Cymbalta 60 milligrams: Side effects, dosage, generic, uses, and more

25.06.201916.04.2021 by alexxlab

Содержание

Side Effects of Cymbalta (Duloxetine Hcl), Warnings, Uses

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capsule, green, imprinted with 20 mg, LILLY 3235

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Cymbalta 20 mg

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Cymbalta 30 mg

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Cymbalta 60 mg

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Duloxetine DR 20 mg 231550654

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Duloxetine DR 20 mg 317220581

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Duloxetine DR 30 mg 317220582

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Duloxetine DR 30 mg 435470380

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Duloxetine ER 20 mg 683820385. JPG

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Duloxetine ER 30 mg 683820386.JPG

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Duloxetine ER 60 mg 683820387.JPG

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Cymbalta (Duloxetine Hcl) Side effects, Images, Uses, Dosage, Overdose at RxList

000023235_PB

capsule, green, imprinted with 20 mg, LILLY 3235

000023240_PB

capsule, blue/white, imprinted with Lilly 3240, 30 mg

000937542_PB

capsule, green, imprinted with TEVA, 7542

000937543_PB

capsule, blue/white, imprinted with TEVA, 7543

000937544_PB

capsule, blue/green, imprinted with TEVA, 7544

002282890_PB

capsule, blue, imprinted with 2890

002282891_PB

capsule, blue/gray, imprinted with LOGO 2891, LOGO 2891

572370017_PB

capsule, green, imprinted with X, 01

572370018_PB

capsule, blue/white, imprinted with X, 02

572370019_PB

capsule, blue/green, imprinted with X 03

604290164_PB

capsule, yellow, imprinted with B, 746

604290165_PB

capsule, green/white, imprinted with B, 747

604290166_PB

capsule, brown/green, imprinted with B, 748

Cymbalta 20 mg

capsule, green, imprinted with 20 mg, LILLY 3235

Cymbalta 30 mg

capsule, blue/white, imprinted with Lilly 3240, 30 mg

Cymbalta 60 mg

capsule, blue/yellow, imprinted with Lilly 3237, 60 mg

Duloxetine DR 20 mg 231550654

capsule, clear/green, imprinted with LOGO, 007

Duloxetine DR 20 mg 317220581

capsule, green, imprinted with H, 190

Duloxetine DR 20 mg 435470379

capsule, white, imprinted with 557, 20mg

Duloxetine DR 30 mg 317220582

capsule, blue/white, imprinted with H, 191

Duloxetine DR 30 mg 435470380

capsule, green/white, imprinted with 558, 30mg

Duloxetine DR 30 mg231550655

capsule, clear/white, imprinted with LOGO, 008

Duloxetine DR 40 mg 681800297

capsule, white, imprinted with LU, h35

Duloxetine DR 60 mg 002282892

capsule, gray/white, imprinted with LOGO 2892, LOGO 2892

Duloxetine DR 60 mg 231550656

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Duloxetine DR 60 mg 317220583

capsule, blue/green, imprinted with H, 192

Duloxetine DR 60 mg 435470381

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Duloxetine ER 20 mg 683820385. JPG

capsule, green/white, imprinted with 241, 20 mg

Duloxetine ER 30 mg 683820386.JPG

capsule, blue/green, imprinted with 242, 30 mg

Duloxetine ER 60 mg 683820387.JPG

capsule, blue/white, imprinted with 243, 60 mg

Cymbalta Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Duloxetine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Common and Rare Side Effects for Cymbalta oral

COMMON side effects

If experienced, these tend to have a Severe expression i

Sorry, we have no data available. Please contact your doctor or pharmacist.

If experienced, these tend to have a Less Severe expression i

dry mouth
constipation
drowsiness
dizziness
difficulty sleeping
low energy
excessive sweating
decreased appetite
nausea
diarrhea

INFREQUENT side effects

If experienced, these tend to have a Severe expression i

If experienced, these tend to have a Less Severe expression i

altered interest in having sexual intercourse
problems with ejaculation
agitation
blurred vision
indigestion
the inability to have an erection
itching
muscle spasm
sensation of spinning or whirling
a sleep disorder
chills
muscle tremors
temporary redness of face and neck
weight gain
weight loss
headache
yawning
cough
gas
urination during the night
low energy and weakness
generalized weakness
orgasm problems
abnormal dreams
anxious feelings

