Why I Quit Taking Cymbalta for Fibromyalgia?

by M G Rana, MD.

Cymbalta

Cymbalta belongs to a class of medications called serotonin and norepinephrine reuptake inhibitors (SNRIs). Cymbalta was previously approved by the FDA for the treatment of depression, generalized anxiety disorder, and diabetic peripheral neuropathic pain. The agency approved Cymbalta for the management of fibromyalgia in adults in June 2008. On the surface, duloxetine seems like an ideal drug. It will ease your pain and relieve any related depression. Not surprisingly, Cymbalta became very successful. Today, the generic duloxetine formulation is prescribed quite frequently.

How does Cymbalta works?

How Cymbalta helps make patients with fibromyalgia feels better is not clearly understood by the scientists; fibromyalgia itself is poorly understood. Many scientists think that the pain is due to changes in the nervous system which cause nerve cells to fire off too many signals down pain pathways. This makes a person overly sensitive to things that would normally not be painful. By increasing the level of two naturally occurring substances called serotonin and norepinephrine cymbalta helps calm down these pain signals. These substances can affect mood and are believed to help control and suppress feelings of pain and they are found in the brain and other parts of the nervous system.  Cymbalta and other SNRIs block serotonin and norepinephrine from re-entering cells, and therefore increase the levels of these substances. In patients with fibromyalgia this process is thought to improve mood and alleviate pain.

Side effects

The most universal side effects were vomiting, dry mouth, constipation, decreased hunger and anorexia in the fibromyalgia study of Cymbalta. The most widespread side effects were nausea, dry mouth, constipation, decreased hunger, exhaustion, sleepiness, and increased sweating in clinical studies of Cymbalta for depression.

How to consume Cymbalta

Cymbalta is available in the form of a capsule that you take by mouth once a day. Doctors suggest that the dose should be 60 milligrams a day. On the other hand, your doctor will likely tell you to take 30 milligrams a day for the first week, before increasing you to the full dose. It is important to keep in mind that there is no evidence to suggest that taking more than 60 milligrams a day will further reduce your pain. Actually, doing so enhances your chances of side effects.

Warnings

Cymbalta and other antidepressants may increase the risk for suicidal thoughts and behaviors in people under age 24. When you are prescribed Cymbalta after that your doctor will observe you closely for strange behavior changes, new or aggravating signs of depression, or suicidal thoughts. Cymbalta may decrease salt (sodium) levels in the blood, a potentially serious condition called hyponatremia. Older adults, particularly those who take diuretics (“water pills”) are more likely to develop this complication. Headaches, confusion, weakness, and in extreme cases hyponatremia can lead to fainting, seizures, coma, and death.

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Withdrawal symptoms

Although such side effects are creepy, there is another setback with Cymbalta. When people try to stop taking this drug they frequently report unpleasant withdrawal symptoms including blackouts, suicidal thoughts, tremor, and vomiting. Several cases involved hospitalization. One patient stated that “I have been on Prozac over the last 20 years off and on and it finally stopped working. I was taking the generic from Barr the blue and white capsule and this was the last time I took it. I was feeling as if I were in the deepest dark hole there ever was.

“My doctor prescribed me Cymbalta from which I had a lot of side effects such as palpitations, feeling constant dread, panic attacks, sweats, lightheadedness and general feeling of not being well. “She added Abilify which put me over the edge. I was in the worst depression I have ever been in. Finally after living like this for several months, I asked to be put back on Prozac. I was taking the generic from Sandoz. I ended up on the big blue and white capsules from Barr when the prescription ran out.

“It has been constant crying spells over the last couple of weeks, quarrelling with everyone and feeling pretty low. I discussed it with my doctor and she wrote the prescription for Sandoz only generic. The blue and white capsules are like taking a placebo. My doctor said she had had other patients who complained of the same thing and she had to write prescriptions for a certain generic or name brand.”

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Who should not take Cymbalta

You should not take Cymbalta if you Are taking a medication called thioridazine or you are taking a medicine called MAOI or have used one in the last 14 days or you have uncontrolled narrow-angle glaucoma. It has been confirmed that Cymbalta has adverse effects on a developing fetus in animal studies. In pregnant or breastfeeding women not sufficient or well-controlled studies of the drug have been done. Women should talk to their doctor about whether or not Cymbalta is right for them who are breastfeeding, pregnant, or planning to become pregnant.

You should only take Cymbalta if the benefits outweigh the risks. In rare cases, a life-threatening condition called serotonin syndrome has occurred in patients who have taken Cymbalta. When someone takes two or more medications that increase the body’s serotonin levels at the same time then most often it can lead to Serotonin syndrome. Serotonin is necessary for your brain and nerve cells to function, but too much of it can be unsafe.

Serotonin syndrome can cause quick changes in blood pressure, muscle rigidity, seizures, and may even leads to death. This is why it is so important that your health care providers know what medications you are taking. Always tell them about all the medicines you take, including over-the-counter drugs and herbs and supplements.

Also Read:

9 Side Effects of Some of Fibromyalgia Drugs you are not familiar with

References:

  • why i quit taking cymbalta for fibromyalgia via Pro Health
  • Cymbalta for Fibromyalgia via Drugs.com
  • via Medical News Today

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