Cymbalta is the brand name of duloxetine and is classified as a selective serotonin reuptake inhibitor (SSRI). The medication is prescribed by a physician and is used to treat several medical conditions including anxiety and depression.
Cymbalta (Duloxetine) Prescription Facts
Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant that has been FDA approved to treat major depressive disorder (MDD), generalized anxiety disorder (GAD), diabetic peripheral neuropathic pain (DPNP), fibromyalgia, and chronic musculoskeletal pain. Prescribed dosages of Cymbalta are usually the same regardless of the medical condition being treated. This dosage usually begins at 20 mg twice a day. Often, the dosage is later increased to 30 mg twice a day, eventually increasing to 60 mg once a day. The maximum dose can be as high as 120 mg a day.
Duloxetine may be taken for weeks before signs of improvement appear. Improvement in physical symptoms like sleep, appetite and energy generally happen faster, typically within two weeks. An improvement in mood can take as long as eight weeks to take effect.
For those under age 25, antidepressants including Cymbalta may increase the risk of suicide 2-fold in children and adolescents and 1.5-fold in anyone from the age of 18 to 24.
Adults prescribed Cymbalta for depression should be monitored for an increase in suicidal thinking or behavior, especially during the first few weeks of treatment or during a dosage change.
Cymbalta (Duloxetine) Regulations and Abuse
Duloxetine is a member of the class of drugs called selective serotonin/norepinephrine reuptake inhibitors (SNRIs). It is not a scheduled drug under the Controlled Substance Act since it does not cause dependency or lead to misuse. However, a prescription from a doctor is required to obtain duloxetine.
Cymbalta is very rarely misused. Misuse of duloxetine includes snorting or taking a large dosage in a short amount of time.
How Cymbalta (Duloxetine) Affects the Brain and Body
Duloxetine is an SNRI, a serotonin and norepinephrine reuptake inhibitor. It works by altering the levels of serotonin and norepinephrine, two important neurotransmitters in the body’s central nervous system.
Serotonin and norepinephrine both occur naturally in the brain and spinal cord. They help control a person’s emotional responses and then transfer those responses to other parts of the brain. Both serotonin and norepinephrine also help the body mitigate pain.
Because low levels of these neurotransmitters have been linked to depression, Cymbalta works to treat depression by raising the levels of these neurotransmitters and changing their natural behavior. Duloxetine does not let the body’s cells absorb the serotonin and norepinephrine, leaving increased levels in the brain. This allows the brain to fight more effectively against depressive moods and pain.
Cymbalta also has some analgesic or pain-killing effects. It assists in controlling pain symptoms associated with fibromyalgia, bone pain and diabetic neuropathy. This effect is believed to be caused by duloxetine’s sodium ion channel blockade.
Half-Life of Cymbalta (Duloxetine)
Once the last dosage of duloxetine has been taken, it can take up to two and a half days to leave the body almost completely (99 percent). However, 50 percent of the duloxetine will have left the body within approximately 12 hours, with a range between 8 and 17 hours. Withdrawal symptoms from the discontinuation of Cymbalta usually begins when at least 90 percent of the drug has cleared from your system.
Factors That Influence How Long Cymbalta (Duloxetine) Stays in the System
While Cymbalta leaves the system relatively quickly (almost completely in two and a half days), the results of discontinuing the drug can lead to withdrawal that lasts much longer. The length of withdrawal depends on the length of time Cymbalta was taken, the dosage taken, a person’s individual physiology, and the sudden stopping or tapering off of the drug. Typically, for a lower dosage of duloxetine and a shorter period of use, withdrawal symptoms are likely to be less severe and not last as long. Also, tapering off duloxetine rather than abruptly discontinuing use will lessen the length and severity of withdrawal as well.
How Long Does Cymbalta (Duloxetine) Stay in Urine, Hair and Blood?
The idea that antidepressants like Cymbalta can show up in urine, hair and blood when a person takes a drug test may worry those who don’t want their condition to be public, particularly because of the stigma associated with a diagnosis of depression.
However, a drug screening must specifically be looking for antidepressants in order to detect them. Because antidepressants are not typically misused, employers have no reason to include that in their drug-screening.
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