Cymbalta (duloxetine) is commonly used to treat depression and generalized anxiety. The drug belongs to a class of antidepressant medicines known as serotonin and norepinephrine reuptake inhibitors (SNRIs). In some cases Cymbalta may be prescribed to treat pain due to diabetic neuropathy and fibromyalgia.

History of Cymbalta

In August 2004, the U.S. Food and Drug Administration (FDA) approved duloxetine for the treatment of depression under the brand name Cymbalta. Shortly afterward, Cymbalta became the first and only officially indicated drug in the United States for the management of pain from diabetic peripheral neuropathy. In February 2007, Cymbalta got approval from the FDA for the treatment of generalized anxiety.

How Does Cymbalta Work?

Cymbalta inhibits the reuptake of serotonin and norepinephrine in the central nervous system. It also increases dopamine by acting on dopamine reuptake pumps, thus increasing the diffusion of dopamine in the brain. It also decreases pro-inflammatory cytokines and increases the anti-inflammatory ones, which assist in relieving depression symptoms. The pain-relieving properties of this drug are thought to be due to the blocking of sodium channels.

Dosage FAQs

Possible Side Effects

The most frequent adverse effects of this medication include, but are not limited to the following:

The patient should stop taking the drug if they experience seizures, painful skin rashes, symptoms of allergic reaction, difficulty breathing, and symptoms of serotonin syndrome that include experiencing confusion, restlessness, sweating, shivering, shaking, hallucinations, rapid heartbeat, and sudden muscle jerking.

Drug Interactions

This medication carries with it several important drug interactions of which to be aware. If you are prescribed this medication, please consult your doctor and/or pharmacist on the following drug interactions:

Precautions

While taking this drug, you should be aware of the following important warnings:

How to Safely Withdraw

Quitting this drug abruptly can result in severe withdrawal symptoms. In fact, in light of much anecdotal evidence, the FDA has labeled severe withdrawal from this drug Cymbalta Discontinuation Syndrome. Stopping this medication without a safe plan between you and your physician may cause these side effects:

The dose should be tapered down gradually to minimize the effects of withdrawal.

References:

  1. Alessandro, S. and Kato, M. (2008). The serotonin transporter gene and effectiveness of SSRIs. Expert Review of Neurotherapeutics, 8(1), 111.
  2. Bab, I. and Yirmiya, R. (2010). Depression, selective serotonin reuptake inhibitors, and osteoporosis. Current Osteoporosis Reports, 8, 185.
  3. Barrera, A.Z., Torres, L.D., and Munoz, R.F. (2007). Prevention of depression: The state of the science at the beginning of the 21st century. International Review of Psychiatry, 19(6), 655.
  4. Bellingham, G.A. and Peng, P.W. (2010). Duloxetine: A review of its pharmacology and use in chronic pain management. Regional Anesthesia Pain Medication, 35, 294.

Page content reviewed by James Pendleton, ND.