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Cymbalta (Duloxetine)

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Cymbalta is used to treat depression in adults and generalized anxiety disorder (GAD; excessive worry and tension that disrupts daily life and lasts for 6 months or longer) in adults and children 7 years of age and older.

Other names for this medication:
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Also known as: Duloxetine


Cymbalta (duloxetine) is a selective serotonin and norepinephrine reuptake inhibitor antidepressant (SSNRI). Duloxetine affects chemicals in the brain that may be unbalanced in people with depression.

Cymbalta is used to treat major depressive disorder in adults. It is also used to treat general anxiety disorder in adults and children who are at least 7 years old.

Cymbalta is also used in adults to treat nerve pain caused by diabetes (diabetic neuropathy), or chronic muscle or joint pain (such as low back pain and osteoarthritis pain).

Cymbalta is also used to treat fibromyalgia (a chronic pain disorder) in adults and children at least 13 years old.


Usual Adult Dose for Depression:

Initial dose: 20 mg to 30 mg orally 2 times a day Maintenance dose: 60 mg per day, given either once a day OR 30 mg orally 2 times a day Maximum dose: 120 mg/day.

Usual Adult Dose for Fibromyalgia:

Initial dose: 30 mg orally once a day for at least 1 week Maintenance dose: 30 to 60 mg orally once a day.

Usual Adult Dose for Generalized Anxiety Disorder:

Initial dose: 60 mg orally once a day Maintenance dose: 60 to 120 mg orally once a day Maximum dose: 120 mg/day.

Usual Adult Dose for Pain:

Initial dose: 30 to 60 mg orally once a day Maintenance dose: 60 mg orally once a day.

Usual Adult Dose for Neuropathic Pain:

Initial dose: 30 to 60 mg orally once a day Maintenance dose: 60 mg orally once a day.

Usual Adult Dose for Chronic Pain:

Initial dose: 30 to 60 mg orally once a day Maintenance dose: 60 mg orally once a day.

Usual Geriatric Dose for Generalized Anxiety Disorder:

Initial dose: 30 mg orally once a day for at least 2 weeks Maintenance dose: 60 mg orally once a day Maximum dose: 120 mg/day.

Usual Pediatric Dose for Generalized Anxiety Disorder:

7 to 17 years: -Initial dose: 30 mg orally once a day for at least 2 weeks -Maintenance dose: 30 to 60 mg orally once a day -Maximum dose: 120 mg/day.

Usual Pediatric Dose for Fibromyalgia:

13 years and older: -Initial dose: 30 mg orally once a day for at least 1 week -Maintenance dose: 30 to 60 mg orally once a day.

Detailed Cymbalta dosage information


If you overdose Generic Cymbalta and you don't feel good you should visit your doctor or health care provider immediately.


Store at a room temperature between 4 and 30 degrees C (39 and 86 degrees F) away from moisture, light and heat. Throw away the after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Cymbalta are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


Do not take Cymbalta if you are allergic to Duloxetine, other SNRIs or to any of the medication's components. Do not take Cymbalta if you have taken recreational drugs such as ecstasy (MDMA), ketamine, LSD, poppers (amyl nitrate), narcotics or benzodiazepines. Do not take Cymbalta if you are taking other medications, including erythromycin, alpha-blockers, antifungal medications (ketoconazole and itraconazole), medications for HIV (ritonavir, saquinavir, nelfinavir and atazanavir), certain antibiotics (telithromycin), alprazolam (Xanax), anticoagulants (warfarin), antidepressants (Elavil, Asendin, Anafranil, Norpramin), MAOI antidepressants (Marplan, Nardil, Eldepryl, Emsam, Zelapar), SSRI antidepressants (fluvoxamine), herbal remedy St. John’s Wort, NSAIDs (Advil, Motrin, Aleve, Naprosyn), clopidogrel (Plavix), diazepam (Valium), digoxin (Lanoxin), diuretics ('water pills'), linezolid, flecainide (Tambocor), medications for diabetes, lithium (Eskalith, Lithobid), medications for anxiety and Parkinson's disease, methylene blue, medications for mental illness (Clozaril, Haldol), medications for migraine (Axert, Relpax, Frova, Amerge), medications for seizures (Tegretol, Dilantin), sedatives, sibutramine (Meridia), sleeping pills, tramadol (Ultram), tranquilizers, and vinblastine (Velban). Do not take Cymbalta if you experience seizures (convulsions or fits). Do not take Cymbalta if you suffer from or have history of cardiovascular disease, liver or kidney disorders, hypotension, leukemia, peptic ulcer disease, rhinitis, glaucoma, epilepsy. Do not take Cymbalta if you have a history of fainting, mania (feeling overexcited, irritable or not being able to think clearly) or severe depression. Do not take Cymbalta if you have recently undergone a surgery. Do not to consume alcohol, drive or operate machinery while using Cymbalta, as it can lower your blood pressure, causing dizziness, drowsiness. Cymbalta is not for use in patients under age 18 years.

