Cymbalta(r) is the brand name for duloxetine hydrochloride, a delayed-release capsule that, since 2004, has been approved for use in major depressive disorder (MDD), generalized anxiety disorder (GAD), diabetic peripheral neuropathic pain (DPNP), and fibromylagia. (See Reference 1)
Although Cymbalta is not indicated for bipolar disorder, it is often used "off-label" (an indication not yet approved by the Food and Drug Administration) because of its efficacy and safety in treating depression and anxiety.
The Role of Chemicals In The Brain
Scientists have long known that mood disorders have an organic root and that certain chemical imbalances in the brain are at fault. These chemicals include serotonin, norepinephrine, and dopamine, which are responsible in regulating our emotions and our ability to enjoy life. They can also affect our sleep patterns and our ability to concentrate.
Although we do not know exactly why these chemical become imbalanced, we do know that medications that regulate them can help regulate our moods.
Cymbalta's Effect On the Brain
Cymbalta is in a class of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). Its mechanism of action involves three brain chemicals--serotonin, norepinephrine, and dopamine--responsible for depression and anxiety and it has been proven to work in several clinical studies.(See Reference 2)
Cymbalta And Mania
There has been controversy over using antidepressants for bipolar disorder, as they may increase the risk of mania. However, studies show that this is much more rare than previously thought. An analysis of eight studies published in the Journal of Affective Disorders in 2005 found that bipolar patients on Cymbalta were only slightly more at risk of developing mania than those bipolar patients on placebo--0.2 percent versus 0.1 percent. (See Reference 3)
As with any medication, there are some risks in taking in taking Cymbalta. A black box warning in its prescribing information states that "Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders." It is also not approved for children. (See Reference 1)
Cymbalta should not be given to a patient using a type of antidepressant called a monoamine oxidase inhibitor (MOI), or with an eye condition called narrow-angle glaucoma. (See Reference 1)
Cymbalta is a tablet that comes in 40 mg and 60 mg dosages. Nausea is the most common side effect of Cymbalta,. It can also cause sleepiness and dizziness, as well as constipation, loss of appetite, and sweating. People taking Cymbalta should not drive or work with hazardous machinery. (See Reference 1)
Cymbalta has been proven to ease the symptoms of bipolar disorder and may help people suffering from this condition. But, as with any medication, a doctor should be consulted before taking Cymbalta.
- Cymbalta prescribing information
- Dunner DL, et al. J Affect Disord. 2005 Jul;87(1):115-119.