Information For Patients On CYMBALTA (DULOXETENE)

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Information For Patients On CYMBALTA (DULOXETENE)

AIM:  This medication is intended to correct the chemical changes in your body, which are associated with anxiety and depressive illness.  This normally takes 3 to 4 weeks, but Cymbalta has a short half-life  (the time it takes to metabolise the medication) and seems to work very quickly in some patients.  This medication is a new antidepressant, designed to improve transmission of chemical messages in the brain using the chemical pathways current research suggests are most relevant in depressive illness, being both the serotonin and noradrenaline pathways.  

We know that the vast majority of individuals with depressive illness will benefit from one of the available antidepressant agents, but it is not possible to predict which particular medication is best suited to any individual patient’s chemistry, so that the antidepressant first prescribed may need to be changed after some time if it is not effective.  Any antidepressant has a 70% chance of helping an individual 

DOSAGE: To reduce possible side effects, start with a low dose for 2 days (open the capsule, pour out half of the pellets, reseal the capsule and swallow this lower dose) and then take one capsule a day, usually in the morning after food.   If it makes you tired or sleepy, you can take it in the evening or at bedtime, as this medication usually does not interfere with sleep.

IMPORTANT: Taking the medication after food lessens the risk of nausea.

SIDE EFFECTS: Most side effects will subside within a few weeks.  You may experience some, or none, of the following:

  1.  Tiredness, or lack of energy:  Try taking smaller doses more frequently, or more of the medication at night.  Avoid driving or using machinery if you are not fully alert. 
  2. Dry mouth, constipation, or blurring of vision:  The antidote medication Urocarb may help with these effects.  Laxatives may be useful.  If you develop dry mouth, good dental hygiene is important, due to the absence of protective saliva.  Bitter drinks or sugar free gum may help.
  3. Nausea: Take the medication after food. Maxolon or Stemetil may help.
  4. Headache:  This can be a problem and may last a few weeks in some people.   Paracetamol may help.
  5. Sexual difficulties – these are usually related to the dose of the medication you are taking.

 

LENGTH OF TREATMENT: Once you recover, you will need to keep taking the tablets for some months afterwards, to prevent the chemical imbalance from returning.  These tablets are not at all addictive. However, do come off them slowly to avoid withdrawal symptoms such as electic shock sensations, dizziness, or feeling you have the flu.

 PRECAUTIONS: Do not take these tablets if you have taken Parnate or Nardil within the previous 2 weeks, if you intend becoming pregnant in the next month, if you are taking Tramadol (painkiller), or if you are driving or using machinery and the medication makes you drowsy

USE OF ALCOHOL: You can have a small amount of alcohol safely with these tablets, but  one drink may have the effect of 2 or 3 drinks

COUGHS & COLDS: The warning not to take Sudafed, Sinutabs etc if taking antidepressants does not apply to this medication.

This information is intended to improve your knowledge of the treatment you are receiving.  Any further points can be discussed at your next consultation with me.

MAY BE REPRODUCED FOR GENERAL PATIENT USE, BUT PLEASE ACKNOWLEDGE SOURCE

DR DAVID HORGAN ACCEPTS RESPONSIBILITY ONLY FOR HIS OWN PATIENTS