Generic Cymbalta (Duloxetine) for Depression Treatment

Cymbalta refers to the group of antidepressants. It inhibits the reuptake of serotonine and noradrenaline in the human body in case of depression. As a result, serotonergic and noradrenergic neaurotransmission in the central nervous system increases.

Stresses are all around us. At home, in the office, in city transport we face different stressful situations. Moreover, the soaring pace of life and the growing number of tasks that should be fulfilled every day sometimes draw people crazy. No wonder that our century is called the century of psychic disorders. So, people are looking for the methods how to fight against stresses and depression. The fastest way to release tension is to take antidepressants. Here we will study Cymbalta, one of the most frequently prescribed remedy.

Cymbalta’s active ingredient is Duloxetine that is famous for its mechanism of the pain syndrome neutralization that causes the increase of the pain threshold in case of pain syndrome of neuropathic etiology.

Cymbalta is manufactured in the form of jelly capsules that contain 30 mg and 60 mg of Duloxetine. The pack of Cymbalta contains 14 capsules.

Usage of Cymbalta

Cymbalta or Duloxetine is prescribed for the patients who suffer from depression, diabetic neuropathy with pain syndrome, generalized anxiety disorder, chronic pain syndrome of the musculoskeletal system including pain syndrome caused by fibromyalgia and chronic pain syndrome in the lower back and in the knee caused by osteoarthrosis.

The medicaltion is taken orally regardless of meal. The Duloxetine capsule should be swallowed with some water. The pill should not be chewed or crushed. The drug should not be added to food or mixed with tea, juice or other liquids as the enteric coating of the pellet may be damaged.

Dosage and Overdosing

The recommended starting dosage of Cymbalta is 60 mg per day. Some patients need the increased dosage of 120 mg twice a day (that is the maximal recommended dosage) in order to feel the improvement of their health state. The dosage correction should be coordinated with the doctor.

Patients with chronic kidney failure should start with 30 mg of Duloxetine per day. The same thing refers to the patients with liver disorders. Patients with liver problems should take smaller dosage; patients suffering from hepatic cirrhosis should decrease the dosage frequency.

In case of overdosing (one-time intake of up to 1000 mg of Duloxetine) the patient may face the symptoms of somnolence, coma, clonic seizures, serotonine syndrome, vomiting and tachycardia.

There is no specific antidote for the treatment of Duloxetine overdosing. In case of overdosing the stable air flow should be provided. It is necessary to constantly monitor the patient’s heart activity and other vital marks while conducting symptomatic and supportive treatment.

Who should take Cymbalta with care?

Cymbalta is a strong drug that may affect nearly all the internal systems of the human body and cause serious problems for the patient’s health. That is why it is vitally important to consult the doctor if you suffer from any health disorders in order to decide whether it is dangerous to take Cymbalta or not. The list of Cymbalta’s contraindications is rather substantial; the most important ones are given below.

Cymbalta is not used in children under 18 years old and patients with increased sensitivity towards the drug’s ingredients. Liver and kidney disorders like kidney or liver failures (especially severe kidney failure) are also in the risk list as Duloxetine is able to concentrate in the blood plazma. Patients with liver or kidney disorders should take Cymbalta with care and only in case if the drug intake is clinically justified. In this case smaller dosages are recommended.

People with uncontrolled arterial hypertension should either refrain from Duloxetine therapy or constantly monitor their blood pressure as the intake of Cymbalta may cause the state of hypertension.

Cymbalta (Duloxetine) may cause mydriasis so patients with uncompensated closed-angle glaucoma or high intraocular tension are the reasons why doctors do not prescribe the medication for the patients.

Patients suffering from sucrase-isomaltase insufficiency, fructose intolerance or glucose-galactose malabsorption should refrain from taking Cymbalta either.

Duloxetine is prescribed with care for the patients who have manias and bipolar disorders (including those suffered in the past medical history), spasmodic strictures (including those suffered in the past medical history), and increased risk of hyponatremia (elderly patients, cirrhosis, dehydratation, intake of diuretics).

