What is Cymbalta®?
We are no longer accepting new Cymbalta withdrawal cases.
Duloxetine hydrochloride, marketed as Cymbalta®, is a selective serotonin norepinephrine reuptake inhibitor (SSNRI but
more commonly known as an SNRI) prescription antidepressant drug used
to treat major depression. It is also used to treat anxiety, pain associated
with diabetes, for the management of fibromyalgia, and for chronic muscle
or bone pain.
Eli Lilly and Company, a major pharmaceutical and antidepressant drug manufacturer,
manufacturers and markets Cymbalta. The U.S. Food and Drug Administration
(FDA) first approved Cymbalta on August 3, 2004.
The FDA placed Cymbalta as a pregnancy “category C” drug. The
FDA uses the category system to determine possible risks to a fetus when
medicines are taken during pregnancy. When a drug is placed in category
C, it means that the drug has not been studied in pregnant women, but
has shown harmful side effects on fetuses in animal testing.
The first generic versions of Cymbalta (duloxetine delayed-release capsules),
were approved by the FDA in December of 2013.
What is Cymbalta Used For?
Cymbalta Details:
Pharmaceutical: Cymbalta
Manufacturer: Eli Lilly and Company
Generic name: Duloxetine (or duloxetine hydrochloride)
Drug Class: Selective norepinephrine reuptake inhibitor (SNRI) antidepressant
CAS Number: 59729-33-8
Guidelines:
Cymbalta, known generically as duloxetine, is in the class of antidepressant
drugs known as serotonin and norepinephrine reuptake inhibitors (SNRIs).
SNRI antidepressants are believed to function by increasing levels of
the neurotransmitters serotonin and norepinephrine in the synaptic cleft.
Cymbalta is used to treat
major depressive disorder (MDD) general anxiety disorder (GAD), diabetic
peripheral neuropathic pain (DPNP), fibromyalgia (FM), osteoarthritis,
and chronic musculoskeletal pain. It is available in 20 mg., 30 mg., and
60 mg. tablets.
Contraindications:
The use of Cymbalta with monoamine oxidase inhibitors (MAOIs) is contraindicated
due to the risk of serious drug interactions that can be fatal (see section
on Serious Adverse Outcomes below). Cymbalta is also contraindicated for
patients with narrow-angle glaucoma.
Common Adverse Outcomes: [ From Physician’s Desk Reference 2013 ]
- Nausea
- Headache
- Dry mouth
- Fatigue, weakness
- Sleepiness
- Insomnia
- Constipation
- Dizziness
- Diarrhea
- Decreased appetite, anorexia
- Excessive sweating
- Abdominal pain
- Sexual dysfunction
Serious Adverse Outcome:
The development of a potentially life-threatening serotonin syndrome or
Neuroleptic Malignant Syndrome (NMS)-like reactions have been reported
with SNRIs (including Cymbalta) and SSRIs alone, and when these drugs
are used with medications that impair metabolism of serotonin (including
MAOIs), or with antipsychotics or other dopamine antagonists. Serotonin
syndrome symptoms may include:
-
Mental status changes
- agitation
- hallucinations
- coma
-
Autonomic instability status changes
- tachycardia (fast heart rate)
- blood pressure changes
- hyperthermia (high temperature)
-
Neuromuscular aberrations
- hyperreflexia (overactive bodily reflexes)
- incoordination
-
Gastrointestinal symptoms
Serotonin syndrome, in its most severe form, can resemble neuroleptic malignant
syndrome, which includes high temperature, muscle rigidity, and autonomic
instability (refers to the autonomic nervous system, which controls heart
rate, breathing rate, body temperature, digestion, etc.), with possible
rapid fluctuation of vital signs and mental status changes.
Warnings:
- Suicide Risk: Cymbalta carries the following black box warning on its label:
Antidepressants increased the risk compared to placebo of suicidal thinking
and behavior (suicidality) in children, adolescents, and young adults
in short-term studies of major depressive disorder (MDD) and other psychiatric
disorders.
- Liver Failure: There have been reports of hepatic failure, sometimes fatal,
in patients treated with Cymbalta
- Abnormal Bleeding: SSRIs and SNRIs, including Cymbalta, increase the risk
of bleeding events.