What is the use of Duloxetine (Cymbalta)?

From the Guidelines

Duloxetine (Cymbalta) is primarily used to treat depression, anxiety disorders, fibromyalgia, and certain types of chronic pain, including neuropathic pain, with a typical dose of 60 mg once daily. The medication belongs to a class of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs), which work by increasing levels of serotonin and norepinephrine in the brain to help maintain mental balance and reduce pain signals 1.

Key Uses of Duloxetine

• Treatment of depression and anxiety disorders
• Management of fibromyalgia
• Relief of certain types of chronic pain, including neuropathic pain associated with diabetic peripheral neuropathy (DPN) 1
• Potential off-label uses for other types of neuropathic pain, though efficacy in these conditions is less established 1

Dosage and Administration

• Typical starting dose for depression or anxiety is 30 mg once daily, often increased to 60 mg daily after one week
• For fibromyalgia or chronic pain, the dose is usually 60 mg once daily
• Should be taken at the same time each day, with or without food
• Should never be stopped abruptly as this can cause withdrawal symptoms

Side Effects and Interactions

• Common side effects include nausea, dry mouth, constipation, decreased appetite, fatigue, increased sweating, and dizziness 1
• These effects often improve over time
• May interact with other medications, particularly MAOIs, blood thinners, and certain pain medications, so it's essential to inform your doctor about all medications you're taking

Efficacy in Neuropathic Pain

• Duloxetine has shown efficacy in the treatment of pain associated with diabetic peripheral neuropathy (DPN) at doses of 60 or 120 mg/day 1
• Approximately 50% of patients achieved at least 50% pain reduction in clinical trials 1
• The number needed to treat (NNT) to achieve at least 50% pain reduction was 4.9 for 120 mg/day and 5.2 for 60 mg/day 1

From the FDA Drug Label

1. Indications and Usage Duloxetine delayed-release capsules are indicated for the treatment of: Major depressive disorder in adults Generalized anxiety disorder in adults and pediatric patients 7 years of age and older Diabetic peripheral neuropathic pain in adults Fibromyalgia in adults Chronic musculoskeletal pain in adults

What are duloxetine delayed-release capsules? Duloxetine delayed-release capsules are a prescription medicine used to treat a certain type of depression called Major Depressive Disorder (MDD) Duloxetine delayed-release capsules belong to a class of medicines known as SNRIs (or serotonin-norepinephrine reuptake inhibitors). Duloxetine delayed-release capsules are also used to treat or manage: Generalized Anxiety Disorder (GAD) Diabetic Peripheral Neuropathic Pain (DPNP) Fibromyalgia (FM) Chronic Musculoskeletal Pain

The use of Duloxetine (Cymbalta) is for the treatment of:

• Major Depressive Disorder (MDD) in adults
• Generalized Anxiety Disorder (GAD) in adults and pediatric patients 7 years of age and older
• Diabetic Peripheral Neuropathic Pain (DPNP) in adults
• Fibromyalgia (FM) in adults
• Chronic Musculoskeletal Pain in adults 2 2

From the Research

Uses of Duloxetine (Cymbalta)

• Duloxetine is a selective dual neuronal serotonin (5-Hydroxytryptamine, 5-HT) and norepinephrine reuptake inhibitor (SSNRI) used for various medical conditions, including:
  • Major depressive disorder (MDD) 3
  • Generalized anxiety disorder (GAD) 4, 5
  • Diabetic peripheral neuropathic pain 6, 7
  • Fibromyalgia 6, 7
  • Chronic musculoskeletal pain due to chronic osteoarthritis pain and low back pain 6
  • Painful physical symptoms associated with depression 7, 3

Efficacy of Duloxetine

• Duloxetine has been shown to be effective in the short-term and long-term treatment of MDD, with significant improvements in core emotional symptoms and painful physical symptoms associated with depression 3
• Duloxetine is also effective in the treatment of GAD, with improvements in anxiety and functional impairment 4
• In the treatment of diabetic peripheral neuropathic pain, fibromyalgia, and chronic musculoskeletal pain, duloxetine has been shown to be effective in reducing pain symptoms 6, 7

Dosage and Administration

• The recommended dosage of duloxetine varies depending on the medical condition being treated, with common dosages ranging from 40 to 120 mg/day 6, 4, 3
• Duloxetine can be administered without regard to food or time of day, and is highly protein bound and widely distributed throughout tissues 4