Cymbalta For Pain Anxiety & Other Uses
Reviewed by Michael Espelin APRN
Cymbalta is an antidepressant drug that millions of people in the United States use daily. Like other antidepressants, Cymbalta for anxiety or depression is the most widespread use. However, there are other health conditions it is used to treat off-label. Although the medication is not generally considered addictive, it still has some abuse potential. Cymbalta abuse can occur even in those who only meant to use it as prescribed.
So, what is Cymbalta used for? Is it safe? What are the symptoms of misuse? And how to avoid abuse while taking it?
Cymbalta And Herbs And Supplements
You shouldnt use Cymbalta with St. Johns wort. This is an herb that can be used to treat depression.
Cymbalta can raise your serotonin levels. Because St. Johns wort also increases serotonin levels, taking Cymbalta with this supplement may raise your risk for serotonin syndrome. For more information on serotonin syndrome, see the Cymbalta and other drugs that affect serotonin section above.
Cymbalta Use Approved To Treat Major Depressive Disorder
The FDA first approved Cymbalta to treat major depressive disorder on August 4, 2004. MDD is also called clinical depression or just simply depression. It is a persistent feeling of sadness and a loss of interest. It is a common but serious mood disorder and can cause severe symptoms that can affect how a person thinks or feels. It can also interfere with a persons daily routine, disrupting how a person eats, sleeps or works.
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Side Effects Of Cymbalta
When taking Cymbalta, you may experience adverse effects while your body adjusts to the medication.
The following side effects usually do not require medical attention as they tend to go away.
The most common side effect of Cymbalta is nausea.
Other common side effects include:
- Body aches or pain, including muscle aches
- Symptoms of an allergic reaction
When you start taking the medication or increase your dose, you may develop dizziness or lightheadedness.
Avoid getting up quickly from a seated or lying position.
This will reduce the risk of dizziness, lightheadedness, or falls.
Many who are prescribed this medication do not experience any of the potential side effects but be sure to consult with your health care provider immediately if you experience any concerning symptoms or if you have any questions regarding Cymbalta.
Can Antidepressants Help People With Arthritis
These medications may help certain people with mood and pain problems if other measures fail.
Depression and anxiety affect about one in five U.S. adults with arthritis, according to the Centers for Disease Control and Prevention, but it isnt clear why some people struggle with mood disorders and others dont.
Chronic pain, fatigue, co-existing health problems, lifestyle and socioeconomic factors all may play a part. And inflammation, which causes symptoms in rheumatoid arthritis, psoriatic arthritis, lupus and other rheumatic conditions, might also cause inflammation in the brain. The reverse may also be true: Depression has been associated in research with an increased risk of developing inflammatory arthritis. Depression can also make arthritis pain feel worse and contribute to sleep troubles, poor diet, lack of exercise, failure to take arthritis medications regularly, poor treatment outcomes and a lower quality of life overall.
Treatments including moderate-intensity exercise, an anti-inflammatory diet and mindful meditation may help relieve relatively mild arthritis pain and other symptoms and boost mood, too. In addition, the CDC recommends that rheumatologists refer all patients to self-management programs, where they can learn to manage pain and stress.
What About Antidepressants?
Other experts are equally cautions, noting that antidepressants may relieve symptoms but not resolve deeper physical and psychological problems.
What Antidepressants Do
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Financial And Insurance Assistance
If you need financial support to pay for Cymbalta, or if you need help understanding your insurance coverage, help is available.
Eli Lilly and Company, the manufacturer of Cymbalta, offers a program called Lilly Cares. For more information and to find out if youre eligible for support, call 800-545-6962 or visit the program website.
Fda Warning: Suicidal Thoughts And Behaviors
This drug has a boxed warning . This is the most serious warning from the Food and Drug Administration . A boxed warning alerts doctors and patients about drug effects that may be dangerous.
Clinical studies have shown antidepressants such as Cymbalta increase the risk of suicidal thoughts and behaviors in children and young adults ages 24 years or younger. In people ages 65 and older, antidepressants can actually reduce this risk.
During your treatment, you should watch closely for any new or sudden changes in your behavior, feelings, moods, or thoughts. Also ask your family members, caregivers, and healthcare providers to look for changes in your behavior or moods. Call your doctor right away if you or someone else notices any changes.
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Fda Approves Cymbalta For Chronic Musculoskeletal Pain
Cymbalta Effectively Treats Osteoarthritis and Chronic Low Back Pain, Studies Show
Nov. 5, 2010 â A drug used to treat depression, anxiety, fibromyalgia, and diabetic neuropathy has been approved by the FDA for a new use — to treat chronic musculoskeletal pain, including pain caused by osteoarthritis and chronic low back pain.
The drug is sold under the brand name Cymbalta and is manufactured by Eli Lilly and Co., a major pharmaceutical company based in Indianapolis. Chronic low back pain is one of the most common forms of musculoskeletal pain, and finding an effective treatment can sometimes be challenging.
