For Those Of You On Cymbalta...

[poppetkazutaka]

So I was researching this 'shortage' my pharmacy mentioned and I noticed this in a websearch and in the wiki article:

A review in Prescrire International summarizing the existing evidence noted that duloxetine has limited efficacy in depression and no advantages over any other antidepressant. Prescrire observed that, taking into account the risk of hepatic disorders and drug interactions, there is no reason to choose duloxetine when so many other options are available.[2] Similar analysis was presented by Drug and Therapeutics Bulletin, which is a part of the respected BMJ Group.[20]

Summing up the existing evidence, a review in Prescrire International recommends pelvic floor exercises, which are "risk-free and effective in two-thirds to three-quarters of cases", as the first line treatment of SUI. Duloxetine use reduced the frequency of stress incontinence by one episode a day as compared with placebo. "The tangible effect of duloxetine on the quality of life is doubtful, with a maximum gain of five points on a 100-point scale." The review notes that, at best, duloxetine efficacy is "modest and transient, while its adverse effects are numerous and potentially severe."[1]

Duloxetine was not effective for the numbness or tingling, nor for the other complications of diabetes. It reduced the pain without treating the underlying nerve damage.[30] Only tight glycemic control was unequivocally demonstrated to slow the progression of neuropathy.[31][32] Benfotiamine, alpha-lipoic acid and ranirestat have also shown some promise.[32]

The comparative efficacy of duloxetine and established pain-relief medications for DPN is unclear. An independent systematic review in BMJ noted that tricyclic antidepressants (imimpramine and amitriptyline), traditional anticonvulsants and opioids have better efficacy than duloxetine. Duloxetine, tricyclic antidepressants and anticonvulsants have similar tolerability while the opioids caused more side effects.[31] A review in Drug and Therapeutic Bulletin saw no place for duloxetine in the treatment of DPN, based on its high cost and insufficient evidence of the comparative efficacy with tricyclic antidepressants.[3] Another independent review in Prescrire International, considered the moderate pain relief achieved with duloxetine to be clinically insignificant and the results of the clinical trials?unconvincing. The reviewer saw no reason to prescribe duloxetine in practice.[2] The comparative data collected by reviewers in BMC Neurology indicated that amitriptyline, other tricyclic antidepressants and venlafaxine may be more effective. However, the authors noted that the evidence in favor of duloxetine is much more solid.[33]

So...yeah...I've already called the doctor prior to reading this because of the expensive co-pay, the antibiotics I'm always on, and the 'shortage', but I'm wondering if they're not thinking of taking this off the market because of its dangerous side effects and limited use?

[kayjay]

Hi- I take it. I switched a few months ago using Cymbalta to replace both lexapro and lyrica.

It helps me with my fibro pain and doesn't have the side effects for me that lexapro did.