Cymbalta and fibromyalgia
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Fibromyalgia (FM) is a condition that arises from abnormalities in central neurotransmitter processing. many medicantions that modify neurotransmitter activity appear to work for FM. Cymbalta or duloxetine is a drug that enhances neurotransmitter activity.
It is currently available for treatment of depression. It increases levels of serotonin and norepinephrine. In an early study, it reduced fibromyalgia pain.
Cymbalta was approved for treatment of fibromyalgia in the second quarter of 2008.
It should be started at a low dose and slowly increased. While the usual starting dose is 30 mgs, there is a 20 mg dose also available. Most patients with FM wind up being on 30-90 mgs.
The mechanism of action is through the mediation of both nor-epinephrine as well as serotonin pathways.
Cymbalta is generally well-tolerated but needs to be escalated in dosage slowly.
It can be combined with other neurotransmitter acting drugs which have different mechansims of action. Examples are the combination of Cymbalta with GABA stimulators such as neurontin or Lyrica.
Rheumatologists in clinical practice appear to be using this drug more for the management of fibromyalgia.
Get more information about cymbalta and fibromyalgia as well as...
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