Cymbalta is one among the many medications that are prescribed for treating certain conditions including MDD (major depressive disorder) and generalized anxiety disorder. It is also prescribed for treating certain types of chronic pain conditions – neuropathic pain, fibromyalgia, and chronic musculoskeletal pain. Patients and caregivers often try to ascertain the time taken for results from the medication, apart from the onset of action, due to the nature of the conditions. Following sub-sections offer a detailed look at the drug, mechanism of action and effects, offering patients in-depth information. This also answers the question – how long does it take for Cymbalta to work?
Overview and mechanism of action of Cymbalta
Belonging to the category of serotonin-norepinephrine reuptake inhibitors (SNRIs) Cymbalta is available in capsule form and is typically taken once daily. It works by inhibiting the reuptake of two neurotransmitters, serotonin and norepinephrine. These are important neurotransmitters that play a role in regulating mood, anxiety, and pain perception. Cymbalta works by blocking the reuptake of serotonin and norepinephrine in the presynaptic neurons, which increases their concentration in the synaptic cleft between neurons. This increased concentration of neurotransmitters in the synaptic cleft leads to enhanced neurotransmission, which can improve mood, reduce anxiety, and modulate pain perception.
The drug is known to have a higher affinity for the serotonin transporter than the norepinephrine transporter, and this increases the levels of serotonin in the brain. It exercises some effect on norepinephrine levels, and this is known to contribute to its efficacy in treating certain types of pain.
Side effects of Cymbalta
All medications come with the likelihood of undesirable outcomes and Cymbalta is no exception. Some of the effects are typically mild in nature while some are adverse. Depending on the intensity, and the persistent nature of the effects it may be necessary to take remedial actions to prevent the effects from turning serious in nature. Here are some of the most commonly reported side effects of Cymbalta.
- Nausea
- Dry mouth
- Constipation
- Diarrhea
- Decreased appetite
- Fatigue
- Drowsiness
- Insomnia
- Headache
- Dizziness
- Sweating
- Sexual dysfunction
- Increased blood pressure
- Suicidal thoughts or behaviors
- Manic episodes
- Serotonin syndrome
- Abnormal bleeding
- Liver damage
- Seizures
In the event of certain side effects, it is necessary to seek urgent medical intervention. For instance, symptoms of serotonin syndrome, suicidal tendencies or sudden spike in blood pressure levels. Other mood related symptoms such as manic disorder also require the attention of specialist medical professionals.
Drug interactions of Cymbalta
In addition to the side effects of drugs, there is also the possibility of drug interactions. Cymbalta is likely to interact with various medications, and this could have an impact on the effectiveness or it could increase the risk of side effects. Medications that may interact with Cymbalta include the following listed below. This is not a comprehensive or exhaustive list and is intended to only serve as a broad reference.
- Monoamine oxidase inhibitors (MAOIs)
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Triptans
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Aspirin and other salicylates
- Warfarin and other blood thinners
- Antiplatelet drugs
- Antidepressants
- Antipsychotics
- Benzodiazepines
- Stimulants
Cymbalta may also interact with certain herbal supplements, including St. John’s Wort, and alcohol. The risk of bleeding may also increase when the drug is taken with other medications, such as blood-thinners.
How long does it take for Cymbalta to work?
With the basic information above, it is time to answer the question. The length of time it takes for Cymbalta to start working may vary and depend on the condition being treated. Overall, it may take many weeks for noticeable or significant improvements in mood, anxiety, or pain.
For depression and anxiety, it usually takes between 2 to 4 weeks for the full therapeutic effect of Cymbalta to be experienced. However, it is possible for some patients to notice improvements in symptoms earlier, within the first week of treatment.
For chronic pain conditions such as fibromyalgia and neuropathic pain, it may also take few weeks before improvements in pain are experienced. It is important to add here that Cymbalta may not be effective for pain relief in some instances, and it may then be necessary to choose other alternative treatment options.
Any abrupt cessation of the medication or modification of dosage may result in withdrawal symptoms or other complications. It is necessary to seek medical guidance regarding discontinuation or dosage modification.
Categories of patients advised to avoid the drug
The drug may not be appropriate for all patients, and certain individuals are cautioned against using Cymbalta. The actual use or inapplicability will be determined by treating specialists and this is intended to only serve as a reference. Here is a small compilation of some of the categories of patients who may not be suitable to take the drug.
- Patients allergic to duloxetine or any of the ingredients in the medication
- People on monoamine oxidase inhibitors (a gap of two weeks since last use is mandatory)
- Patients with uncontrolled narrow-angle glaucoma, severe liver disease or kidney disease
- Individuals with a history of seizures or epilepsy, manic episodes or bipolar disorder
- Pregnant women or breastfeeding women
What are the different medications for MDD?
Various medications are available for treating Major Depressive Disorder. All antidepressants may not work for everyone with the condition, and identification or narrowing down the options to the best medication may take some time. This will also include the comparison of side effects, and factoring in other medications in use, as this will also help in pre-empting possible drug interactions. In addition to medications, it is necessary to bring about lifestyle changes and undergo psychotherapy to effectively treat MDD. Medications to treat MDD include the following:
- Selective serotonin reuptake inhibitors – drugs like fluoxetine, sertraline, and escitalopram.
- Serotonin-norepinephrine reuptake inhibitors – drugs like duloxetine and venlafaxine.
- Tricyclic antidepressants (TCAs) – drugs like amitriptyline and imipramine.
- Monoamine oxidase inhibitors (MAOIs) – drugs like phenelzine and tranylcypromine. These medications, however, have dietary restrictions and are known to interact with other medications. Therefore, this is not the first line of treatment or the first option, but is prescribed only when other treatment regimens have failed.
- Atypical antidepressants – drugs like bupropion and mirtazapine.