The approved dose for chronic musculoskeletal pain is a 60-milligram capsule taken once a day, swallowed whole it does not have to be timed with meals.
“Up to three-quarters of the population experience chronic pain at some time in their lives,” Janet Woodcock, MD, director of the FDA’s Center for Drug Evaluation and Research, said in a prepared statement.”This approval means that many of those people now have another treatment option.”
Clinical trials showed that taking Cymbalta significantly reduced chronic pain, compared with a placebo. More than 29,000 patients used Cymbalta in clinical trials, including people with osteoarthritis and chronic low back pain.
Since its approval in 2004, an estimated 30 million people have used Cymbalta.
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Dosage For Chronic Musculoskeletal Pain
The recommended Cymbalta dose for treating chronic musculoskeletal pain* in adults is 60 mg once daily.
Youll start by taking 30 mg once daily for a week. Then, assuming you respond well to the drug, your doctor will increase your dose to 60 mg once daily. Doses above 60 mg arent recommended for treating this condition.
* With chronic musculoskeletal pain, you have ongoing pain in your bones, muscles, ligaments, nerves, and tendons.
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Cymbalta Significantly Reduced Osteoarthritis Knee Pain In New Study
INDIANAPOLIS, Jan 30, 2009 /PRNewswire-FirstCall via COMTEX News Network/ — In a new study, Cymbalta 60-120 mg, taken once daily, reduced pain severitysignificantly, compared with placebo, in patients with osteoarthritis pain ofthe knee. Data from the 13-week randomized, double-blind, placebo-controlledclinical trial were presented at the annual meeting of the American Academyof Pain Medicine in Honolulu, Hawaii.
Duloxetine-treated patients showed greater reductions from baseline on theprimary endpoint, the 24-hour average pain score on the Brief Pain Inventory, compared with placebo-treated patients. In the study, 65 percent ofduloxetine-treated patients experienced a clinically significant improvement in pain, compared with 44 percent of placebo-treatedpatients.
The duloxetine-treated patients also showed improved physical function,compared with placebo-treated patients, as measured by the Western Ontario andMcMaster Osteoarthritis Index . In this study, patients on duloxetinedid not show statistically significant improvements on the WOMAC pain andstiffness subscales compared with placebo.
“The disabling nature of osteoarthritis pain can greatly impact a person’slife,” said Vladimir Skljarevski, M.D., a study author and medical fellow atEli Lilly and Company. “As our population ages, osteoarthritis of the knee islikely to become an increasing problem.”
Additional Study Highlights
— PGI-Improvement .
How Long Does It Take To Work
Cymbalta begins working as soon as you take your dose. It takes about 3 days for levels of the drug to become stable in your body. Depending on the condition its being used to treat, it may take longer than this before you notice the full effects of the drug.
For example, in clinical trials, some adults with pain caused by diabetic neuropathy , as well as some adults with fibromyalgia, noticed improvement within 1 week of starting the drug.
However, the National Alliance on Mental Illness notes that full improvement of depression symptoms may take up to 8 weeks.
If you have questions about how Cymbalta works, or how long it takes to work, talk with your doctor or pharmacist.
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Data Extraction And Quality Assessment
Data from the included RCTs were extracted into RevMan software by two independent reviewers . Information was collected on study characteristics and demographic characteristics of the sample, duloxetine dosing regimen, concomitant medication usage, and rescue medication protocols. Quality assessments were performed independently by two reviewers within RevMan using the Cochrane Risk of Bias tool .
What Is Cymbalta And How Does It Work
The drug is sold under the brand Cymbalta and is manufactured by Eli Lilly and Co., a significant pharmaceutical company based in Indianapolis. Chronic low back pain is among the most common types of musculoskeletal pain, and finding an effective treatment can often be challenging.
The approved dose for chronic musculoskeletal pain is a 60-milligram capsule taken once a day, swallowed whole it does not need to be timed with meals.
Approximately three-quarters of the population experience chronic pain at a long time in their lives, Janet Woodcock, MD, director of the FDAs Center for Drug Examination and Research, stated in a prepared statement. This approval means that many of those individuals now have another treatment option.
Clinical trials revealed that taking Cymbalta considerably minimized chronic pain, compared to a placebo. More than 29,000 patients used Cymbalta in scientific trials, including people with osteoarthritis and chronic low back pain.
The most typical side effects amongst Cymbalta users were queasiness, dry mouth, insomnia, sleepiness, constipation, tiredness, and dizziness. There were major side effects also, consisting of liver damage, hives, rashes, swelling in the face, pneumonia, depressed state of mind, and self-destructive thoughts and habits. These more serious side effects have happened in less than 1% of patients taking Cymbalta.
Considering that its approval in 2004, an approximated 30 million individuals have actually used Cymbalta.
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Cymbalta For Chronic Musculoskeletal Pain
Cymbalta is FDA-approved to treat chronic musculoskeletal pain. This refers to pain in the bones, muscles, ligaments, nerves, and tendons. Chronic pain is pain that lasts for more than 3 to 6 months.
