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Cymbalta
Cymbalta (DULOXETINE) is an antidepressant recently approved by the FDA that has also been approved to treat peripheral neuropathy. People who suffer from depression will often experience pain; people with depression are more sensitive to pain, and treating depression improves one's threshold for pain. Cymbalta not only treats the emotional effects of depression, but the physical pain of depression as well.

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Common uses

Cymbalta is used for treating depression and generalized anxiety disorder. It is used for managing pain caused by diabetic peripheral neuropathy (DPNP). It may also be used for other conditions as determined by your doctor.

Before using

Do not use Cymbalta together with thioridazine (Mellaril), or an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with Cymbalta. You must wait at least 14 days after stopping an MAO inhibitor before you can take Cymbalta. After you stop taking Cymbalta, you must wait at least 5 days before you start taking an MAOI. Do not use this medication if you are allergic to duloxetine, or if you have untreated or uncontrolled glaucoma.
Before taking Cymbalta, tell your doctor if you are allergic to any drugs, or if you have:
- liver or kidney disease;
- seizures or epilepsy;
- bipolar disorder (manic depression); or
- a history of drug abuse or suicidal thoughts.
If you have any of these conditions, you may need a dose adjustment or special tests to safely take Cymbalta.
You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.
Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Directions

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.
Try to take the medicine at the same time each day. Follow the directions on your prescription label.
Do not crush, chew, break, or open a delayed-release capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time. It may take 4 weeks or longer for your symptoms to improve. For best results, keep using the medication as directed. Do not stop using Cymbalta without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly. Store Cymbalta at room temperature away from moisture and heat.

Cautions

Avoid drinking alcohol while taking Cymbalta. Alcohol may increase the risk of damage to your liver. Cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by Cymbalta. Tell your doctor if you regularly use any of these other medicines. Cymbalta can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Possible side effects

Like most medications, there are some side effects associated with Cymbalta. Most side effects - if they do occur - will resolve after the body becomes adjusted to the medication, usually in a couple of weeks. In clinical trials, the most commonly reported side effects include:
- nausea
- dry mouth
- constipation
- decreased appetite
- fatigue
- drowsiness or feeling sleepy
- increased sweating
- sexual side-effects
- possible withdrawal symptoms if abruptly discontinued
While not common, there have been reported cases of elevated blood pressure when taking Cymbalta. Your doctor will monitor your blood pressure while taking the drug.

If you take too much

Seek emergency medical attention if you think you have taken too much of this medication. Overdose symptoms may include nausea, vomiting, diarrhea, agitation, confusion, hallucinations, fast heart rate, feeling light-headed, or fainting.

Additional information

Cymbalta is a serotonin and norepinephrine reuptake inhibitor (SNRI). It works by restoring the balance of certain natural substances in the brain (serotonin and norepinephrine), which helps to improve certain mood problems.

Drug interactions

Do not take Cymbalta together with thioridazine (Mellaril), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take Cymbalta. After you stop taking Cymbalta, you must wait at least 5 days before you start taking an MAOI.
You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

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