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The E-selectin S149R polymorphisms in breast cancer in a northern Iran population. The range of skin changes in hemostasis disorders includes hemorrhages of 5 various types, thromboses, pigmentation disorders, and pustular involvement. The pathogenesis and results of the surgical treatment of stress urinary incontinence in women. With proper management, long-term physical and psychologic sequelae of lightning injury are rare. The experiment showed that the accuracy of the MR method for temperature measurements is better than 1 degree C. Sonographic sliding sign in localization of right upper quadrant mass. The initial search identified a total of 338 potential citations. The results of our investigations show that the Ni-Ti marker has a non negligible impact on the dose distributions for the used radiation types. Gas-phase ion/ion reactions are universally applicable and have proved to be useful in mixture analysis and top-down biomolecule characterization.

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Furthermore, after coupling of NAv-linked fluorescence dyes to BPEG-functionalized NP, differences in binding and uptake could be demonstrated using two epithelial cell lines (Caco-2, A549). A candidate subspecies discrimination system involving a vomeronasal receptor gene with different alleles fixed in M. To identify calcified scleral plaques on orbital computed tomography. ramesis at high densities was significantly lower than at low densities when it parasitized either host species. (1992) suggested the possibility that such high signals were caused by hemorrhage.

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The prevention of VHA consists in active immunization, while that of VHE requires primarily that pork meat and offal should be heat processed and cross contamination between raw materials and final products should be avoided. Minor corneal trauma may be handled on an out-patient basis with the use of contact lenses and tissue adhesives. We identified the following facilitators: intervention by family members, social connections within the health care system, and referral services from a nongovernmental organization. Their frequency, accessibility and various morphological forms provide the basis of excellent models for carcinogenesis. These tumour markers have been examined for their utility as prognostic indicators in 2 different manners. Compared to obese OSA patients, non-obese OSA patients were noted to have less prevalence of hypertension and less history of nocturia.

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Microsatellite instability (MSI) is known to result from inactivation of mismatch repair genes largely by promoter methylation. Innate immune gene variation and differential susceptibility to uterine diseases in Holstein cows. Inflammatory changes affect the peritoneal fluid and hence the intratubal milieu, since the ampulla (where fertilization takes place) is exposed to peritoneal fluid through the fimbria. Polycyclic aromatic hydrocarbons (PAHs) are an important class of environmentally prevalent xenobiotics that exert complex effects on the immune system. Subsequently, the FW2.2 gene was cloned and shown to contain a PLAC8 domain, originally identified in mammalian placental proteins. Cerebral revascularization strategies for acute ischemic stroke have been developed during the past decade. The relaxation processes are identified with specific molecular motions and activation energies are calculated in a linear approximation for comparison with literature data. Before the morphologic study, the nerves were isolated and the pressure-nerve activity curve was determined for each ADN.

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It is suggested that many deaths from neonatal meningitis may be preventable by early detection and treatment of ventriculitis with intraventricular antibiotics. The M-FISH results were confirmed by individual chromosome-specific painting probes. It allows clinician to select the most relevant views of the area of interest resulting in improved detection of periapical lesions. An inverse correlation was observed between the alterations in concentration of free cholesterol and an antioxidative activity of lipids in several tissues and cells. Nosocomial infection in a high risk cohort: an illustration of a sampling method. Combination of a brief irrigation with tissue factor pathway inhibitor (TFPI) and adenovirus-mediated local TFPI gene transfer additively reduces neointima formation in balloon-injured rabbit carotid arteries. Sarcoidosis is a systemic inflammatory disorder of unknown etiology.

