Cymbalta is the trade name of the medication duloxetine. This medication belongs to the serotonin-norepinephrine reuptake inhibitor (SNRI) drug group. By inhibiting the reuptake of the neurotransmitters serotonin and norepinephrine, duloxetine changes brain chemistry potentially alleviating certain psychiatric and pain disorders. The U.S. Food and Drug Administration (FDA) has approved duloxetine for the treatment of major depressive disorder, generalized anxiety disorder, fibromyalgia and the pain associated with diabetic neuropathy.
Major Depressive Disorder
The National Institute of Mental Health (NIMH) reports that 14.8 million American adults age 18 and older have major depressive disorder. Symptoms of major depression include pervasive sadness, hopelessness, worthlessness, helplessness, fatigue, poor concentration, sleep and appetite disturbances and a variety of physical ailments. Major depression interferes with the ability to accomplish the tasks of daily living and enjoy life.
The FDA approved duloxetine for the treatment of depression in 2004. In a 2009 study published in the journal "Human Psychopharmacology," Dr. P. Girardi and colleagues concluded that based on evidence from 17 clinical trials, duloxetine is effective for the treatment of major depression. They further noted that response to duloxetine is dependent on dose; the best responses were observed at doses of 80 to 120mg daily.
Generalized Anxiety Disorder
People with generalized anxiety disorder or GAD are consumed with anxiety and worry, which is out of proportion to their circumstances and interferes with everyday living. Symptoms of GAD include sleep disturbances, muscle tension, headaches, trembling, irritability, nausea and lightheadedness. NIMH reports an estimated 6.8 million adults age 18 and older in the U.S. have GAD, which disproportionately affects women.
Drs. N. Carter and P. McCormack concluded in their 2009 review article, "Duloxetine: A Review of Its Use in the Treatment of Generalized Anxiety Disorder" published in "CNS Drugs" that duloxetine can effectively relieve the symptoms of GAD, improving functioning and health-related quality of life.
Fibromyalgia
Fibromyalgia is a chronic pain syndrome characterized by fatigue and muscle and joint pains. A variety of other symptoms may occur with fibromyalgia including dulled thinking, sleep disturbances, headaches, numbness or tingling and sensitivity to bright light or loud noise. The National Institute of Arthritis and Musculoskeletal and Skin Diseases estimates 5 million American adults are affected by fibromyalgia with 80 to 90 percent of cases occurring in women.
Duloxetine is FDA-approved for the treatment of fibromyalgia. In a 2009 study published in "The Primary Care Companion to the Journal of Clinical Psychiatry," Dr. Lesley Arnold and colleagues concluded duloxetine significantly reduced pain and improved functioning in people with fibromyalgia.
Pain Associated with Diabetic Neuropathy
People with long-standing diabetes often develop nerve abnormalities or neuropathies. When the sensory component of the affected nerves is involved, chronic pain often develops. The National Institute of Diabetes and Digestive and Kidney Diseases reports 17.9 million Americans had a diagnosis of diabetes as of 2007. It is further stated that 60 to 70 percent of people living with diabetes have neuropathy.
In a 2009 article published in the "Cochrane Database of Systematic Reviews," Dr. M. Lunn and colleagues concluded that 60 to 120mg of duloxetine daily is effective in treating the pain associated with diabetic peripheral neuropathy.
References
- Drugs.com: Cymbalta FDA Monograph
- Lilly USA: Cymbalta Prescribing Information
- National Institute of Mental Health: Numbers Count, Mental Disorders in America--Major Depressive Disorder
- "Human Psychopharmacology"; Duloxetine in Acute Major Depression--Review of Comparisons to Placebo and Standard Antidepressants Using Dissimilar Methods; P. Girardi, et al; April 2009
- National Institute of Mental Health: Generalized Anxiety Disorder
