Mental Health


Duloxetine: medicine to treat Depression, Anxiety, and Diabetic Neuropathy

By A.S. (staff writer) , published on January 09, 2021

Medicine Telehealth Health Duloxetine Dose GAD Diabetic Neuropathy Fibrmyalgia



 

 

Duloxetine is used for the treatment of depression, generalized anxiety disorder, pain associated with diabetic peripheral neuropathy, fibromyalgia, and chronic musculoskeletal pain.

Duloxetine is a prescription drug. It comes under the Brand name

CYMBALTA, Irenka.

Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor that comes under the category of anti-depressant (SSRI) drugs. It inhibits the reabsorption of serotonin and no-epinephrine neurotransmitter by blocking NET (norepinephrine transporter) and SERT (serotonin reuptake transporter) in the brain. It increases the level of serotonin and norepinephrine in the bloodstream. Duloxetine is thought to work by increasing the amount of mood-elevating chemicals serotonin and norepinephrine.

Serotonin is a naturally occurring neurotransmitter that plays a key role in:

  • Mood regulation

  • Gastrointestinal function

  • Pain perception

 

Nor-epinephrine, both a hormone and a neurotransmitter. It affects how people perceive;

  • Pain

  • Mood

  • Emotions

  • Blood pressure

  • Thought processes

In short, it works by balancing chemicals in the brain that cause anxiety and depression.

 

 

What’s Duloxetine used for?

 

Duloxetine is used to treat

  • Generalized anxiety disorder (GAD)

  • Major depressive disorder

  • Nerve pain caused by diabetes (Peripheral Diabetic Neuropathy)

  • Fibromyalgia pain

  • Chronic muscle and joint pain

Duloxetine is available as a capsule or a delayed-release capsule

 

 

 

Mechanism of Action of Duloxetine

 

Duloxetine belongs to a class of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs). Duloxetine inhibits the reuptake of both serotonin and norepinephrine, thus combining two therapeutic mechanisms in one agent to treat depression and anxiety.

It works by increasing the amounts of serotonin and norepinephrine, natural substances in the brain. This drug increases the level of these chemicals by blocking their uptake in synaptic terminals; that help maintains mental balance. Duloxetine also helps inhibit pain signals from your nerves to your brain, effective for managing fibromyalgia, peripheral diabetic neuropathy, and chronic musculoskeletal pain.

 

 

Dosage and Strength of Duloxetine

 

Capsule, delayed-release

  • 20mg (Cymbalta, Drizalma Sprinkle, generic)

  • 30mg (Cymbalta, Drizalma Sprinkle, generic)

  • 40mg (Drizalma Sprinkle, Irenka)

  • 60mg (Cymbalta, Drizalma Sprinkle, generic)

 

Dose for Depressive Disorder

People who have an anxiety disorder might start the drug by taking 40-60 mg (in single daily dose or divided q12hr for 1 week if patient needs to adjust to therapy)

Initial dosages for people with conditions like; Major depressive disorder; 40-60 mg per day with some people starting at 30 mg per day.

 

Dose for Peripheral Diabetic Neuropathic Pain

Duloxetine is also used to treat pain and tingling sensation caused by nerve damage associated with Diabetes (Peripheral Diabetic Neuropathy).

60 mg/day per oral (PO) initially (in single daily dose or divided doses per 12hr); consider lowering dosage if symptoms are manageable.

 

Dose for Fibromyalgia and Chronic Musculoskeletal Pain


30 mg/day for fibromyalgia initially for 1 week to allow for therapy adjustment. The target dosage is 60mg/day PO.

Treatment of chronic musculoskeletal pain, including discomfort from osteoarthritis and chronic lower back pain

30 mg/day PO initially for 1 week to allow for therapy adjustment.

 

 

How this medicine is used?

 

Duloxetine comes as a delayed-release capsule to take by mouth. For depression, anxiety, and nerve pain, you'll usually take duloxetine 30mg-60mg once a day or in divided doses q12 hrs.

For stress urinary incontinence, duloxetine comes in 20mg and 40mg capsules.

Take duloxetine exactly as directed. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take duloxetine at around the same time(s) every day.

 

 

 

Duloxetine Possible Side Effects

 

  • Dizziness

  • Constipation

  • Excessive sweating

  • Diarrhea

  • Right upper abdominal pain

  • Itching

  • Changes in blood pressure and falls. Monitor your blood pressure before starting and throughout treatment

  • Decrease in blood pressure when standing and cause dizziness or fainting, mostly when first starting Duloxetine (Cymbalta) or when increasing the dose.

 

 

Precaution

                                     

Precaution should be taken while taking duloxetine because it can also lead to “serotonin syndrome”, which can lead to potentially fatal conditions that can cause agitation, hallucinations, and coma with other symptoms.

 

 

References

 



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