heartbeat
There is also a condition referred to as serotonin syndrome that may occur when Cymbalta is combined with certain medications, such as prescription medications for migraine headaches, other antidepressants or medication for obesity. Symptoms of serotonin syndrome can include hallucinations, restlessness, problems with coordination, rapid heartbeat, extreme dizziness, fever of unknown origin, severe stomach problems and twitching of muscles. If you are experiencing any of these symptoms, you should seek immediate medical help.
Allergic reactions to Cymbalta can also sometimes occur. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, and problems breathing. You should call 911 or seek immediate medical help if you are experiencing an allergic reaction.
Pregnancy and Nursing
Cymbalta may cause harm to an unborn baby, especially if taken during the third trimester of pregnancy. Talk with your doctor if you are pregnant or plan to become pregnant while taking Cymbalta.
In addition, the medication can pass to a baby during nursing and cause harm to your child. You should speak with your doctor if you are breast-feeding, or plan to breast feed, while taking this medication. You and your doctor can decide whether the benefits of taking this medication outweigh the risks involved.
“SSNRI”, 2008, Author Unknown, SSNRI.com
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“Cymbalta Oral”, 2007, Author Unknown, FirstDataBank, Inc, HealthCentral.com