RARE side effects

If experienced, these tend to have a Severe expression i

a condition with low thyroid hormone levels
a high prolactin level
a disorder with excess antidiuretic hormone called syndrome of inappropriate antidiuretic hormone
low amount of sodium in the blood
an increased risk of bleeding
manic behavior
a form of mania that has a lower severity of symptoms
suicidal behavior
suicidal thoughts
myoclonus, quick and involuntary muscle jerks
extrapyramidal disease, a type of movement disorder
serotonin syndrome, a type of disorder with high serotonin levels
high blood pressure
extremely high blood pressure
a heart attack
supraventricular tachycardia
inflammation of blood vessels in the skin
bleeding
a feeling of throat tightness
a stomach ulcer
a type of stomach irritation called gastritis
inflammation of the large intestine
liver damage
liver failure
inflammation of the liver called hepatitis
a blockage of the bile duct that resulting in high bilirubin levels
acute inflammation of the pancreas
bleeding of the stomach or intestines
erythema multiforme, a type of allergic skin reaction
a skin disorder with blistering and peeling skin called Stevens-Johnson syndrome
hallucinations
seizures
a feeling of restlessness with inability to sit still
a type of abnormal movement disorder called dyskinesia
high amount of bilirubin in the blood
abnormal liver function tests
a broken bone
a significant type of allergic reaction called anaphylaxis
a type of allergic reaction called angioedema
secondary angle-closure glaucoma, a type of eye disorder
accidental falls
takotsubo cardiomyopathy
a high alanine transaminase level
a high aspartate transaminase level

If experienced, these tend to have a Less Severe expression i

high cholesterol
confusion
grinding of the teeth
aggressive behavior
dry eye
dilated pupils
ringing in the ears
an earache
orthostatic hypotension, a form of low blood pressure
a sore throat
stomatitis, a condition with painful swelling and sores inside the mouth
breastmilk production not associated with childbirth or nursing
bleeding not related to menstrual period
increased sensitivity of the skin to the sun
contact dermatitis, a type of skin rash that occurs from contact with an offending substance
hives
lockjaw
muscle twitching
taste impairment
abnormal manner of walking
numbness
excessive thirst
a type of speech disorder called dysarthria
nosebleed
bad breath
heart throbbing or pounding
burping
difficult or painful urination
excess urination
high blood sugar
a feeling of pins and needles on skin
hematoma, a collection of blood outside of the blood vessels
a feeling of general discomfort called malaise
irritability
restless legs syndrome, an extreme discomfort in the calf muscles when sitting or lying down
a sensation of feeling cold
indifferent behavior
pain in the testicles
night sweats
a delay when starting to urinate
pain in the muscles or bones
fast heartbeat

Duloxetine (Oral Route) Proper Use

Proper Use

Drug information provided by: IBM Micromedex

Take this medicine only as directed by your doctor to benefit your condition as much as possible. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes with a Medication Guide. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Swallow the delayed-release capsule whole with or without food. Do not chew, crush, or break the capsule. Do not open the Cymbalta® delayed-release capsule and sprinkle the contents on food or in liquids.

If you cannot swallow the Drizalma Sprinkle™ delayed-release capsule whole, you may do the following:

You may open the capsule and sprinkle the contents over one tablespoon (15 mL) of applesauce. Swallow the mixture right away and do not save any of the mixture to use later.

You may open the capsule and pour the contents to an all plastic catheter tip syringe and add 50 mL of water. Do not use other liquids. Gently shake it for 10 seconds, and then use it through a nasogastric tube. Rinse with additional water (about 15 mL) if needed.

