Cymbalta, which is the brand name for the medication duloxetine, is a commonly prescribed medication for the treatment of depression. It can also be used to treat neuropathic or diabetic pain as well as anxiety. Like many psychiatric medications, Cymbalta can cause certain side effects, though it is generally safe for use.
Mechanism
Duloxetine belongs to a class of medications called serotonin and norepinephrine reuptake inhibitors, which are also called SNRIs, the National Institute of Mental Health explains. Serotonin and norepinephrine are two chemicals which are often found in decreased concentrations in the brain in depressed patients. SNRIs work to increase the amount of time that these chemicals are present in the brain, which helps to correct the neurochemical imbalance.
Pharmacology
When duloxetine is taken orally, it appears in the blood roughly two hours after administration, according to RxList.com. The medication is well absorbed by the body and reaches a steady concentration in the blood after three days of regular use. Medline Plus notes, however, that it can take one to four weeks for the full effects of Cymbalta to be felt by the patient. Taking the medication with food slows its absorption somewhat but does not interfere with the effectiveness of the medication. Duloxetine is metabolized by the liver and is eliminated from the body via urination and defecation.
Administration
When Cymbalta is being used to treat depression, it is typically prescribed in doses that range from 40 to 60 milligrams per day, RxList.com explains. The daily dose can be broken up into two separate pills of lower doses if the patient desires. Patients should make sure that they take their medication every day and should avoid abrupt cessation of this medication to avoid experiencing symptoms of withdrawal, according to Medline Plus. Withdrawal symptoms include nausea, anxiety, diarrhea, dizziness and headache. Patients may also experience abnormal sweating, insomnia, nightmares and irritability during withdrawal.
Side Effects
Many of the side effects of duloxetine involve the digestive system; they include nausea, constipation/diarrhea, vomiting, heartburn, stomach pain and dry mouth. Patients may also have problems with urination, increased sweating, fatigue, muscle pain and a lowered libido as well as difficulty in achieving arousal and orgasm. In extreme cases patients may also develop liver damage.
Warnings
Occasionally when patients begin pharmaceutical treatment for depression, there is an initial period where the depression becomes worse and patients develop suicidal thoughts, RxList.com explains. Patients starting Cymbalta for the treatment of depression should contact their physician immediately if this occurs. Patients taking SNRIs can also experience a condition known as serotonin syndrome, the FDA explains. Serotonin syndrome can lead to hallucinations, coma, rapid heartbeat, increased body temperature, overactive reflexes and vomiting.
