Cymbalta general information
What is Cymbalta used for?
Depression is a common mental health illness that affects many people. The cause may not be apparent when depression strikes. However, it can often be linked to a significant event such as trauma, abuse, a chronic health condition, loss of a loved one, redundancy, and many other life-changing events.
Cymbalta capsules 60mg are an antidepressant medication used to treat depression and other mood disorders. They are also effective for nerve pain relief and are used to treat pain caused by nerve damage in diabetes (diabetic neuropathy).
Depression
Depression can range in severity from mild to very severe. Major Depressive Disorder is the correct medical name for severe depression because it is not a short term illness but can last months or even years. Symptoms of depression include feelings of sadness and feeling down all the time, loss of interest in usual activities, disturbed sleep, change in appetite, extreme tiredness and fatigue, feelings of self-loathing, worthlessness or guilt, difficulty thinking or concentrating. In severe cases, depression may cause recurrent thoughts of suicide. Major Depressive Disorder is a serious illness and needs medical attention. Depression is known to be caused by an imbalance of chemicals in the brain. These chemicals, known as neurotransmitters, are produced by nerve cells (neurons) in the brain, acting as chemical messengers that allow nerve cells to communicate with each other. An imbalance in these neurotransmitters, particularly serotonin, which regulates mood, contributes to the development of depression.
Generalised anxiety disorder
We all feel anxious and stressed at times. It usually relates to a stressful event or a significant change in our life, or when something goes wrong. Most of us can manage those feelings of anxiety, and they pass. Generalised anxiety disorder (GAD) is a mental health condition, where constant feelings of anxiety can take over your life and interfere with the way you function. Symptoms of GAD include uncontrollable, extreme worry, and anxiety over many aspects of your life, such as health, work, money, and relationships. This chronic anxiety of several factors at the same time, can continue for many months. GAD is thought to be associated with low levels of serotonin, and noradrenaline also plays a role in anxiety.
Peripheral diabetic neuropathy
Diabetic neuropathy or nerve damage is a common problem associated with diabetes and is linked to high blood sugar levels. Nerve damage can affect all types of nerves in the body. These include sensory nerves that detect sensations like touch, temperature, and pain; motor nerves carry nerve messages to the muscles. Autonomic nerves that control automatic body functions like the digestive tract and the heart can also be affected. Damage to nerves outside the spinal cord is known as peripheral neuropathy. Diabetic neuropathy usually affects the peripheral nerves in the hands and feet and can result in the amputation of fingers or toes. Symptoms of diabetic neuropathy include numbness, reduced ability to feel sensations such as touch or temperature, and nerve pain. Painful diabetic neuropathy is difficult to treat and can seriously affect the quality of life.
Nociceptive pain is acute pain, such as caused by a cut, a burn, or a fracture. It triggers sensory nerves to send messages to the brain that are interpreted as pain. Nerve pain works differently. This type of pain is caused by nerve damage resulting in a malfunction of the nerves sending pain signals to the brain. The sensation of nerve pain is quite different. It is described as electric shocks, stabbing, burning, extreme sensitivity to touch, also with tingling, numbness or pins and needles.
How does Cymbalta work?
Cymbalta capsules 60mg contain duloxetine, an antidepressant belonging to the class of drugs known as selective serotonin-noradrenaline reuptake inhibitors (SSNRIs). Duloxetine is used to treat depression, generalised anxiety disorder, and peripheral diabetic neuropathy.
Nerve cells communicate by releasing neurotransmitters like serotonin and noradrenaline into the synapse, which is the gap between nerve cells. This stimulates the next nerve to release more neurotransmitter, and so the signal is transmitted down a nerve pathway. Once the message has been passed on, the first nerve cell (pre-synaptic) takes up the remaining neurotransmitter from the synapse. The receiving nerve cell (post-synaptic) is no longer stimulated. This completes the signal pathway at that point in the chain. If neurotransmitter levels are low, the signal transmitted is weak and is rapidly lost due to reuptake from the synapse.
Serotonin is an important neurotransmitter that and plays a vital role in regulating cognitive functions like memory and learning, and in regulating mood. Your brain needs a certain amount of serotonin to nurture those "feel good" messages. However, if there is a lack of serotonin in the brain, the nerve pathways that control mood cannot be maintained. This generates feelings of anxiety, low mood, sadness, despair, and panic instead of well-being. Noradrenaline is another neurotransmitter that plays a role in depression and anxiety. Stimulation of the noradrenergic nerve pathway is particularly important in regulating anxiety.
