Cymbalta Index | Brand and Generic Availability ›
Crazy Meds Comprehensive Cymbalta pages

This is our summary of Cymbalta. Clicking on a “More…” link will take you to a page with greater detail. The Comprehensive Cymbalta pages contain the information from all of the “More…” pages.

1.  Brand & Generic Names; Drug Class

US brand name:	Cymbalta
Generic name:	duloxetine hydrochloride
What is Cymbalta (duloxetine hydrochloride)?	Cymbalta (duloxetine hydrochloride) is in the Antidepressants class of drugs.

More about Cymbalta’s generic availability, worldwide trade names, and more

2.  What is Cymbalta (duloxetine hydrochloride) used for

2.1  US FDA approved treatment(s)

Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), Fibromyalgia, Diabetic Peripheral Neuropathic Pain, Chronic Musculoskeletal Pain

2.2  Popular off-label uses

Stress urinary incontinence in women (It’s officially approved in Europe for this problem), and possibly for men as well. Bulimia. ADD/ADHD. Smoking cessation.

More about Cymbalta’s approved & off-label uses

3.  When will Cymbalta (duloxetine hydrochloride) start working?

3.1  How long until Cymbalta starts working

Between three days and a month, with an average of around two weeks.

3.2  Will Cymbalta really work for what I have?

Like most SNRIs, pretty damn good. They’re not the solution for everyone, but they all have a decent response rate.

More about how long until, and how well will Cymbalta work; and how Cymbalta compares with other drugs

4.  How to take and stop taking Cymbalta (duloxetine hydrochloride)

4.1  How to take Cymbalta

Eli Lilly’s recommendations, per the PI sheet
For MDD: start at 40–60mg, taken either in one or two doses. The target dosage is 60mg a day, with a maximum of 120mg a day.
For GAD: start at 60mg once a day, with a maximum of 120mg.

As usual, we disagree.
For MDD & GAD we suggest starting at 20mg a day, and increasing by 20mg a day as required. We also suggest taking Cymbalta twice a day due to its short half-life, but since you can take it only once a day at 20mg, if you need to increase your dosage you’ll know soon enough which works better for you.

4.2  How to stop taking Cymbalta

Very slowly. If 20mg per day every week is too fast, try to get some samples from your doctor so you can step down by 10mg per day until you hit 20mg. Cymbalta comes in 20, 30 and 60mg capsules. Now do the math.

More about taking and discontinuing Cymbalta

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5.  Cymbalta’s (duloxetine hydrochloride’s) pros and cons

5.1  Pros

Works quickly with a fairly low side effect profile for an SNRI. Less likely to poop-out than an SSRI. Probably the best painkiller around as far as approved antidepressants are concerned (because Savella (milnacipran) is not approved in the US as an antidepressant).

5.2  Cons

It’s an SNRI, which means a discontinuation syndrome from hell if you want/need to stop taking it.

5.3  Interesting stuff your doctor probably didn’t tell you

Cymbalta is more effective when taken in the morning than in the evening. This has nothing to do with meals, it all has to do with our circadian rhythms. Smoking decreases Cymbalta’s bioavailability by about one-third in smokers. Eli Lilly doesn’t recommend any changes to how much you take or how fast to increase the dosage if you smoke, but don’t be surprised if you need to take more sooner than you thought.
More of Cymbalta’s pros, cons, and interesting stuff

6.  Cymbalta’s (duloxetine hydrochloride’s) side effects

6.1  Typical side effects

The usual for SNRIs - headache, nausea, dry mouth, sweating, urinary hesitancy (it is a med for urinary incontinence after all), sleepiness or insomnia, and diarrhea or constipation, weight gain, loss of libido and a host of other sexual dysfunctions. Most everything but the constipation, urinary hesitancy and weight gain, if any, will go away in a couple of weeks. Sexual dysfunction is a coin toss, although some women will get a sexual boost instead of a sexual dampening.

6.2  Uncommon side effects

Controlled narrow glaucoma (but you already have to be at risk for eye problems to start with), elevated liver serum (an annual liver panel with this med probably isn’t a bad idea), blurry vision, muscle cramps, weight loss.

6.3  Freaky rare side effects

Retinal detachment. Excessive disturbing and disabling yawning. I guess they considered it “excessive and disturbing” because Lexapro wasn’t involved.
More about Cymbalta’s side effects

7.  What Cymbalta (duloxetine hydrochloride) is best known for

More about Cymbalta’s black box warnings, noted traits & effects

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8.  Cymbalta’s (duloxetine hydrochloride’s) half-life & how long until Cymbalta clears your system

Half-life: 12 hours. Clearance: 3–4 days.
Drugs.com’s drug-drug and drug-food interaction checker
More about Cymbalta’s pharmacokinetics & noted drug-drug & drug-food interactions

9.  How Cymbalta (duloxetine hydrochloride) works (the best current guess at any rate).

Cymbalta is a serotonin and norepinephrine reuptake inhibitor (SNRI). SNRIs boost the amount of serotonin and norepinephrine in various parts of your brain and allow the receptors for those neurotransmitters to marinate longer in them. Neurotransmitter wackiness is a popular theory as to the cause of depression, anxiety, and assorted other brain cooties.
More about how Cymbalta works. AKA Cymbalta’s mechanism/method of action, or pharmacodynamics.

10.  Comments

In a rare case of useful information in advertising, Eli Lilly’s “Depression Hurts” campaign let people know that physical pain is a common symptom of MDD. It’s too bad that they dropped the part about all meds that are serotonin and norepinephrine reuptake inhibitors (including cheap-as-dirt TCAs) could help with depression-induced pain from the TV commercials. In fairness to Lilly, they did need to address that bit about severe liver problems.

Cymbalta is vastly more potent than Effexor and Pristiq. Transitioning between Cymbalta and either Effexor or Pristiq has to be done carefully.
More comments As if I didn’t go on long enough here.
Consumer/patient comments about & experiences with Cymbalta

11.  Discussion board, PI sheet and other allegedly useful links

Crazy Meds’ Cymbalta discussion board
Cymbalta’s Full US Prescribing Information / PI Sheet
Allegedly Useful Links. Mostly any official sites we could find for this med and PI sheets from countries other than the US.

Cymbalta Index | Brand and Generic Availability ›
Crazy Meds Comprehensive Cymbalta pages

Bibliography

Date created 31 Dec 1969 - 17:00 Page Creator: JerodPoore Last edited by:

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Cymbalta Basic Overview by JerodPoore is copyright 1969

Page design and explanatory material copyright © 2004 - 2012 Jerod Poore. All rights reserved.

Almost all of the material on this site is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, and 2012 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and the following disclaimer, I’m usually cool with it.

All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you.
The information on Crazy Meds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else.
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All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away.
Crazy Meds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
All brand names of the drugs listed in this site are the trademarks of the companies named on the PI/SPC sheet associated with the medication, sometimes on the pages about the drugs, even though those companies may have been acquired by other companies who may or may not be listed in this site by the time you read this. Or the rights to the drug were sold to another company. And any or all of the companies involved may have changed their names.
Crazy Meds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Firefox or Safari, which is what a plurality of visitors use. And I’m running Windows XP3. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazy Meds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazy Meds is not responsible for whatever weird shit your browser does or does not do when you read this site².
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‘Everything is true, nothing is permitted.’ - Jerod Poore

¹ While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

² Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazy Meds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had the forerunner to QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]