Brand & Generic Names; Drug Classes
|US brand name: Cymbalta|
|Generic name: duloxetine|
|Primary drug class: Antidepressants|
|Additional drug class(es): Headache & Neuropathic Pain Medications, Anxiolytics / Anti-anxiety Medications, Serotonin and Norepinephrine Reuptake Inhibitors|
Approved & Off-Label Uses (Indications)
Cymbalta’s US FDA Approved Treatment(s)Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), Fibromyalgia, Diabetic Peripheral Neuropathic Pain (DPNP) , Chronic Musculoskeletal Pain (CMSP)
Uses Approved Overseas but not in the US
Stress urinary incontinence in women in the EU under the trade name Yentreve.
Off-Label Uses of Cymbalta
Stress urinary incontinence in women, and possibly for men as well. ADD/ADHD. Smoking cessation. Migraines and other headaches .
When & If Cymbalta Will Work
Cymbalta’s Usual Onset of Action (when it starts working)
For Psychiatric Conditions (AKA brain cooties)
Between three days and a month, with an average of around two weeks.
For DPNP & CMSP - like TCAs and any other med with a positive effect on norepinephrine, you could start feeling some relief anywhere from a couple of days to two-three weeks.
For fibromyalgia - how long does it take for anything to start working on fibro1?
Likelihood of Working
Depression & Anxiety Spectrum Disorders
As with most SNRIs, your chances are pretty damn good that Cymbalta will work for depression and anxiety spectrum disorders. They’re not the solution for everyone, but they all have a decent response rate, they are far less likely to poop-out than SSRIs, and Cymbalta is no different.
For DPNP & CMSP The odds are decent. It’s about as good as a TCA, with fewer side effects, which basically makes it a first-choice coin-toss.
For fibromyalgia - who the fuck knows. Even opioids may as well be placebos for a lot of people, and those folks are the Crazymeds’ demographic. And meds tend to poop-out (tachyphylaxis) a lot. I’ll get back to you if I can find some numbers I can trust.
Taking and Discontinuing
How to Take Cymbalta
Per the PI sheet Eli Lilly Recommends:
For adults with Major Depressive Disorder (MDD): start at 40 to 60 mg , taken either in one or two doses a day . The target dosage is 60mg a day, with a maximum of 120mg a day.
For adults with Generalized Anxiety Disorder (GAD): start at 60 mg once a day , with a maximum of 120mg.
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.
While theoretically a once-a-day, delayed-release product, so is Depakote ER. And you only need to take regular Keppra twice a day. From all the evidence I’ve collected I’ve learned that you
sometimes often need to take some meds more frequently than what the PI sheet states. And, please, discuss that with your doctor and pharmacist. The only real side effect to taking two 30 mg capsules instead of one 60 mg is how much it costs. Your doctor will probably be OK with it. You insurance company might have a different idea.
How to Stop Taking Cymbalta (discontinuation / withdrawal)
2.4 Discontinuing Cymbalta
Symptoms associated with discontinuation of Cymbalta and other SSRIs and SNRIs have been reported. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible [see Warnings and Precautions (5.7)]. --the PI sheet And that’s it.
Very slowly. Reduce your dosage by 10–20 mg a day each week. If 20mg per day every week is too fast, try to get some samples from your doctor2 so you can step down by 10mg per day until you hit 20mg. Cymbalta comes in 20, 30 and 60 mg capsules. Now do the math. Once you’re at 20mg you have to stop taking it after one or two weeks at that dosage. If the discontinuation symptoms don’t go away, ask your doctor for a Prozac prescription.