From the Guidelines
The therapeutic dose of Cymbalta (duloxetine) typically ranges from 30 to 120 mg per day, with 60 mg daily being the most common effective dose for most conditions, as supported by the most recent study 1. When considering the treatment of depression and generalized anxiety disorder, 60 mg once daily is the standard dose, while diabetic peripheral neuropathic pain may be treated with 60 mg once daily. Some key points to consider when prescribing Cymbalta include:
- Starting treatment at 30 mg daily for one week before increasing to 60 mg to improve tolerability, as seen in the study 1.
- The potential need to increase the dose to 90 or 120 mg daily for patients with depression who do not respond adequately to 60 mg.
- The importance of taking Cymbalta at the same time each day, with or without food, and swallowing the capsules whole without crushing or chewing.
- The need to gradually reduce the dosage when discontinuing Cymbalta to avoid withdrawal symptoms.
- The consideration of lower doses for elderly patients or those with liver or kidney impairment, as noted in the study 1. It is essential to weigh the benefits and risks of Cymbalta treatment, considering its mechanism of action, which involves increasing serotonin and norepinephrine levels in the brain to regulate mood, pain perception, and anxiety. The study 1 provides the most recent and highest quality evidence, guiding the therapeutic dose of Cymbalta and its application in various conditions.
From the FDA Drug Label
2.2 Dosage for Treatment of Major Depressive Disorder in Adults The recommended starting dosage in adults with MDD is 40 mg/day (given as 20 mg twice daily) to 60 mg/day (given either once daily or as 30 mg twice daily)
2.3 Dosage for Treatment of Generalized Anxiety Disorder Recommended Dosage in Adults Less than 65 Years of Age For most adults less than 65 years of age with GAD, initiate duloxetine delayed-release capsules 60 mg once daily
2.4 Dosage for Treatment of Diabetic Peripheral Neuropathic Pain in Adults Administer 60 mg once daily in adults with diabetic peripheral neuropathic pain.
The therapeutic dose of Cymbalta (duloxetine) varies by condition:
- Major Depressive Disorder (MDD): 40 mg/day to 60 mg/day
- Generalized Anxiety Disorder (GAD): 60 mg once daily
- Diabetic Peripheral Neuropathic Pain: 60 mg once daily 2
From the Research
Therapeutic Dose of Cymbalta
The therapeutic dose of Cymbalta (duloxetine) varies depending on the condition being treated.
- For generalized anxiety disorder (GAD), the effective dose is 60-120 mg once daily 3, 4.
- For major depressive disorder (MDD), the effective dose is 40-120 mg/day, with significant improvements seen at 60 mg once daily 5.
- For patients with anxiety disorders or comorbid anxiety and MDD, duloxetine may be considered an effective treatment option, but more research is needed 6.
Dosing Strategies
Different dosing strategies have been compared in patients with MDD.
- Starting with 30 mg once daily and increasing to 60 mg once daily after one week may improve initial tolerability, especially when taken with food 7.
- Taking duloxetine with food may reduce the incidence of nausea, especially at higher starting doses 7.
Common Adverse Events
Common adverse events associated with duloxetine include: