I have battled chronic depression since my adolescence. Years of therapy and rigorous exercise helped little until I started taking the new-generation anti-depressants. For the last 15 years or so, I have had (temporary) good results with a series of these: Zoloft worked well for some years, then lost its efficacy. A couple of years ago, rather than change to a new drug when the Cymbalta started to work less well, my doctor prescribed Provigil as an adjunct to it. Because my insurance will not cover the drug for off-label use (I don't have narcolepsy, just depression), the cost of the prescription drug is prohibitive, so I have been buying modafinil from overseas pharmacies, and have mostly had good luck with these sources (once, the product delivered seemed inert). I find myself not depressed, have normal levels of energy (like other people, instead of feeling barely able to get out of bed), have little in the way of side effects. I am more prone to motion sickness or other nausea than when not taking the drugs, but the problem is mild. The one concern I have is that I have found that cutting the dose (as I did once for several days when I didn't place the online order in time) seems to have a dramatic negative effect. A couple of days at 100 mg/day instead of 200mg/day had me sleeping 12 or 14 hours/night and dragging myself around feeling exhausted, and after 3 or 4 days at the lower dose, I experienced a pretty serious bout of depression (uncontrollable weeping; ruminative, self-lacerating thoughts; generally excruciating misery). A day or so back on the full dose put me right, but it has left me a bit nervous about the prospect of ever getting completely off the drugs. Duloxetine (Cymbalta) is a serotonin and norepinephrine reuptake inhibitor in the same class as venlafaxine (Effexor). In Europe it is marketed for the treatment of stress urinary incontinence; it is not approved for that indication in the United States. In one open-label study1 there were seven suicide attempts among 1,279 patients in one year (one suicide attempt per 115 patient-years of drug exposure) and no cases of fatal acute overdose. Food and Drug Administration (FDA) for use in the treatment of major depressive disorder and of diabetic peripheral neuropathic pain. Duloxetine should not be used in patients taking a monoamine oxidase inhibitor (MAOI), including a period of five days before initiation of the MAOI and 14 days after its discontinuation.2 Duloxetine is metabolized extensively by cytochrome P450 enzymes 1A2 and 2D6. Duloxetine plasma concentrations may be increased significantly by some antidepressants, quinidine, and quinolone antibiotics. Duloxetine may increase the plasma concentrations of other antidepressants, antipsychotics, and type 1C antiarrhythmics such as propafenone (Rythmol) and flecainide (Tambocor). Serum alanine transaminase levels increased to more than three times the upper limit of normal in about 1 percent of patients taking duloxetine in placebo-controlled trials2; alcohol may increase this risk. However, there have been no reports of hepatic failure. Prednisone horses Tamoxifen or letrozole Valtrex other uses Jan 3, 2014. Duloxetine is a drug used to treat depression and urinary urge. from eight studies performed by the manufacturers of duloxetine that doses of. Duloxetine only comes as a capsule you take by mouth. Duloxetine oral capsule is used to treat anxiety, depression, diabetes nerve pain, fibromyalgia, and chronicdizziness or fainting when standing. This may occur more often when you first start duloxetine or when you increase the dose. Duloxetine is safe and effective for the treatment of major depressive disorder. Duloxetine Cymbalta is a serotonin and norepinephrine reuptake inhibitor in the same class as venlafaxine Effexorclinical trials for depression, the discontinuation rate in patients receiving duloxetine. Duloxetine hydrochloride is a type of antidepressant called a serotonin and noradrenaline reuptake inhibitor (SNRI). It works by enhancing the activity of the neurotransmitters serotonin and noradrenaline in the brain. Neurotransmitters are natural body chemicals that act as chemical messengers between the nerve cells. Serotonin and noradrenaline are neurotransmitters known to be involved in regulating emotions, mood and behaviour, among other things. In depression and anxiety disorders less serotonin and noradrenaline than normal is released from nerve cells in the brain. Duloxetine works by stopping the serotonin and noradrenaline that has been released from being reabsorbed back into the nerve cells in the brain. This helps to prolong their effects and over time this helps to lighten mood and relieve depression. Restricted benefit Duloxetine (Cymbalta) 30 mg and 60 mg capsules can be prescribed on the Pharmaceutical Benefit Scheme (PBS) for people with a major depressive disorder.1 The 30 mg capsule is listed as a month's supply with no repeats. People with renal impairment who require this strength on an ongoing basis will need an authority for any repeats. The Pharmaceutical Benefits Advisory Committee (PBAC) considered duloxetine to be as effective as venlafaxine (Efexor-XR), but with more adverse effects in the first 6 weeks of therapy. In the following 6 weeks the incidence of adverse effects was similar for the two drugs.2 The PBAC had previously accepted as plausible the argument that the discontinuation rate with duloxetine could be reduced by slower dose titration. However, it remained concerned that in trials twice as many people stopped taking duloxetine because of adverse events as stopped taking venlafaxine. 3 Antidepressants are effective in moderate or severe major depressive disorder. There are many different antidepressants available in a number of classes, with similar efficacy but differences in adverse effects. Duloxetine dose for depression DULOXETINE Drug BNF content published by NICE, Duloxetine Side Effects, Dosage, Uses, and More Zovirax buy online May 1, 2007. Especially for patients with moderate to severe depression. The recommended starting dose of duloxetine is 20 mg taken twice a day, for a. Questions & Answers Advantages of Cymbalta for depression.. Duloxetine Cymbalta for Treatment of Major Depressive. Duloxetine Cymbalta, Antidepressant, Side Effects, Dosing, Uses. Mg PO qd Start 20-30 mg PO bid; Max 120 mg/day; Info may start 30 mg PO qd x1wk if tolerability concern; doses 60 mg/day rarely more effective, may. Medscape - Generalized anxiety disorder, major depressive disorder, fibromyalgia-specific dosing for Cymbalta duloxetine, frequency-based adverse effects. Depressed mood - feeling sad, empty, or tearful; Feeling worthless, guilty. Missing doses of duloxetine may increase your risk for relapse in your symptoms.