You will need to use this medicine for several weeks before you begin to feel better. Keep using the medicine even if you feel you are not getting better, and talk to your doctor if you have any questions.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (delayed-release capsules):
- For treatment of anxiety:
  - Adults—At first, 60 milligrams (mg) once a day. Some patients may start at 30 mg once a day for 1 week before increasing the dose to 60 mg once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 120 mg per day.
  - Older adults—At first, 30 mg once a day for 2 weeks before increasing the dose to 60 mg once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 120 mg per day.
  - Children 7 years of age and older—At first, 30 mg once a day for 2 weeks before increasing the dose to 60 mg once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 120 mg per day.
  - Children younger than 7 years of age—Use and dose must be determined by your doctor.
- For treatment of chronic muscle pain:
  - Adults—60 milligrams (mg) once a day. Some patients may start at 30 mg once a day for 1 week before increasing the dose to 60 mg once a day.
  - Children—Use and dose must be determined by your doctor.
- For treatment of depression:
  - Adults—40 milligrams (mg) per day (given as 20 mg two times per day) to 60 mg per day (given either once a day or as 30 mg two times per day). Your doctor may increase your dose as needed. However, the dose is usually not more than 120 mg per day.
  - Children—Use and dose must be determined by your doctor.
- For treatment of diabetic peripheral neuropathy:
  - Adults—60 milligrams (mg) once a day.
  - Children—Use and dose must be determined by your doctor.
- For treatment of fibromyalgia:
  - Adults—60 milligrams (mg) once a day. Some patients may start at 30 mg once a day for 1 week before increasing the dose to 60 mg once a day.
  - Children 13 years of age and older—At first, 30 mg once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 60 mg per day.
  - Children younger than 13 years of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Portions of this document last updated: April 01, 2021

Side effects, dosage, uses, and more

Duloxetine oral capsule is available as both a generic and brand-name drug. Brand names: Cymbalta and Irenka.
Duloxetine only comes as a capsule you take by mouth.
Duloxetine oral capsule is used to treat anxiety, depression, diabetes nerve pain, fibromyalgia, and chronic muscle and joint pain.

FDA warning: Suicidal thoughts and behaviors

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.
This drug may increase the risk of suicidal thoughts and behaviors in people aged 24 years and younger. This drug can make depression worse in the early stages of treatment. Tell your doctor right away if your depression gets worse or if you have thoughts about suicide.

Drowsiness warning: This drug can cause sleepiness or affect your ability to make decisions, think clearly, or react quickly. You shouldn’t drive, use heavy machinery, or do other dangerous activities until you know how the drug affects you.
Serotonin syndrome warning: This drug affects a chemical in your brain called serotonin. Taking this drug with other medications that affect serotonin may result in increased risk of a serious side effect called serotonin syndrome. Symptoms may include:
- agitation
- confusion
- increased blood pressure or heart rate
- sweating
- loss of coordination
Dizziness and falling warning: This drug can cause a sudden drop in blood pressure if you stand up too fast. This can cause dizziness and increase your risk of falling.

Duloxetine is a prescription drug. It only comes in the form of an oral capsule.

Duloxetine oral capsule is available as the brand-name drugs Cymbalta and Irenka. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug.

Why it’s used

Duloxetine oral capsule is used to treat:

generalized anxiety disorder
major depressive disorder
nerve pain caused by diabetes
fibromyalgia pain
chronic muscle and joint pain

How it works

Duloxetine belongs to a class of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs).

It works by balancing chemicals in your brain that cause depression and anxiety. By balancing these chemicals, this drug also helps inhibit pain signals from your nerves to your brain.

Duloxetine oral capsule can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You shouldn’t drive, use heavy machinery, or do other dangerous activities until you know how it affects you. It can also cause other side effects.

More common side effects

In adults, the more common side effects of duloxetine can include:

In children, the more common side effects of duloxetine can include:

nausea
decreased weight
dizziness
diarrhea
stomach pain

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

Liver damage. Symptoms can include:
- itching
- pain in the right side of your upper abdomen
- dark-colored urine
- yellowing of your skin or the whites of your eyes
Changes in blood pressure. Symptoms can include:
- dizziness or fainting when standing. This may occur more often when you first start duloxetine or when you increase the dose.
Serotonin syndrome. Symptoms can include:
- agitation
- hallucinations
- coma
- coordination problems or muscle twitching
- racing heart
- high or low blood pressure
- sweating or fever
- nausea, vomiting, or diarrhea
- muscle rigidity
- dizziness
- flushing
- tremor
- seizures
Abnormal bleeding. Duloxetine may increase your risk of bleeding or bruising, especially if you take warfarin or nonsteroidal anti-inflammatory drugs.
Severe skin reactions. Symptoms can include:
- skin blisters
- peeling rash
- sores in your mouth
- hives
Manic episodes in people with depression or bipolar disorder. Symptoms can include:
- greatly increased energy
- severe trouble sleeping
- racing thoughts
- reckless behavior
- unusually grand ideas
- excessive happiness or irritability
- talking more or faster than usual
Vision problems. Symptoms can include:
- eye pain
- changes in vision
- swelling or redness in or around your eye
Seizures or convulsions
Low salt (sodium) levels in your blood. Symptoms can include:
- headache
- weakness or feeling unsteady
- confusion, problems concentrating, or thinking or memory problems
Problems with urination. Symptoms can include:
- decrease in your urine flow
- trouble passing urine

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Duloxetine oral capsule can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with duloxetine are listed below.