It isnt known how Cymbalta works to treat chronic musculoskeletal pain.
Effectiveness for chronic musculoskeletal pain
Clinical studies have shown Cymbalta to be effective for treating chronic musculoskeletal pain. These studies involved adults with chronic low back pain or chronic pain caused by osteoarthritis .
In one study, adults with chronic low back pain took either Cymbalta or a placebo every day for 13 weeks. Before the study, people rated their pain on a scale of 0 to 10 . The researchers had people rate their pain again at the end of the study.
The results showed that:
- nearly 45% of people who took Cymbalta had at least a 30% reduction in their pain score
- about 30% of people who took a placebo had at least a 30% reduction in their pain score
Does Cymbalta Help With Pain
If you are struggling with depression or anxiety, your healthcare provider may prescribe you Cymbalta, which is the brand-name of the prescription medication duloxetine.
This medication is primarily classified as an antidepressant, used to treat depression and anxiety but it can also be prescribed for nerve pain.
It has been studied for its success at improving the symptoms of a range of other medical conditions that can cause nerve pain. This includes fibromyalgia, musculoskeletal conditions, arthritis, and chronic low back pain.
While Cymbalta cannot cure the underlying causes of these conditions, it can be used as an effective tool of pain management in addition to other treatments.
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WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health.
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Is Cymbalta A Controlled Substance Is It A Narcotic
No, Cymbalta isnt a controlled substance or a narcotic. Narcotics is another term for opioids, which are a type of pain reliever. Controlled substances are medications that could cause either physical or mental dependence. With dependence, your body needs the drug to feel normal. The Drug Enforcement Administration sets limits on who can make, possess, and use medications that are controlled substances.
Animal studies of Cymbalta didnt show dependence in rats, although animal studies dont always predict what will happen in humans.
However, Cymbalta could cause withdrawal symptoms if you stop taking the drug suddenly. See the Cymbalta withdrawal and dependence section above to learn more.
Clinical studies didnt show any signs that Cymbalta is addictive. Addiction is different from dependence. Addiction is a disease in your brains reward pathways. This disease leads someone to continue using a drug even though its causing serious problems in their life. Over time, someone with addiction needs more and more of a drug to feel its effects.
Although Cymbalta isnt known to cause dependence or to be addictive, its not always possible to predict whether it could be misused. This is because the drug affects your central nervous system . The CNS is where your brains reward pathways are located.
If you have questions or concerns about your risk for dependence with Cymbalta, talk with your doctor.
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Others About Cymbalta: The Length Of Time Does It Require To Work For Pain
- I take Cymbalta and it does aid with my leg pain. Im not sure for how long it was prior to it began to work as Ive been on it for over a year. Some individuals have actually had side effects and your doctor will keep an eye on any side effects you have if any. Its truly helped in reducing the pain and tingling and numbness in my leg though not totally.
- I also take cymbalta for nerve pain in addition to depression. Ive been on it 60mgs/day for several years for depression and my pain mgmt doc increased to 60mgs 2x/day to assist with the nerve pain. I still have the nerve pain as I have 2 damaged screws pressing on the S1 nerve which causes the sciatic pain down my legs so I cant inform if the cymbalta is working. I think I will need to wait and see after surgery if it works. The screws will not be pressing on the nerves at that point however I might have the nerve pain for a bit cuz its been pushing on the nerve for nearly 2yrs.
Side Effects And Risks
Cymbalta and Lexapro have some similar side effects and others that vary. Below are examples of these side effects.
Mild side effects
This list contains 10 of the most common mild side effects that can occur with both Cymbalta and Lexapro :
- headache
for this side effect. This is the most serious warning from the Food and Drug Administration . See the FDA warning: Suicidal thoughts and behaviors section at the beginning of this article to learn more.
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Is Cymbalta An Ssri
No, Cymbalta isnt a selective serotonin reuptake inhibitor . However, its similar to an SSRI.
Cymbalta belongs to a class of medications known as serotonin-norepinephrine reuptake inhibitors . It affects your levels of both serotonin and norepinephrine. SSRIs, on the other hand, only affect your serotonin levels.
If you have questions about whether an SSRI or SNRI is right for treating your condition, talk with your doctor.
Does Cymbalta Make You Sleepy
Its possible that youll feel sleepy while taking Cymbalta. This was one of the more common side effects of the drug in clinical studies. In the studies:
- 10% of people who took Cymbalta reported feeling sleepy
- 3% of people who took a placebo reported feeling sleepy
Because Cymbalta can cause sleepiness, its important to use caution or avoid driving or and operating machinery until you know how the drug will affect you.
If you have questions about side effects from Cymbalta, talk with your doctor or pharmacist. You can also learn more in the Cymbalta side effects section above.
You may wonder how Cymbalta compares with other medications that are prescribed for similar uses. Here we look at how Cymbalta and Lexapro are alike and different.
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