Cymbalta, generically known as duloxetine hydrochloride, is a drug used to treat major depressive disorder and generalized anxiety disorder. It is manufactured by Eli Lily and was approved by the U.S. Food and Drug Administration in 2004. It can also be prescribed for the treatment of diabetic peripheral neuropathy and fibromyalgia. Cymbalta works by selectively inhibiting the reuptake of serotonin and norepinephrine, two neurotransmitters that have been implicated in mood disorders such as depression.
Dosage
Cymbalta is generally prescribed in doses of 40 to 60 mg, which can be ingested all at once or split into two equal doses. Initial therapy may begin at 30 mg per day for the first week, to determine how the patient tolerates the medication. The dose can then be increased.
Symptoms of Discontinuation
Adverse symptoms from discontinuing Cymbalta therapy have been observed, so it is important to consult with a physician before stopping this medication. Side effects of quitting are very similar to those experienced with selective serotonin reuptake inhibitors, but they are generally more mild. Some of the symptoms may include irritability, headache, and dizziness. Additionally, there may be sleep disturbances such as sleeplessness, nightmares, and fatigue. Nausea, vomiting, and diarrhea have also been reported. Finally, uncontrollable and unpredictable sweating, vertigo, tingling or numbness of the skin, and anxiety may occur. To decrease the risk of experiencing these side effects, the dose should be slowly tapered off.
Symptoms of Abrupt Discontinuation
A set of symptoms called "discontinuation syndrome" is associated with abrupt discontinuation of selective norepinephrine/serotonin reuptake inhibitors, as well as selective serotonin reuptake inhibitors alone. These side effects usually dissipate within a few weeks. If Cymbalta therapy is abruptly discontinued, these side effects may occur. Mood disturbances can include dysphoric or bad mood, emotional lability, irritability, and anxiety. Peripheral symptoms may include dizziness, electric shock-like sensations called paresthesias, and ringing of the ears. Finally, headache, confusion and seizures have been reported.
References
- Lilly: Product insert for Cymbalta
- Washington.edu: DynaMed Medical Database
- UpToDate: Medical Database
- "CNS Drugs"; Duloxetine: A Review of its Use in the Treatment of Generalized Anxiety Disorder; Natalie J. Carter and Paul L. McCormack; June 1, 2009