Serotonergic drugs

Taking these drugs with duloxetine may increase your risk of serotonin syndrome, which can be fatal. If you take any of these drugs, your doctor will start you on a lowered dosage of duloxetine and monitor you for signs of serotonin syndrome. Symptoms can include agitation, sweating, muscle twitches, and confusion.

Examples of serotonergic drugs include:

selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine and sertraline
serotonin-norepinephrine reuptake inhibitors (SSNRIs) such as venlafaxine
tricyclic antidepressants (TCAs) such as amitriptyline and clomipramine
monoamine oxidase inhibitors (MAOIs) such as selegiline and phenelzine
the opioids fentanyl and tramadol
the anxiolytic buspirone
triptans
lithium
tryptophan
amphetamines
St. John’s wort

Schizophrenia drug

Taking thioridazine with duloxetine can increase the amount of thioridazine in your body. This may increase your risk of an arrhythmia (abnormal heart rate).

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Taking duloxetine with NSAIDs may increase your risk of abnormal bleeding. Examples of NSAIDs include:

ibuprofen
indomethacin
naproxen

Mental health drug

Taking aripiprazole with duloxetine may increase the amount of aripiprazole in your body. This can lead to increased side effects.

Anticoagulants (blood thinners)

Taking blood thinners with duloxetine may increase your risk of abnormal bleeding. Examples of blood thinners include:

apixaban
warfarin
clopidogrel
dabigatran
edoxaban
prasugrel
rivaroxaban
ticagrelor

Gaucher disease drug

Taking eliglustat with duloxetine can increase the amount of eliglustat in your body. This may cause side effects on your heart.

Drug for depression and stopping smoking

Taking bupropion with duloxetine may increase the amount of duloxetine in your body. This may increase your risk of seizures.

Cancer drug

Taking doxorubicin with duloxetine may increase the amount of doxorubicin in your body. This can cause increased side effects.

Antibiotic

Taking ciprofloxacin with duloxetine may increase the amount of duloxetine in your body. Avoid taking these drugs together.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Duloxetine oral capsule drug comes with several warnings.

Alcohol interaction warning

Drinking heavily while taking this drug increases your risk of severe liver injury. Talk to your doctor about how much alcohol you drink before starting duloxetine.

Allergy warning

This drug can cause a severe allergic reaction. Symptoms may include:

trouble breathing
swelling of your throat or tongue
hives

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Warnings for people with certain health conditions

For people with liver disease: Avoid taking this drug if you have chronic liver disease or cirrhosis of the liver. You may have trouble clearing the drug from your body. This can lead to further liver damage.

For people with kidney disease: Avoid taking this drug if you have severe kidney disease or if you receive dialysis. Your kidneys may have trouble removing the drug from your body. This could lead to a buildup of the drug and increase your risk of side effects.

For people with diabetes: This drug may affect your blood sugar levels. If you have diabetes, your doctor may want you to monitor your levels more closely and may need to change the dosage of your diabetes medication.

For people with bladder problems: This drug may affect your ability to urinate. Talk to your doctor if you have any problems with urine flow.

Warnings for other groups

For pregnant women: This drug is a category C pregnancy drug. That means two things:

Research in animals has shown adverse effects to the fetus when the mother takes the drug.
There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or plan to become pregnant. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

If you take this drug during pregnancy, you can take part in a registry that monitors outcomes in women exposed to duloxetine during pregnancy. To enroll, talk to your doctor or call 1-866-814-6975.

For women who are breastfeeding: This drug may pass into breast milk. If you take this drug while you breastfeed, your baby may have side effects of the drug. Tell your doctor if you wish to breastfeed. You may need to decide whether to breastfeed or take this drug.

For seniors: If you’re aged 65 years or older and you take this drug, you may be at a greater risk for falls due to blood pressure changes. You may also be at greater risk for low sodium (salt) in your blood. Symptoms may include:

headache
weakness or feeling unsteady
confusion, problems concentrating, or thinking or memory problems

For children: This drug hasn’t been proved to be safe or effective in treating generalized anxiety disorder in children younger than 7 years. It hasn’t been proved to be safe or effective in treating other conditions in children younger than 18 years.

