Cymbalta, based on duloxetine, represents a new class of antidepressants - selective blockers of reuptake of serotonin and norepinephrine. The preparation
was approved by FDA and The European Commission for the introduction of new drugs as a new therapeutic solution in the treatment of depressive conditions.
A brand-new and well-tolerated medication contributes to an efficient treatment of not only mental, but oftentimes underestimated physiological symptoms
(such as pain in the back), observed against the background of depressive disorders.
Duloxetine affects both neurotransmitters, the positive results of treatment are typically reported after the first 2 weeks: both mental and somatic
symptoms are reduced (pain sensations in particular, which often accompany depression). The therapeutic effect of duloxetine has been studied in more than
6,000 adult patients with depression
The 4 large placebo-controlled studies of acute depression as well as a long-term study of the treatment of chronic depression have documented a greater
effectiveness and tolerability of Cymbalta against the background of other preparations.
In the US Cymbalta the drug has been approved for commercial sales in August, 2004 (the formulation was updated in 2010); the drug is available in 30 and
60 mg capsules, resistant to gastric juice. The preparation is available by prescription only; self-treatment must not be initiated for the reason of
possible complicated adverse reactions and significant behavioural changes.
Dosage regimen
The drug is designed for oral intakes. Swallow the pill wholly, don’t chew and crush it. Take the preparation with little water (? of the glass) regardless
of meals.
However, plan your reception schedule so you don’t mix the table with liquids or foods to exclude the risk of damaging the coating (which may lead to zero
effectiveness of the intake).
The dosage is selected manually by the treating doctor; however, the starter dose appointed on average is 60mg prescribed for a single intake during the
day (preferably in the morning hours).
In some patients achieving the desired results requires increasing the dosage, although the maximum daily intake must not exceed 120mg. In case the doctor
makes a decision to increase the dose, dividing it into 2 intakes is allowed.
The preparation is used with caution in those suffering from kidney disease and/or renal failure, as well as in the elderly (as a rule, a two-fold
reduction in dosage is applied); an individual treatment course schedule is required in people taking MAO inhibitors.
Important information
In accordance with FDA requirements, the manufacturer, Eli Lilly and Company, is obliged to indicate the potential risks of behaviour changes and the
increased risk of suicide on the package (thus, the patients under 25 years old fall in the risk group).
The requirement to put the warning on the package is explained by a series of studies conducted in 18 - 24 years old volunteers suffering from depressive
conditions; as a result, a 150% increase in the risk of committing suicide and/or emergence of suicidal behaviour patterns was clinically confirmed.
The preparation forms addiction in the body during long term treatment courses, and therefore it is recommended to gradually decrease the dosage within an
average 2-3 weeks (please, double check with your doctor) to exclude the risk of acute adverse reactions.
Clinical trials in pregnant women were not conducted so the use of Cymbalta is not recommended in this case.