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What is Cymbalta - Duloxetine and when is it prescribed

Today we will tell you about what the drug "Cymbalta" is. Instructions for the use of this medicine, its composition, side effects and indications will be described below. Also from the presented article you will learn about the form in which this medicine is produced, how much it costs, whether it has contraindications and how to use it correctly.

The work of our brain, including the general background of mood and emotions, depends on the content of special substances in it - neurotransmitters. One of these substances is serotonin, called the hormone of joy. It keeps you in a good mood and creates a feeling of happiness. In people with depression, serotonin levels decrease. These are purely biochemical processes, and offering a person suffering from depression against a background of low serotonin levels to "just pull himself together and start moving" is about as productive as offering a patient with diabetes to maintain the right sugar level by willpower.

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Cymbalta increases the amount of serotonin in the body, restoring the "normal" state of a person. By the way, Cymbalta is prescribed not only to lift the mood. Another frequent area of use of the antidepressant Cymbalta is chronic pain (back pain, headaches, fibromyalgia, pain with irritable bowel syndrome, and so on). Against the background of constant pain, the synthesis of the body's own painkillers is disrupted; doctors call this a dysfunction of the antinociceptive system. Cymbalta - Duloxetine restores the natural mechanisms of pain suppression. Moreover, if for their main action – improving mood – it takes 2-3 weeks, then the analgesic effect manifests itself literally with 1-2 tablets. Antidepressants are also recommended for anxiety disorders, premenstrual and menopausal syndromes, urinary and fecal incontinence, and other pathologies.

In terms of efficacy and safety, it is comparable to other antidepressants, but has a pronounced central analgesic effect. Therefore, it is especially recommended for prolonged pain syndromes of neurogenic origin. The drug Cymbalta reduces the reaction rate, so it is not shown to drivers. It is not recommended for pregnant, lactating and children under 18 years of age due to the lack of safety data (obviously, no one will risk deliberately experimenting on these categories of people).

Precautions for the treatment of Cymbalta

Cymbalta does not cause dependence, but in order for the body to adapt to biochemical changes, it is necessary to start taking them and finish them gradually. Usually doctors recommend taking a quarter of the normal dosage in the first two days, then use half a tablet for a few days, and only then - the full dose. You need to finish the course in reverse order.

When starting the use of Cymbalta, it should be borne in mind that the desired effect does not occur before two weeks, and the minimum recommended duration of the course is six months (except in situations when the drug is not prescribed for the treatment of depression). You can't take breaks, so you need to plan visits to the doctor in advance to update the prescription.

Since serotonin receptors are not only in the brain (and most of them, oddly enough at first glance, in the intestine), the side effects of Cymbalta (Duloxetine):

  • Abdominal pain and discomfort,
  • Stool disorders,
  • Dry mouth,
  • Taste disorders,
  • Hand trembling,
  • Pupil dilation,
  • Increased heart rate and increased blood pressure.

Other undesirable phenomena are also possible. Therefore, taking medicine, you need to monitor your condition and consult a doctor if you suspect any problems. Just in case, we remind you: a long list of possible side effects does not mean at all that they will all necessarily appear when taking Cymbalta medication.

Based on the results of the analysis of these studies, the authors conclude about the persistent and powerful antidepressant effect of Duloxetine, as well as its safety and good tolerability in the treatment of BDR in old age. Moreover, concomitant somatic diseases do not affect the efficacy and safety of Duloxetine. It is also suggested that Cymbalta may be effective in patients with previous SSRI inefficiency. Thus, the authors summarize the results of published studies and conclude that Duloxetine is a promising tool in the treatment of depression in the elderly.

The antidepressant Cymbalta cannot be combined with melatonin (sold without a prescription and is very popular as an effective and safe sleeping pill that is not addictive); St. John's wort and medications based on it; weight loss products based on sibutramine and dietary supplements based on 5-HTP (a precursor of serotonin,). This can provoke an excessive increase in the level of serotonin in the body, the so-called serotonin crisis, extremely unpleasant in its manifestations and potentially life-threatening. It is impossible to combine them with a group of drugs called monoamine oxidase inhibitors, but since these drugs are also prescription, doctors usually take into account possible drug interactions.

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It is often said that because of antidepressants can provoke suicide attempts. Indeed, the recommendations for specialists explicitly prohibit prescribing these funds to people who have expressed thoughts about suicide. But it also happens that shortly after the start of using antidepressants, people who have not previously demonstrated such intentions commit suicide. The fact is that during severe depression, a person usually does not have the strength for anything – and a conscious suicide attempt also requires strength. After starting taking the medication, but before the necessary therapeutic effect appears (we remind you that it usually takes 2-4 weeks), strength and determination are added – but, alas, sometimes these strength and determination go to irreversible actions. Simply put, before the use of antidepressants, a person simply did not have the strength to get out of bed and out of the window, and after the start of their use, they were found. Not every patient with suicidal intentions voices their relatives or doctor.

That is why many experts recommend combining the use of Cymbalta (Duloxetine) with psychotherapy or ask to make control visits in order to be able to assess the patient's condition. We repeat again: antidepressants are very serious drugs, self-medication of which is unacceptable.

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Preventive treatment of migraine with Cymbalta

Prescribing preventive treatment is a responsible task that requires careful preliminary discussion with the patient. Preventive treatment is associated with side effects due to prolonged use of medications and requires patience from the doctor and the patient. However, the lack of preventive treatment can cause the abuse of analgesics and the development of an abusive headache. Frequent migraine attacks are the basis for the occurrence of chronic migraine, as well as risk factors for vascular brain damage.

For the prevention of migraine, various pharmacological agents are used, including those in the recommendations for which this indication is not yet available. Monotherapy is preferred, in difficult cases, combined treatment is allowed, taking into account concomitant diseases. The drugs of choice are beta-blockers. Antidepressants and anticonvulsants, which occupy a leading position in the effectiveness of preventive treatment, still do not have this indication in the instructions for use. Of the anticonvulsants, valproates and the new anticonvulsant topiramate are the most effective. Clinical studies have shown that topiramate effectively prevents migraine attacks, significantly reducing their frequency. Its effect develops quite quickly — during the first month of therapy, there is a persistent long-term decrease in the number of seizures without the development of resistance. Compared with other anticonvulsants, topiramate has a favorable tolerance profile.

Antidepressants have long been used to treat migraines. The basis for their use is the information accumulated during the treatment of chronic pain. Antidepressants reduce the concomitant symptoms of depression, which is either initially present in the patient, or develops due to frequent migraine attacks. Antidepressants potentiate the action of analgesics and triptans, and some of them have independent antinociceptive or analgesic activity. The most favorable efficacy/safety ratio is observed in the new generation of antidepressants Venlafaxine, Duloxetine (Cymbalta).

General information of Duloxetine (Cymbalta)

According to the reviews of specialists and patients, the drug in question completely copes with the task. After taking it, it eliminates anxiety disorder, and also contributes to the disappearance of a depressive state. In addition, this medication relieves pain syndromes in the musculoskeletal system well.

Cymbalta has not been studied in women during the period of carrying a child, in this regard, the use of the drug Cymbalta during pregnancy is not recommended.

Taking this medication can quite easily cause drowsiness. In this regard, patients who take this drug should take special care when driving a car and when working with dangerous moving mechanisms.

The Cymbalta drug must be stored in places that children do not have access to. A specific temperature regime is not required. The shelf life of the drug Cymbalta is 3 years.

Cymbalta is a new highly effective and fairly safe antidepressant, which will undoubtedly occupy an important place in neurological practice, having not only antidepressant, but also analgesic activity, especially in a situation of intractable neuropathic pain.