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Both asexual and mature sexual stages of Plasmodium circulate in the blood. Life-cycle assessments (LCAs) suggest that the net energy generated during corn-to-biobutanol conversion is 6.53 MJ/L, which is greater than that of the corn-derived bioethanol (0.40 MJ/L). These devices promote rapid and spatially selective epidermal cooling to low temperatures without affecting the target chromophore temperature before the laser pulse is delivered. At follow-up, 8 practices continued RAP meetings and found the process valuable in problem solving and decision making. These data demonstrate that inhibition of alpha4 integrin can protect the brain against ischemic brain injury and implicate endogenous alpha4 integrin in the pathogenesis of acute brain injury. Participants in the present experiment adopted determination (high approach positive), satisfaction (low approach positive), or neutral facial expressions while electroencephalographic (EEG) activity was recorded. Special consideration in children should focus on potential problems with drug administration, drug absorption, metabolite patterns, changing drug disposition, idiosyncratic reactions, receptor sensitivity and chronopharmacokinetics. Once high prevalence rates are brought down, however, longer term strategies, including improved STD case management, are essential to maintain reduced rates. Group comparisons and correlations of brain metabolites with clinical and neuropsychological variables.

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Multivariate analysis of 250 laparoscopic cholecystectomy operative reports (125 uncomplicated and 125 with bile duct injury). The decreased rate of incorporation from old animals is dependent from the cytosolic fraction. It is also demonstrated that the learning capacity of the patients depends on the particular type of neuroleptic. Mice with proteoglycan (PG)-induced arthritis were subjected to systemic treatment with 3 different monoclonal antibodies against CD44. Our study supports the inverse association of vitamin D status with gestational diabetes risk, particularly among women who smoke during pregnancy. Academic debate is an effective method to enhance the competences of critical thinking, problem solving, communication skills and cooperation skills. Cultured cells proliferated for at least 6 mo at a rate comparable to that of serum-supplemented cultured cells. The normalized medium speed of the circumferential muscle fiber stretch (MVCL) used as an index for relaxation in the construction of left ventricular function curves. The particle size distribution of the powder products was similar, regardless of the process conditions used for the crystallization.

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Effects of pressure support ventilation and continuous positive airway pressure on diaphragm performance. High-affinity binding of silybin derivatives to the nucleotide-binding domain of a Leishmania tropica P-glycoprotein-like transporter and chemosensitization of a multidrug-resistant parasite to daunomycin. The role of calmodulin in 1,25-dihydroxyvitamin D regulation of calcium transport across the intestinal brush border membrane. The spatio-temporal expression of three crystallin genes (alpha A, beta B1 and gamma) in lenses of Xenopus laevis was studied by in situ hybridization to compare the process of lens formation in embryonic development with that of lens regeneration from cornea that occurs in the tadpole. Thymoma is a rare neoplasm usually with an indolent growth pattern, however, local invasion and/or metastases may occur. New genetic markers for adult acute lymphoblastic leukemia (ALL) have been found to have prognostic impact, such as the lymphoid transcription factor gene IKZF1 alterations, which are associated with a high rate of leukemic relapse in B-ALL.

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Catalytic role of vicinal OH in ester aminolysis: proton shuttle versus hydrogen bond stabilization. One patient died in a traffic accident, his thrombocytopenic purpura had been cured. Although application to diseased models (OZR and SHR) demonstrated normal resting perfusion compared with contralateral limbs, a significant reduction in reserve capacity was uncovered with muscle stimulation. Based on assays predicting reliably the response to hormonal therapy, a more appropriate choice can be made for therapeutic intervention with hormonal therapy and for selecting the appropriate adjuvant therapy in breast cancer patients. they acted as AMD3100, depending on the length and the chemical nature of the linker between the two cyclam moieties. We found no significant associations between androgen levels and risk of prostate cancer in this population-based, non-screened cohort.

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Here we apply the RP method to data from the rural populations of Csaroda, Tiszaadony, and Tiszavid in northeastern Hungary. In 4 patients a long-lasting interdisciplinary approach including orthodontics, metal-ceramic crowns and fixed partial dentures, and direct composite restorations was required. The aim was to determine the effect of surgery for removal of wisdom teeth on the plasma concentration-time profile of ibuprofen enantiomers. coli is a Gram-negative bacillus associated with poor prognosis due to the release of endotoxins. This rise in glycemia, appearing as impaired glucose tolerance, allows glucose to be stored in spite of the resistance to glucose storage. The effects of dexamethasone, a glucocorticoid analog, on interleukin 8 (IL-8) gene expression were studied in cultures of primary human tracheobronchial epithelial cells and an immortalized human bronchial epithelial cell line, HBE1 cells. Furthermore, this work provides evidence contributing to gene function annotation in the context of male fertility. The native structure of cytoplasmic dynein at work translocating vesicles in Paramecium.

