Duloxetine is a prescription medicine, that aids in the treatment of depression and anxiety. It is sold under the brand name Cymbalta. Mostly, it treats a particular type of depression called Major Depressive Disorder (MDD,) along with generalized anxiety disorder in adults and children who are at least seven years old. Doctors prescribe to relieve nerve pain (peripheral neuropathy) in people, with diabetes, arthritis, chronic back pain, chronic muscle, or joint pain. Cymbalta is also given to adults and children. But they must be at least 13 years old and be suffering from fibromyalgia (a chronic pain disorder).
How does it Work?
Cymbalta is a type of medicine known as SNRIs. Its full-form is Serotonin-Norepinephrine Reuptake Inhibitors. It can improve mood, appetite, sleep, and energy level. Cymbalta can also reduce nervousness.
The most common use of Cymbalta is as an antidepressant. Along with other SNRIs, it targets levels of serotonin and norepinephrine. These two chemicals help nerve cells communicate with one another. No one is quite sure exactly why antidepressants help the body feel comfort from pain. Scientists believe that the same neurochemicals used as antidepressant balance both pain and mood. As of their knowledge, low levels of these chemicals may cause depression. And these two chemicals — called neurotransmitters — also affect how a person feels pain.
Points to Keep in Mind Before taking Cymbalta
Cymbalta is not a very fast drug. Like other Duloxetines, it usually takes 2 to 4 weeks to work in case of depression. You must keep in mind that it will require a longer time if you are going to take it for joint or nerve pain.
Before taking Duloxetine, read the Medication Guide provided by your pharmacist carefully. If you still have any questions, ask your doctor or pharmacist.
Are you using an MAO inhibitor like isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, or tranylcypromine? Do not take Cymbalta within five days before or 14 days after you have used these MAO inhibitors. And you must avoid it if you are allergic to Duloxetine. In that case, you can ask your doctor for an alternative. Also, like other Duloxetine, Cymbalta should not be used if the patient has narrow-angle glaucoma.
Take this medication orally as directed by your doctor. To avoid nausea, you may take the drug with food. Usually, one or two times a day with or without food prescribed. Do not crush or chew the capsule. Swallow it. If you mix the contents with food or liquid, it might increase the risk of side effects.
The dosage is based on the patient’s age, medical condition, and response to treatment. To decrease the risk of side effects, the doctor may direct to start this medication at a low dose. And gradually increase it. If you are going to start Cymbalta, follow your doctor’s instructions carefully. Take this medication regularly without skipping the dose to get the most benefit from it. Take it at the same times each day.
Stay alert to any of the changes in your mood, behavior, or symptoms. Report any new or worsening symptoms to your physician, such as anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, hostile, aggressive, hyperactive (mentally or physically), more depressed, or have thoughts about hurting yourself. Do not stop using Cymbalta without informing your doctor.
Side Effects of Cymbalta
Like all medicines, Cymbalta can cause side effects too. These mild to moderate effects generally disappear within a couple of days or few weeks.
Very common side-effects of Cymbalta are headache, feeling sleepy, feeling sick (nausea), and dry mouth. Every one in ten patients may show these side-effects. Other common side-effects are lack of appetite, trouble sleeping, less sex drive, difficulty or failure to experience orgasm, unusual dreams, and anxiety. Some people may face dizziness, tremor, numbness, prickling, or tingling of the skin after using any of the Duloxetine.
Though it may not be very common, other side-effects like blurred eyesight, tinnitus (hearing sound in the ear when there is no sound outside), feeling irregular heartbeat, increased blood pressure, flushing, increased yawning, constipation, diarrhea, stomach pain, indigestion, and breaking wind may also be seen in some patients. In case of an allergic reaction, increased sweating, (itchy) rash, muscle pain, muscle spasms can happen. In some rare cases, male patients have reported having painful urination, frequent urination, and problems getting an erection, and changes in ejaculation after using Cymbalta.
Children and adolescents under 18 years of age with depression treated with Cymbalta had some weight loss when they start taking this type of Duloxetine. The problem may disappear after six months of using it. Older adults may need more attention while using Cymbalta. They are more sensitive to the side-effects of this medicine.
Call Your Doctor
Seek immediate medical attention if you have a light-headed feeling like you might pass out after using Cymbalta or any other Duloxetine. Contacts your physician, in case of vision changes, eye pain or swelling, eye redness, easy bruising.
Some side-effects may risk a patient’s health to some extent. In the case of these side-effects, you must inform your doctor immediately. Side-effects like racing thoughts decreasing the need for sleep, risk-taking behavior, increasing agitation, or talkativeness may increase the risk of further health issues.
In the case of slurred speech, severe weakness, vomiting, loss of coordination, symptoms like low levels of sodium (feeling unsteady) doctor must be noticed immediately. If you feel that you have serotonin syndrome symptoms then you should seek medical help right away. These symptoms are twitching, fast heart rate, agitation, hallucinations, shivering, sweating, and loss of coordination.
Withdrawal of Cymbalta
Cymbalta has an extremely short half-life. It is about twelve hours, which is very uncommon in this type of drug. This means when taking Cymbalta, half of the drug leaves the patient’s system within twelve hours or less. It is extremely fast. Among antidepressants, Cymbalta has the second-fastest half-life. With such a short period of half-life, it could be expected Cymbalta users to experience very high rates of withdrawal effects.
In case of withdrawal of Cymbalta, a feeling of tension and irritability, insomnia, dizziness, and a crawling sensation in the scalp may occur. There are other common side effects of Cymbalta withdrawal, like extreme mood swings, aggression, nightmares, or sleep disturbance. Some patients may also suffer from vertigo.
Timeline of Cymbalta Withdrawal
It is difficult to speculate on an exact timeline for Cymbalta withdrawal. The duration of the withdrawal symptoms will vary from patient to patient. Some people may experience moderate to severe symptoms for just a few days when others will continue to experience symptoms for months after discontinuing Cymbalta or any other Duloxetine use.
It’s impossible to measure how long Cymbalta withdrawal will take. The recommended way to stop using the drug is with a medical detox program with proper guidelines. An experienced physician or medical professional can provide adequate Cymbalta treatment and gradual tapering with a detox program.
Chances of Cymbalta Addiction
Someone who is taking Cymbalta for a long time should never try to quit taking the medication on their own due to the severity of withdrawal. Cymbalta withdrawal symptoms are very common in users. It is called Cymbalta Discontinuation Syndrome. Apart from the physical effects of withdrawal, many people that stop taking the drug, experience negative psychological symptoms like rebound anxiety and depression, and even suicidal thoughts. Detox from Cymbalta should always be done under the supervision of medical professionals. They can monitor vital signs and prescribe any medications necessary to ease the debilitating symptoms of withdrawal.
Those who take Cymbalta or any other Duloxetine may develop “discontinuation syndrome.” It likely occurs because the cell receptors in the brain must adjust to lower levels of serotonin and other chemicals present in Cymbalta. Since Cymbalta is a quick-release antidepressant, it leaves the bloodstream quickly. That is why it tends to result in a more severe level of discontinuation syndrome. It is reported that over 50 percent of those who have been using Cymbalta for any length of time and stop suddenly develop symptoms. For some, this may mean months of panic, brain zaps, insomnia, and crying fits.