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GENERIC NAME: duloxetine Name: generic Cymbalta (Duloxetine)

DRUG CLASS AND MECHANISM: Duloxetine can be a selective serotonin and norepinephrine reuptake inhibitor (SNRI) used in treating depression, anxiety and pain regarding diabetic peripheral neuropathy or fibromyalgia. Other drugs in this particular class include milnacipran (Savella), venlafaxine (Effexor), and desvenlafaxine (Pristiq). Duloxetine affects neurotransmitters, the substances that nerves round the brain make and release as a way to communicate with the other. Neurotransmitters either travel along the space between nerves and correct to receptors outside the body of nearby nerves or they affix to receptors at first glance from your nerves that produced them, to become taken up with the nerve and released again (a procedure referred to as re-uptake).

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Most pros think that an imbalance among neurotransmitters will be the cause of depression along with other psychiatric disorders. Serotonin and norepinephrine are two neurotransmitters released by nerves from the brain. Duloxetine works by preventing the reuptake of serotonin and epinephrine by nerves once they are already released. Since uptake is the central mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves, time period uptake due to duloxetine increases the effect of serotonin and norepinephrine within the brain. The mechanism accountable for its effectiveness treating pain isn't known and is thought to involve its effects on serotonin and norepinephrine inside brain. Duloxetine was licensed through the FDA in August 2004.

PREPARATIONS: Delayed-release capsules: 20, 30, and 60 mg

STORAGE: Capsules need to be stored at 70 degrees, between 15 to 30 C (59 to 86 F).

PRESCRIBED FOR: Duloxetine can be used to treat depression, generalized anxiety, and pain associated with diabetic peripheral neuropathy or fibromyalgia.

DOSING: The recommended dose for your depression is 20 or 30 mg two times a day or 60 mg once daily. Patients might be began with 30 mg once daily first week prior to the dose is advanced to 60 mg daily. The recommended dose for panic attacks, pain related to diabetic neuropathy or fibromyalgia is 60 mg daily. There isn't any evidence that doses in excess of 60 mg/day provide additional benefits.

DRUG INTERACTIONS: Duloxetine shouldn't be utilized in conjunction with a monoamine oxidase inhibitor (MAOI) including phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and selegiline (Eldepryl), or within A couple weeks of discontinuing the MAOI. A minimum of 5 days need to be allowed after stopping duloxetine prior to starting an MAOI. Mixtures of SNRIs and MAOIs lead to serious, sometimes fatal, reactions including huge temperature, muscle rigidity, rapid fluctuations of heartrate and hypertension levels, extreme agitation progressing to delirium, and coma. Similar reactions may occur if duloxetine is mixed with antipsychotics, tricyclic antidepressants as well as other drugs affecting serotonin from the brain (such as, tryptophan, and sumatriptan (Imitrex).