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The present report documents an incidentally discovered, solitary amyloidoma of the jejunum in a 70 year old man with no predisposing disorder or other sites of deposition of amyloid, as was demonstrated at autopsy. Nanosecond-to-microsecond time-resolved Fourier transform infrared (FTIR) spectroscopy in the 3000-1000-cm(-1) region has been used to examine the polarizable proton continua observed in bacteriorhodopsin (bR) during its photocycle. Cord blood serum proteins and their fractions as an index of neonatal maturity. Snodgrass tubularized incised plate urethroplasty and 2 modifications were evaluated in 75 hypospadiacs (distal and midpenile). Immunosuppressive therapy for ulcerative colitis: results of a nation-wide survey among consultant is it ok to drink alcohol while taking medrol dose pack physician members of the British Society of Gastroenterology. In the last 40 years, there were several reports of symptomatic cerebral vasospasm occurring after resection of brain neoplasms. Limited proteolysis of the large isoform by the mitochondrial rhomboid protease Pcp1/Rbd1 generates the short isoform of Mgm1 but how this is regulated is unclear. Our proteomic study shows that prohibitin is involved in oxidative stress signaling in the retina and RPE.

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This initiative has resulted in the ability to collect and report on NSI organization-wide to advance decision-making support and identify quality improvement opportunities within the organization. Isolation and characterization of proteoglycans from the cell lines HEL and ELM-D, which like TF-1 cells have an immature erythroid phenotype, showed that these cells synthesize the same HS proteoglycan, previously detected in TF-1 cells, as a major proteoglycan. A common Hsp90-dependent mechanism for their translocation is discussed. These results also demonstrate the utility of data simulations in reading research. The DNA-binding domain in the Bacillus subtilis transition-state regulator AbrB employs significant motion for promiscuous DNA recognition. This growth defect was specifically caused by production of the secretin protein, YscC. A number of innovative approaches have been investigated for their value in the early detection of acute ischemia or infarction in patients presenting to the emergency department (ED) with chest pain suggestive of a cardiac origin. Best recoveries were obtained using 1 mL of acidic methanol (0.1 M), and limits of detection could be achieved up to 5 x 10(-4) microg mL(-1) (in SIM) and 0.05 microg mL(-1) in full scan mode. The association of disease severity with scores on the instruments supports the construct validity of these outcome measures for an objective assessment of quality of life in controlled studies.

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An analysis of the studies published between 1990 and 2008 is presented and discussed in detail. The circadian clock, an endogenous timekeeper that regulates daily rhythms of physiology, also influences the dynamic release of glucocorticoids. First-episode psychosis: an epidemiological survey comparing psychotic depression with schizophrenia. The application of the ultrasound is sensible in order to force the polymerisation. Ligation of the superficial femoral vein in prevention of pulmonary embolism: an old fashion procedure?. Consecutive calcitriol brand name australia admissions to a department of internal medicine were assessed by two expert panels.

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Cell type-specific activation of actin genes in the early amphibian embryo. Overexpression of MBP20 suppressed the simple-leaf phenotype resulting from upregulation of LA activity or from downregulation of class I knotted like homeobox (KNOXI) activity. From 2000 to 2014, trends on nutrition development among these students were also studied. The most effective treatment is considered to be a combination of medication and appropriate psychotherapy. General metrological requirements of clinical lipid measurements. Glutathione reductase and glucose-6-phosphate dehydrogenase activity decreased, whereas the activity of glutathione-S-transferase, glutathione peroxidase cleocin medication classification , catalase and superoxide dismutase increased in paraquat exposure. In particular, a new and emerging paradigm of T cell immunity is evolving.

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Characteristics of psychiatric day care units: a tentative clarification. The goal of this study was to evaluate its clinical and audiologic results in patients with unilateral or bilateral congenital aural atresia. These results are discussed in the light of empirical data and other theoretical studies, in conjunction with their broader implications for community assembly. Between 1995 and 2000, a total of 1462 patients met rulide tab 150mg 10 the eligibility criteria of the phase 3 trial and were treated with fasudil in a PMS study. Quantum model of light transmission in array waveguide gratings. A retrospective chart review was conducted of 103 infants with gastroschisis over 5 years (1992 to 1997).