This dosage information is for duloxetine oral capsule. All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

your age
the condition being treated
the severity of your condition
other medical conditions you have
how you react to the first dose

Forms and strengths

Generic: Duloxetine

Form: Oral delayed-release capsule
Strengths: 20 mg, 30 mg, 40 mg, and 60 mg

Brand: Cymbalta

Form: oral delayed-release capsule
Strengths: 20 mg, 30 mg, 60 mg

Brand: Irenka

Form: oral delayed-release capsule
Strengths: 40 mg

Dosage for major depressive disorder

Adult dosage (ages 18 years and older)

Typical starting dosage: 30–60 mg per day.
Typical maintenance dosage: Total daily dose of 40 mg (given as 20-mg doses twice daily) or 60 mg (given either once daily or as 30-mg doses twice daily).
Maximum dosage: 120 mg per day.

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years hasn’t been established.

Dosage for generalized anxiety disorder

Adult dosage (ages 18–64 years)

Typical starting dosage: 30–60 mg per day.
Typical maintenance dosage: 60 mg per day.
Maximum dosage: 120 mg per day.

Child dosage (ages 7–17 years)

Typical starting dosage: 30 mg per day for two weeks.
Typical maintenance dosage: 30–60 mg per day.
Maximum dosage: 120 mg per day.

Child dosage (ages 0–6 years)

Dosage for people younger than 7 years hasn’t been established.

Senior dosage (ages 65 years and older)

Typical starting dosage: 30 mg per day for two weeks.
Typical maintenance dosage: 60 mg per day.
Maximum dosage: 120 mg per day.

Nerve pain caused by diabetes

Adult dosage (ages 18–64 years)

Typical starting dosage: 60 mg per day.
Maximum dosage: 60 mg per day.

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years hasn’t been established.

Dosage for fibromyalgia

Adult dosage (ages 18 years and older)

Typical starting dosage: 30 mg per day for one week.
Typical maintenance dosage: 30–60 mg per day.
Maximum dosage: 60 mg per day.

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years hasn’t been established.

Dosage for chronic muscle and joint pain

Adult dosage (ages 18 years and older)

Typical starting dosage: 30 mg per day for one week.
Typical maintenance dosage: 60 mg per day.
Maximum dosage: 60 mg per day.

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years hasn’t been established.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Duloxetine oral capsule is a long-term medication. It comes with risks if you don’t take it as prescribed by your doctor.

If you stop taking the drug or don’t take it at all: If you don’t take the drug, your symptoms won’t get better and could get worse. If you stop this drug quickly, you may have serious side effects, including:

anxiety
irritability
feeling tired or problems sleeping
headache
sweating
dizziness
electric shock-like sensations
vomiting or nausea
diarrhea

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 1-800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: If you miss a dose, take it as soon as you remember. However, if it’s just a few hours until your next dose, skip the missed dose and take your next dose on schedule. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: The symptoms of the condition being treated should improve.

Keep these considerations in mind if your doctor prescribes duloxetine oral capsule for you.

General

Don’t crush or chew the delayed-release capsule.

Storage

Store this drug at room temperature between 68°F and 77°F (20°C and 25°C).
Keep this drug away from light.
Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
Don’t worry about airport X-ray machines. They won’t damage your medication.
You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor may monitor you for new or worsening suicidal thoughts or behaviors.

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

90,000 Duloxetine for the treatment of painful neuropathy, chronic pain or fibromyalgia

Review question

Does duloxetine work to treat pain generated by nerves when damaged by disease or pain caused by fibromyalgia?

Relevance

Duloxetine is a medicine used to treat depression and urinary incontinence (urinary leakage) and may also be helpful for certain types of pain.Pain can occur spontaneously when there is damage to the nerves that carry pain information to the brain (neuropathic pain). When nerve damage occurs outside the spinal cord, it is called peripheral neuropathy. Another type of pain, nociceptive pain, occurs when nerves sense damage to other tissue (such as a pinprick in the skin). Some types of pain of unknown origin occur without visible damage to the nerve or tissues. This type of pain occurs, for example, with fibromyalgia. The aim of this review was to evaluate the benefits and harms of duloxetine for the treatment of neuropathic pain and chronic pain of all types.

Research characteristics

We reviewed all published scientific literature and found 18 trials with a total of 6407 participants that were of sufficient quality to be included in this review. Eight trials examined the effect of duloxetine on painful diabetic neuropathy and six on pain associated with fibromyalgia. Three trials examined the painful physical symptoms associated with depression and one small study looked at duloxetine for pain in stroke or for spinal cord disease (central pain).

