Introduction
Cymbalta (Duloxetine hydrochloride) is generally classified as an anti-depressant medication, used in the treatment of major depressive illness. An estimated 20 million Americans are believed to be struggling with major depression, not the occasional blues that eventually goes away.
Cymbalta is also FDA approved for the treatment of diabetic neuropathic pain, Generalized anxiety disorder and fibromyalgia. It is a prescription drug, usually taken once a day, preferably in the mornings.
How Cymbalta works
Cymbalta is a selective serotonin and norepinephrine reuptake inhibitor, also known as a dual-reuptake inhibitor. Serotonin and norepinephrine are two substances in the brain and spinal cord that transmit messages between nerve fibers. After their release, Cymbalta blocks their reuptake, increasing their availability, thus increasing serotonin and norepinephrine activity. It is this increase in activity in certain parts of the brain that has been postulated as the mechanism of action of Cymbalta as an antidepressant. Researchers think the increased activity of these chemicals (neurotransmitters) is believed to be responsible for the elevation of mood.
Researchers also think serotonin and norepinephrine are involved in regulating the brain's perception of pain by stabilizing the system against the actions of glutamate, another neurotransmitter. This may be the mechanism behind diabetic neuropathic pain and fibromyalgia, two conditions that result from abnormally heightened sensitivity to pain.
Warnings on Clinical Effects of Cymbalta
A patient will not improve immediately with Cymbalta, which has a "lag phase." It takes some time for brain chemicals to adjust to new levels. Suicidal thoughts are more likely in lag phase, prompting the warning on the packaging of Cymbalta, as with other anti-depressants that increase neurotransmitter activity. It may take a few weeks for the patient to feel the anti-depressant effect of Cymbalta. Generalized anxiety disorder, diabetic neuropathic pain and fibromyalgia appear to show a faster response to treatment, in a matter of days.
Side Effects of Cymbalta
Common side effects include nausea, drowsiness, insomnia, dry mouth, constipation, sweating and sexual dysfunction. Using Cymbalta at the same time as some other drugs, particularly monoamine oxidase inhibitors, produces a life-threatening condition called serotonin syndrome. Tell your doctor about any other drugs you are taking before you start Cymbalta.