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Water was infused into the bowel and the pressure at which leakage occurred through the sphincter recorded. Ovarian volume, Antral Follicle Count (AFC) and Resistance Index (RI) of ovarian artery of the operated and the contralateral ovary. The inactive mutants showed neither proton motive force-driven uptake activity nor exchange activity nor glutamate binding. The absence of symptoms prior to death in 2 of the subjects indicates that the possibility of antemortem diagnosis (particularly of HCM) was unlikely. Transformed RAW macrophages were obtained from the American Type Culture collection (ATCC), and the non-transformed human macrophages were obtained from the peripheral blood of 25 male and female volunteers. BHV1 spread to sentinel calves in the adjacent stable within three days, and BRSV within nine days, and BVDV spread to sentinel calves probably within one week. Chiari Type I malformation and upper airway obstruction in adolescents. For boys, increased video game play was linked to increased aggressive behavior problems. The ambisense S segment of Rift Valley fever (RVF) virus (a phlebovirus in the Bunyaviridae family) codes for two proteins: the viral complementary-sense RNA for the N nucleoprotein and the genomic-sense RNA for the nonstructural protein NSs.

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Reproducibility of ultrasound criteria for characterizing carotid artery stenoses. The F-box protein Skp2 mediates c-Myc ubiquitylation by binding to the MB2 domain. A newly developed technique of protein transfection into cells and intact microvessels enables the correlation of fullctional reactions and signaling events at the molecular level in a direct and specific fashion. These cells were also devoid of alloreactivity after one stimulation cycle. A number of prognostic indexes have been developed to predict the outcome of patients pioglitazone 15mg tab 15 with severe heart failure (HF). Six cases have been described in detail, and the medical approach in each instance has been commented on and severely criticized.

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At 3 and 6 months follow-up the Clinician Administered PTSD Scale (CAPS), HDRS, GHQ, and a questionnaire concerning medical problems caused by the accident along with economic and legal problems were applied. Members of the epidermal growth factor receptor (EGFR) family of tyrosine kinases, also known as erbB or HER receptors, are over expressed and/or activated in many types of human tumors zebeta generic and represent important therapeutic targets in cancer therapy. The present in vitro study was performed to investigate, how PFC-aerosolization is affected by type of nebulizer and PFC properties. Appropriate AIDS prevention information is not available in Vietnam for men who have sex with men. This enables a comparison of clinical course of carbon monoxide poisoning, particularly the circulatory system of people who were simultaneously exposed to the same source of carbon monoxide. Leiomyomatosis: intracardiac extension and pulmonary embolization. The effects of some chemicals on the inactivation pattern of Sh. A comparison of four anatomical sites (two internal, two sub-dermal) for measuring body temperature also illustrates shortcomings in using sub-dermal measures to reflect responses to dynamic ambient environments.

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Supercritical ethanol--a fascinating dispersion medium for silica nanoparticles. Detailed chromosome aberrations were analysed by combined FISH with pan-telomere staining and specific whole-chromosome painting (1, 2 and 4). Furthermore, the type of operation should be considered when planning postoperative analgesia for ambulatory surgery. The aim of this study was to compare two immunosuppressive protocols in adult living-related liver transplantation (LRLT). Importantly, inhibiting proteolytic activity or blocking the complex with a specific antibody not only prevented TJ protein degradation but also epithelial barrier disruption. When exposed to mild shock prior to the test, 40-day-old rats decreased these exploratory behaviors, while 65- and 130-day-old rats increased active exploratory behavior (Experiment 1). Scanning electron microscopy showed that adhesion between coatings and the titanium substrate was close.

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Oxygen-derived free radicals induced cellular injury in superior mesenteric artery occlusion shock: protective effect of superoxide dismutase. Functions of GSH in detoxication during radical-induced injury in specific pathological and toxicological conditions are discussed. The onset of IL-3-dependent inhibition was correlated temporally with the appearance of SOCS-3 (suppressor of cytokine signalling-3) protein. Our dynamic angiographic data demonstrated that diabetes could impair the cerebral arterial reactivity. With a diameter of 25 mm or more they are often partially thrombosed and show atheromatous plaques. To describe the benefits of treatment for hypertension in the elderly, the most efficient drugs, those most widely used in clinical practice to reduce morbi-mortality taken from the literature.

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High-fat diet induced adiposity in mice with targeted disruption of the dopamine-3 receptor gene. Endoscopic pancreatic-stent placement and sphincterotomy for relief of pain in tropical pancreatitis: results of a 1-year follow-up. A heterozygous NKX2.1 mutation was identified in the proband and the four other adult family members with histories of childhood lung disease. Furthermore, both conventional and digital radiographic techniques were used. These observations suggest that aortic intervention, such as via an endovascular approach, may be indicated in this intermediate-risk group. Batch culture experiments were performed with 32 different sulfate-reducing prokaryotes to explore the diversity in sulfur isotope fractionation during dissimilatory sulfate reduction by pure cultures.

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