Key results and quality of evidence

The usual dose of duloxetine is 60 mg. There was moderate quality evidence that duloxetine at this dose reduces pain in painful diabetic peripheral neuropathy and fibromyalgia. For diabetic peripheral neuropathic pain, 50% or slightly more improved on duloxetine 60 mg / day more than 1.5 times more often compared to the placebo group. In another way, it can be said as follows: five people with diabetic peripheral neuropathy must receive duloxetine in order for one of them to achieve an effect of 50% or more.The effect on fibromyalgia was similar, but the number of patients who needed to be treated to improve by 50% or more was eight. Based on one study alone, it is not possible to determine whether the 20 mg dose was effective and the 120 mg dose was no more effective than the 60 mg dose.

We calculated that there were enough trials for diabetic neuropathy to draw these conclusions, and no further trials are required. For fibromyalgia and painful symptoms associated with depression, more trials are needed to make convincing claims about the effectiveness of duloxetine.

Most people taking duloxetine will have at least one side effect. They are mostly minor and the most common are feeling unwell, insomnia or drowsiness, headache, dry mouth, constipation or dizziness. About one in six people will stop taking duloxetine due to side effects. Serious problems with duloxetine are very rare.

Although duloxetine is useful in treating neuropathic pain and fibromyalgia, there is little evidence from clinical trials comparing duloxetine with other antidepressants, which one is better.

We conclude that duloxetine can be used to treat pain associated with diabetic neuropathy and probably fibromyalgia.

The information in this review is current up to November 2013, when the most recent literature search was made.

iOncolog – Cancer hurts. And cancer treatment is sometimes …

Imagine being able to observe how cleverly – or clumsily – a surgeon operates on his patients. Your surgeon: the one on whom your life will soon depend.Would you like to know how successful he is? Probably yes. The same is true for some modern medicines. They can treat a disease that is foreign to you. But wait! Certification for your type of cancer may well be around the corner.

If once upon a time one medicine was suitable for one, maximum of two diseases, now it is not so. Immunotherapy, “small molecules” targeted therapy, biological drugs – they all start with a single tumor, and then open up new horizons, helping new patients.So, the drug Kitruda today has almost three dozen indications in fourteen different diseases, and this is not counting the special permission for use in any cancer, if one of two conditions is met (this: bit.ly/FB280420 or this: bit.ly/FB260620 , it doesn’t matter which one). The drug, which we will now talk about, has so far been approved for only two indications. But the last three paragraphs of our article are devoted to an overview of diseases, where it may appear soon.

We’re talking about Trodelwey. This drug received its second certification yesterday.Last April, 2020, Trodelwey was licensed in the United States to fight metastatic triple-negative breast cancer, and we immediately, among the first in Russian, told about it: bit.ly/FB240420. From now on, Trodelwey can be used against metastatic urothelial carcinoma. Speaking less tricky, for tumors of the bladder, as well as in the fight against “typical” cancer of the upper urinary tract: the renal pelvis, ureters, urethra. In the future, exactly the same medicine will run through the veins and in those suffering from other types of cancer – therefore, this information is relevant for them as well.Are you interested in watching the work of your future “surgeon”?

So, Trodelwey, what is this beast? In the article on its use against breast cancer, we dwelt on this issue in more detail (with pictures) (here: bit.ly/FB240420). But in short, this medicine is a “homing missile.” Yes, there are more and more of them: for example, Enhertu “targets” the HER2 protein, and it doesn’t matter which organ cancer is covered with this protein. Breast cancer (bit.ly/FB280320), stomach, intestinal or lung cancer (bit.ly / FB160121). Trodelwey targets a protein called TROP-2. And this protein is directly “strewn” with bladder tumors. The “warhead” of the “rocket” consists of chemotherapy, which is very similar to irinotecan (which is not used anywhere), but in hundreds – indeed, in hundreds! – times more toxic. Therefore, missiles missiles past the tumor have serious side effects in the body. So how successful is Trodelwey in fighting transitional cell carcinoma (another name for urothelial cancer)?