Pregnancy and breast-feeding

Women are recommended to inform their doctors about the planned or actual pregnancy as there is no sufficient information regarding the influence of Duloxetine on pregnant women and baby. That is why Cymbalta should be prescribed only when the potential benefit for mother exceeds the potential risk for the unborn child.

Duloxetine penetrates the breast milk so it is not recommended to feed the child during the therapy with Duloxetine.

Why to tell your doctor about other drugs

Some medical drugs cannot be co-administered with other medicaltions because of conflict of their active ingredients or mutually exclusive effect on the patient’s health. If such things occur the patient may experience deterioration of his health condition.

Below we provide the short list of medical drugs which cause the most dangerous consequences for the human health if co-administered with Duloxetine:

MAO inhibitors. Simultaneous intake of MAO inhibitors and Duloxetine increases the risk of serotonine syndrome. Duloxetine therapy should be started in 14 days after the MAO inhibitor withdrawal. If it is necessary to start the therapy with MAO inhibitors the patient is recommended to wait 5 days after the Duloxetine withdrawal.
Drugs influencing human central nervous system. All the substances that have similar medical action and effect on the human health should not be prescribed together with Cymbalta in order to avoid the risk of serotonine syndrome. The given drugs include Amitriptyline, Triptane, Tramadol, Tryptophan and others. It also refers to alcohol.
Anti-coagulants and antithrombotic drugs. Simultaneous intake of these drugs and Duloxtine increases the risk of bleeding.

Doctors also recommend not taking Cymbalta if oral contraceptives and other steroid drugs are used regularly.

The complete list of dangerous drugs is always provided in the medical insert. Anyway, it is much better to inform the doctor about the medications already prescribed before than to treat the consequences after.

Side Effects of Duloxetine

Among the most frequenly experienced side effects of Cymbalta one can mention nausea, headaches, dry mouth, somnolence and dizziness. Most of these side effects are known to be light or moderate. Usually they appear at the very beginning of the therapy and disappear in the course of treatment.

Below we have collected the most frequent side effects of Cymbalta graded by the human internal system:

Immune system: hypersensitivity;
Endocrine system: hyperglycemia, low appetite, dehydration;
Nervous system: insomnia, agitation, anxiety, suicide thoughts and behavior, apathy, hallucinations, aggression, somnolence, tremor, hyperexcitability, impared concentration, serotonine syndrome, spasmodic strictures;
Cardio-vascular system: headache, dizziness, heartbeat, tachycardia, arrhythmia, arterial hypertension, hyperemia, hypotension,
Sexual function: decreased libido including anorgasmia, erectile dysfunction;
Visual and acoustic organs:vision disorders, dry eyes, glaucoma, mydriasis, tympanophonia;
Respiratory system: yawning, sore throat, nasal bleeding;
Gastrointestinal system: nausea, dry mouth, diarrhea, vomiting, pain in stomach, gastritis, gastrointestinal haemorrhage, liver failure, hepatitis;
Muscoskeletal system: pain in bones and muscles, muscle spasms;
Genitourinary system: frequent urination, urinary retention, nycturia, polyuria, ejaculation disorders, gynecologic haemorrhage, menstrual disorder;
Allergic reactions: excessive sweating, itching, eruption, dermatitis.

If there is any discomfort such as increased fatigue, pain in chest or unusual feelings it is necessary to apply to the doctor as soon as possible.

Withdrawal Symptoms

Doctors always insist that the patients should refrain from the sharp withdrawal of Duloxetine therapy. It is recommended to gradually taper the dose of Cymbalta within the period of one-two weeks in order to eliminate the risk of Cymbalta withdrawal symptoms. However, sometimes these steps are not effective so the doctor may consider the necessity to continue the therapy and to try to taper the dosage much slower.

Cymbalta withdrawal (especially sharp) often results in the withdrawal syndrome that involves dizziness, sensor disorders, sleeping difficulties (insomnia, somnolence or bright dreams), agitation and anxiety, nausea, vomiting, headaches and shivering, and diarrhea.