Cymbalta is a new antidepressant based on duloxetine hcl (hydrochloride) that is used not only for the treatment of depression and anxiety but also in the management of a severe form of neuropathy that occurs against the background of a continued course of diabetes.
Treatment with Duloxetine leads to a fast decrease in the clinical manifestations of depression and reduces the risk of suicide. Patients note excellent tolerability of the drug and the absence of pronounced side effects, which has made use of the medication widespread.
Cymbalta for depression
Numerous studies have shown that depression is one of the main factors that reduces the quality of life in patients with somatic diseases. The proportion of patients whose usual way of life is significantly violated by depression varies depending on the severity of the affective disorder and increases from 18.1% to 52.3% with certain distinct forms of depression.
It is obvious that successful therapy for depression in complex clinical situations requires the use of antidepressants that can effectively reduce the symptoms of depression without adversely affecting the course of somatic pathology.
The effect of Duloxetine hcl
Duloxetine is a selective, powerful, and balanced serotonin-norepinephrine reuptake inhibitor (SNRi). The results of many large-scale studies confirm the clinical efficacy of Cymbalta. It has been shown that the drug not only promotes a significant antidepressant effect as compared with placebo but also exceeds the level of effectiveness of selective serotoninergic antidepressants.
Cymbalta was approved by the FDA in the US as a safe and effective treatment for severe depressive disorder (Diagnostic and Statistical Manual of Mental Disorders, fourth edition). The drug was also approved by the European Research Council and recommended for use in all European countries except Greece, Italy, and Spain (in these countries, this drug is instead distributed under the brand name Xeristar from Boehringer-Ingelheim, Ingelheim am Rhein, Germany).
The effectiveness of Cymbalta has been proven in international clinical trials involving more than 6,000 adult patients suffering from depressive disorders. Cymbalta is also approved for the treatment of neuropathic pain in diabetic patients.
Method of application
In depression and diabetic neuropathy, Cymbalta is administered orally at a dose of 60 mg once a day every day, regardless of food intake. Some patients may be ideal candidates for a higher dose (up to a maximum of 120 mg/day divided into two separate doses).
Initial dosing for patients in the final stage of renal failure is 30 mg once a day daily. Patients with liver cirrhosis are prescribed at a lower initial dose or with long intervals between doses.
Capsules should be swallowed whole, without chewing or crushing. The result of therapy is usually observed two to four weeks after the start of treatment.
Contraindications for Cymbalta
Contraindications for the use of the drug include hypersensitivity to duloxetine. Also, Cymbalta should not be administered together with monoamine oxidase inhibitors (MAO) or within at least 14 days after the discontinuation of treatment with MAO inhibitors.
During pregnancy, Cymbalta can be prescribed only when the expected benefit to the mother is many times higher than the risk of harm to the fetus. When planning a pregnancy, patients should notify the attending physician promptly. During treatment, breastfeeding must be stopped due to the lack of sufficient information about the influence of Cymbalta on the body of a newborn.
Side effects of Cymbalta
During clinical trials, side effects such as constipation, nausea, dry mouth, dizziness, fatigue, insomnia, and headache were recorded in 10% of cases. Less often (with a frequency of less than 10% but more than 1%), tachycardia, dyspepsia, vomiting, decreased appetite, drowsiness, and sweating were found.