Mental health medication: Cymbalta

June 25, 2:07 PMSF Mental Health ExaminerPaul Bright

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 Today’s Medication: Cymbalta                                                                                                       

Cymbalta has been advertised on the airwaves as a medication that could treat symptoms of depression. The commercials indicate that if you are feeling down, lack of interest in the fun side of life or unmotivated for a period of time, you might have depression and you should talk to your doctor about taking Cymbalta. The truth is that depression is a real disorder, but it takes more than a couple of symptoms to qualify, and Cymbalta may or may not be what can help you treat the symptoms.

How Cymbalta Works

Before delving into that answer, it is interesting to note that on the Cymbalta website, the answer to a FAQ is this:

How does Cymbalta work?
Although the exact way that Cymbalta works in people is unknown, it is believed to be related to an increase in the activity of serotonin and norepinephrine, which are two naturally occurring substances in the brain and spinal cord.

Duloxetine (Cymbalta’s chemical name) works as an antidepressant in the same way most antidepressants work by targeting neurotransmitters in order to elevate mood. However, Cymbalta targets both norepinephrine and serotonin neurotransmitters which, at the appropriate levels, help regulate your mood to be more positive.  Most only target the serotonin; they are referred to as SSRIs. Sometimes the neurotransmitter receptors in the brain do not properly receive those neurotransmitters, allowing them to be reabsorbed, therefore reducing the amounts needed to control mood. Reuptake inhibitors prevent that reabsorption. Many medications will target just the serotonin; Duloxetine helps control the reuptake of both.

How Well It Works

Compared to other anti-depressants, Cymbalta is just as effective and, in some populations, more effective. An 8-week study of elderly patients with major depressive disorder taking Cymbalta showed that it works very well with them. However, some studies that compared over 100 different trials of 12 different anti-depressants showed that Cymbalta doesn’t work as well overall when compared to people taking Lexapro, Zoloft, Luvox, or Effexor. For Generalized Anxiety Disorder, Cymbalta reports that in their clinical trials, anxiety symptoms were reduced 46 percent versus 32 percent of people who took the placebo.

Side Effects

Some of the risks associated with Cymbalta may question the value of taking it for major depressive disorder versus other antidepressants that work just as well, if not better, with less risk. Nearly 5 percent of patients in trials suffered from dry mouth, constipation and loss of appetite. But the real risks have to do with liver damage. The FDA released a report in October 2005 stating that increased liver damage could occur in patients with diagnosed liver conditions taking Cymbalta.
 

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