The science of pharmacology is advancing more and more to create increasingly effective drugs with fewer side effects. One of these newly created drugs is duloxetine , which was first marketed in 2004.

Throughout this article we will talk about the properties and form of action of this antidepressant , as well as the disorders in which it is administered, its side effects and the precautions that those who consume it should take into account.

What is Duloxetine?

Duloxetine, commercially known as Cymbalta, is an antidepressant that falls under the category of Serotonin and Noradrenaline Reuptake Inhibitors, or SNRIs. As such it exerts an effect on the levels of these two neurotransmitters, which work to regulate people’s mood.

The good tolerance of duloxetine has made it a drug of choice for the treatment of major depression and to combat the symptomatic pain of diabetic neuropathy and fibromyalgia.

The research carried out on the effectiveness of this drug reveals that the usefulness of duloxetine stands above other antidepressant drugs thanks to its dual mechanism of action. Thus, it is more effective than traditional Selective Serotonin Reuptake Inhibitors (SSRIs) in encompassing and reducing the intensity of symptoms and therefore achieving a much more successful remission.

Finally, like other antidepressant drugs in this category, it also exerts a mild dopamine reuptake inhibitory effect , making it a fairly complete antidepressant.

What disorders is it used for?

The disorders and conditions in which an antidepressant such as duloxetine is given are varied and range from psychological disorders such as major depression and generalized anxiety disorder to physical illnesses such as pain caused by peripheral neuropathic conditions, chronic low back pain, osteoarthritis, or fibromyalgia.

In addition, is also prescribed in the early stages of stress urinary incontinence . This type of incontinence is one in which the person suffers some urine leakage while performing physical or stress activities. It can also occur when coughing, lifting heavy objects, or performing physical tasks.

In any case, the use of this drug can only be given by medical indication, and it is also essential to follow exactly the indications given by the professional.

1. Major depression

In major depression the patient presents a symptomatology that is characterized by a low mood , invasive and persistent. It is usually accompanied by low self-esteem and anhedonia or lack of interest and enjoyment in activities that before the depression were perceived as pleasant.

Generalized anxiety disorder (GAD)

This condition is distinguished by causing a person to have persistent feelings of fear and worry related to any aspect of daily life. The person is completely unable to control this uneasiness which ends up generating other physical and psychological discomforts and interfering with the patient’s daily activities .

3. Peripheral neuropathic pain

Neuropathic pain is that product of an injury or disease that acts on the somatosensory system. Its main symptoms are: allodynia or when a harmless stimulus provokes a disproportionate pain response, and hyperalgesia or when a mild painful stimulus produces an accentuated pain reaction.

4. Chronic low back pain

Duloxetine has also proven to be very effective in the treatment of chronic low back pain. This pain appears in a localised manner at the level of the lumbar region of the spine and should last for more than three months.

5. Osteoarthritis

Osteoarthritis pain is caused by damage to the cartilage that lines the end of the bones in the joints . This causes direct friction of the bones which results in pain, swelling and impaired joint movement.

6. Fibromyalgia

Fibromyalgia is a chronic condition that is distinguished by causing a musculoskeletal type of pain in those patients who suffer from it, without it having an organic origin that justifies it.

How is this drug administered?

Duloxetine is produced in time-release capsules to be taken by mouth. This means the active ingredients are not released until they reach the intestine and thus avoid the gastric acids of the stomach which could interfere and spoil the effect of the medication.

The treatment will be started gradually, initially with a low dose which will be increased once a week. In the treatment of anxiety, the amount will normally be one or two daily doses, depending on the patient’s condition, while in other cases doctors usually prescribe a single dose per day .

In any case, the patient must follow the instructions given by the doctor to the letter. In no case may the patient vary the dose on his own, nor take it more times than indicated.

What are the side effects?

Like other serotonin and noradrenaline reuptake inhibitor drugs, duloxetine has a number of side effects . However, they are not all serious and are more manageable than those caused by other antidepressants. In addition, these are significantly reduced if it is consumed with food.

Unwanted side effects can be divided into serious and non-serious. In the first case, the patient should contact his doctor if the side effects become worse or longer, while in the second case he should report them immediately.

Non-serious side effects

The side effects of Duloxetine that are considered minor are as follows.

  • Gastric problems.
  • Vomiting.
  • Lack of appetite .
  • Dry mouth.
  • Problems with urination.
  • Dizziness .
  • Headaches.
  • Sweating and/or night sweats.
  • Feeling of fatigue.
  • Weakness.
  • Drowsiness .
  • Muscle pain and/or spasms.
  • Altered sexual desire and/or ability.
  • Uncontrollable tremors .

Serious side effects

This psychoactive drug also has other, more serious side effects. They are as follows.

  • Skin alterations and itching.
  • Bleeding and/or bruising for no apparent reason.
  • Swelling of the abdomen.
  • Yellowish eye colouring .
  • Dark-colored urine.
  • Extreme fatigue.
  • Confusion .
  • Vision problems.
  • Fever .
  • Flu symptoms.
  • Blisters, rash and/or hives .
  • Breathing and swallowing problems
  • Inflammation in various areas of the body.
  • Hoarseness.

Precautions to be taken

It is necessary for the patient to report any allergies, illnesses, conditions or special health conditions that could interfere with the effectiveness of the treatment.

In addition, you will also need to provide information about any medication, vitamin supplements or natural complexes that the patient is taking at the time of starting treatment with duloxetine, as well as his/her alcohol consumption habits.

Due to the sedative effects of this antidepressant, patients may experience confusion or impaired judgment , so they should avoid or take special precautions when driving or operating heavy machinery.

In cases of pregnancy and lactation should only be administered in cases where it is demonstrated that there is no risk to the fetus or baby, since duloxetine can be excreted by breast milk.