Treating Your Depression and Nerve Pain With Cymbalta

Nerve pain — a side effect of HIV medications and the infection itself — can be treated with duloxetine (Cymbalta), a common antidepressant. This offers a great benefit to people infected with HIV, as both nerve pain, or peripheral neuropathy, and depression are common ailments.

In addition, people with HIV have the burden of taking lots of medications — now their pain and low mood can potentially be treated with just one medication, a huge bonus.

Man lying on sofa looking depressed
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Duloxetine (Cymbalta) is an antidepressant that is also approved by the FDA to treat peripheral neuropathy. This is of great benefit to people with HIV who frequently suffer from both conditions.

How It Works

To understand how Cymbalta works, you must first understand the physiology or cause of depression. There are two naturally occurring chemicals in the brain that are responsible for mood and mood stability. Under normal circumstances, these two chemicals — serotonin and norepinephrine — are in a specific balance. However, these chemicals can become out of balance, causing changes in mood, specifically depression. Cymbalta works by re-establishing the balance of these two chemicals, and in turn, relieving the symptoms of depression.

The same two chemicals responsible for mood also have an influence on pain perception. Just as an imbalance causes depression, an imbalance of these chemicals causes pain. When Cymbalta re-establish chemical balance, the symptoms of pain may be relieved, as well.

How Cymbalta Is Taken

Cymbalta is available in 20mg, 30mg, and 60mg capsules. The preferred dose is 60mg once daily, but some people may require less than 60mg each day. As is the case in any medication, the prescribed dose should be the lowest dose at which there is a therapeutic effect.

One benefit of Cymbalta is that it can be taken as one capsule once daily, which makes adherence much easier. This is in contrast to other medications commonly used to treat peripheral neuropathy that require multiple doses a day.

What to Expect

Like most antidepressants, it will take some time before you feel the beneficial effects of Cymbalta on both mood and pain. Some people will feel better after about a week on the drug and most will feel better by four to five weeks after starting. You should not stop the drug until speaking with your physician.

Side Effects

Like most medications, there are side effects associated with Cymbalta. Many side effects — if they do occur — will resolve after the body becomes adjusted to the medication, usually in a couple of weeks. In clinical trials, the most commonly reported side effects include:

  • Nausea
  • Dry mouth
  • Constipation
  • Decreased appetite
  • Fatigue
  • Drowsiness or feeling sleepy
  • Increased sweating
  • Sexual side-effects
  • Possible withdrawal symptoms if abruptly discontinued

Drug Interactions and Precautions

While Cymbalta has been deemed safe by the FDA, there are people who should not take the medication because of certain drug interactions. Some drugs, when taken together can cause unpredictable and potentially dangerous side effects. For that reason, you should not take Cymbalta if:

  • You have had an allergic reaction to Cymbalta in the past
  • You have taken medications known as monoamine oxidase inhibitors (MAOI) — consult your doctor or pharmacist if you are taking an MAOI drug
  • You have glaucoma
  • You are taking the medication Mellaril (thioridazine).

Important Note! Inform your doctor of all prescription and over-the-counter medications you are taking before starting Cymbalta in order to avoid dangerous drug interactions.

In addition to the above precautions, it's important to note that Cymbalta has not been approved for use in people less than 18 years of age.

Talk With Your Doctor

If you suffer from HIV-related pain and/or a low mood, please see your doctor for an evaluation. Cymbalta may or may not be the appropriate medication for you.

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  • Physicians Desk Reference Package Insert — Cymbalta; Eli Lilly and Company, September 2006.