Duloxetine in Cymbalta capsules 60mg works by blocking the reuptake of serotonin and noradrenaline in specific neural pathways in the brain. Blocking neurotransmitter uptake by the pre-synaptic neuron means that more serotonin and noradrenaline remain to stimulate the post-synaptic neuron. This increases the amount of serotonin and noradrenaline in the brain and allows nerve cells to communicate with each other for longer. Therefore, stimulation of nerve pathways that control mood and regulate anxiety is prolonged. The effect of duloxetine on the serotonin pathway is much greater than the noradrenaline pathway. A combined effect of enhancing two neurotransmitter pathways increases the effectiveness of duloxetine, particularly in treating anxiety.
Both serotonin and noradrenaline play a role in regulating the transmission of pain signals from peripheral nerves to the brain. They work by inhibiting the pain pathways from the brain, which reduces the sensation of pain felt in the rest of the body. It is thought they work synergistically, such that they have a more significant pain-relieving effect when they act together than separately. An imbalance in the serotonin and noradrenaline pathways that reduce the pain sensation (called disinhibition) contributes to neuropathic pain. Duloxetine in Cymbalta capsules 60mg increases the amount of serotonin and noradrenaline in the central nervous system, which reduces the transmission of pain sensations to the peripheral nerves, where the pain is felt. This helps reduce the pain of peripheral diabetic neuropathy.
What does Cymbalta contain?
Cymbalta capsules 60mg contain the active ingredient duloxetine, an antidepressant belonging to the selective serotonin-noradrenaline reuptake inhibitors (SSNRIs) class of drugs that is used to treat depression, generalised anxiety disorder, and peripheral diabetic neuropathy.
They also contain Hypromellose, hypromellose acetate succinate, sucrose, sugar spheres, talc, titanium dioxide (e171), triethyl citrate, gelatin, sodium lauryl sulfate, titanium dioxide (E171), indigo carmine (E132), yellow iron oxide synthetic (E172). Edible white ink contains (titanium dioxide (E171), propylene glycol, shellac, povidone).
What are the side effects of Cymbalta?
Most medications have some side effects, but they are not experienced by everyone. Some side effects are commonly experienced when taking Cymbalta capsules 60mg, but others are not so common, and you should discuss any problems or concerns with your primary care physician.
Common side effects when taking Cymbalta include nausea, vomiting, abdominal pain, constipation, dry mouth decreased appetite, fatigue, drowsiness, dizziness, increased sweating, sexual problems, blurred vision, palpitations, flushing, increased sweating, rash, muscle pain.
When should Cymbalta not be used?
Have a talk with your primary healthcare physician before taking Cymbalta capsules 60mg so that you have a full understanding of what this medicine is for and how to use it. There are some reasons for not taking a medication; these are called contraindications, and for Cymbalta you should consider the following before taking Cymbalta:
- Have you ever had an unusual reaction or an allergy when taking Cymbalta?
- Are you pregnant or breastfeeding?
- Do you have any problems with your kidneys or your liver?
- Do you have high blood pressure, increased heart rate or a heart condition?
- Do you have glaucoma (increased eye pressure), seizures or bipolar disorder?
What medications interact with Cymbalta?
Some medicines interact with Cymbalta capsules 60mg and may affect the way it works, or are affected by Cymbalta or increase side effects; you should discuss possible interactions with your primary care physician. These may include monoamine oxidase inhibitors (MAOIs) for depression, other antidepressants, the analgesic tramadol, migraine medicines like sumatriptan, antipsychotics like chlorpromazine or thioridazine, herbal remedies containing St. John´s Wort, the antifungal ketoconazole, the antibiotic ciprofloxacin, clozapine for schizophrenia, medication that affects blood clotting such as clopidogrel and warfarin may increase risk of bleeding
If other medications may interact with Cymbalta, your doctor will discuss these with you.
How should Cymbalta be taken and for how long?
You should take your Cymbalta capsules 60mg swallowed whole with a glass of water, with or without food, once a day, at the same time each day. You should continue to take your Cymbalta capsules 60mg for several weeks or months, depending on your condition and your doctor’s recommendations. It may take several weeks before you begin to feel better. Your doctor may increase your dose, depending on what you are being treated for and how well you respond.
Missed dose of Cymbalta
If you miss a dose of Cymbalta capsules 60mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.
How should Cymbalta be stored?
You should store your Cymbalta capsules 60mg below 25°C in a cool dry place.