Cymbalta, or duloxetine, falls under the category of a serotonin and norepinephrine reuptake inhibitor. The development of this medication occurred initially for the treatment of depression. Subsequently, other outcomes appeared coincidentally in research studies on depression. The drug exerts a strong effect on the serotonin and norepinephrine system in the central nervous system, but also exhibits a weak inhibition on dopamine, histamine, muscarinic, opioid and calcium ion channels.
Generalized Anxiety Disorder
Generalized anxiety disorder appears in five percent of patients seen in primary care settings. Natalie Carter and Paul McCormack in "CNS Drugs" define generalized anxiety disorder as excessive anxiety and worry accompanied by at least three symptoms from a list that includes fatigue, edginess, sleep dysfunction, irritability, muscle tightness and trouble concentrating. The mechanism of action of Cymbalta on genralized anxiety disorder is unknown, but it is thought to involve the serotonin and norepinephrine reuptake inhibition. Research demonstrated a significant decrease in the anxiety of individuals taking Cymbalta.
Chronic Pain Conditions
Cymbalta produces pain relief by increasing the availability of serotonin and norepinephrine in the pathways exiting the brain and inhibits the pain impulses. In 2009, the "Cochrane Database of Systematic Review" reviewed the evidence supporting the efficacy of Cymbalta in diabetic pheripheral neuropathy, fibromyalgia, osteoarthritis, chronic back pain and physical pain symptoms of depression. Research showed a significant decrease in pain and other discomforts in these conditions.
Irritable Bowel Syndrome
According to a 2007 article in the "International Journal of Clinical Practice" describes individuals with irritable bowel syndrome as presenting with abdominal pain relieved by passing loose bowel movements. Individuals also report pain with passing frequent stools. Treatment for irritable bowel syndrome consists of controlling symptoms. Serotonin, or 5-hydroxytrptamine, regulates the muscles and secretions of the intestines. The "International Journal of Clinical Practice" article notes that the exact mechanism for the effectiveness of Cymbalta to reduce the symptoms of irritable bowel remains unknown, but it appears that Cymbalta may affect directly or indirectly the intestine motion.
Overactive Urinary Bladder
According to a 2009 article in "Current Opinions in Urology," Cymbalta produces an effect on the urinary bladder muscle. Females report more problems with overactive bladder than males. One study showed a significant decrease in the number of episodes of urinary bladder emptying and incontinence. Research remains sparse in this area of overactive urinary bladder and urinary incontinence. Consequently, more investigations are needed to definitively determine the outcome on the urinary tract system.
References
- "CNS Drugs"; Duloxetine in Treatment of Generalized Anxiety Disorder; Natalie Carter and Paul McCormack; 2009
- "International Journal of Clinical Practice"; Irritable Bowel Syndrome; C. U. Pae et al.; 2007
- "Cochrane Database of Systematic Review"; Duloxetine for Treating Painful Neuropathy or Chronic Pain; M. P. Lunn et al.; 2009
- "Current Opinions in Urology"' Pharmacologic Treatment of Overactive Bladder; K. E. Andersson et al.; 2009
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