The study that tested this involved 113 patients aged 33 to 90 years with metastatic urothelial carcinoma.Bladder cancer is a disease of older men, and a quarter of the patients were over 75 years old, three-quarters were men. The condition of the participants was not easy: according to the conditions of the experiment, all of them already had both immunotherapy and chemotherapy with platinum preparations behind them. That is, both main weapons in the fight against this type of tumor have been used (bit.ly/FB310120). Half of the participants had 3 or more treatment lines (up to 8). More than a quarter had liver metastases, which is a bad sign.It is time to mention here that it is better to stop cancer in advance, before it reaches the fourth stage. In our recent article on upcoming innovations in oncology, we mentioned two drugs for non-metastatic bladder cancer, be sure to read: bit.ly/FB270221. In another article, we described how often laboratory workers are mistaken when investigating urothelial carcinoma at an early stage (read here: bit.ly/FB200620). The result is an incorrectly set stage, inappropriate treatment and a high risk of relapse.The solution is to review the biopsy in another laboratory. For example, in our (bit.ly/wspServicesPrices). But what about Trodelwee?

In this challenging group, described above, Trodelwey injections (two infusions every three weeks) allowed an average of 5.4 months to survive without disease progression. Half of the patients had a life expectancy of 10.5 months or more. A separate group – patients whose tumor and metastases responded to treatment. There were 27% of those (including 25% – in the presence of liver metastases), including 5% of people in whom – even if for a while – all evidence of cancer disappeared.Moreover, at least 76% gave in to the tumor even slightly! It was just that for many, the deviation was insufficient to fall under the rigid definition of “response to treatment”, or the progression of individual metastases was detected. So, if you focus on 27% of the respondents, then a decrease in neoplasm was usually recorded on the first control images, one and a half months after the start of treatment, and for another six months the disease did not progress. The official bodies in the certification report operate with the figures “27.7% of the response, 7.2 months of the response time”.

Note that the trials involved ten people who had previously been treated with Padsev (we talked about it here: bit.ly/FB270120 and here: bit.ly/FB170221). This is another “homing missile”, but aimed at a different protein on the surface of cells. Among these ten patients, three responded to Trodelwey’s treatment: that is, the response was 30%. Ten people is not a good statistical sample, but 30% of the answer is very similar to 27% of the overall answer. Probably Trodelvy remains effective after Padsev.At the moment, it seems that the latter drug is slightly more effective: both the chances of responding to treatment are slightly higher (44% versus 27%), and the life expectancy is slightly higher (11.7 months versus 10.5). However, such comparisons from different groups are flawed and further research is needed to understand which is best. In general, it is questions of this level, when standard therapy has been completed, that most often are the reason for obtaining a Second Opinion. On the other hand, the sooner an experienced doctor can assess the situation, the more likely they are to influence the outcome of therapy.By the way, in the last article we mentioned: Trodelvy and Padsev are trying to use at the same time. Dual aiming – why not?

Since yesterday, Trodelwey has been approved for patients with metastatic urothelial carcinoma previously treated with chemotherapy with platinum drugs and immunotherapy. But what about those who are not able to receive “platinum chemistry”? At first, of course, Keytrud’s checkpoint inhibitor or another immunotherapy drug, but how then? A little research explores this issue as well.So far, data are available for 18 patients, and the intermediate results are similar to those presented above: 28% chance of a response; the main tumor, at least a little, but gave in in 61% of people. Research is underway on another question: is it possible to use Trodelwey before and not after immunotherapy? For “ordinary” patients who started treatment with “chemistry”. Naturally, do not forget: there is still Balvers’ drug in stock, which we also wrote about earlier: bit.ly/FB130120. Unfortunately, all three: Trodelvy, Padsev and Balversa are fabulously expensive.We add that full-fledged clinical trials with hundreds of participants and a head-to-head comparison of Trodelwey with today’s third-line standard (paclitaxel, docetaxel or Javlor) have already begun. Unfortunately, in the territory of the former USSR, no research is being carried out and is not yet planned. Including those that we will describe below.

Let’s dwell on the side effects. It turns out that Trodelwey can be ruthless to the bone marrow, often leading to anemia (here’s what to do with it: bit.ly/FBanemia) and a lack of other blood cells.Among other things, 10% of patients experienced severe febrile neutropenia: a high fever with almost no neutrophil cells protecting against infection. Moreover, in 3% of people, the condition proceeded in a deadly form, and one patient died from it. A high temperature for cancer patients is a reason to immediately see a doctor (or call an ambulance), and we discussed this in detail in our article: bit.ly/FB300121. Fortunately, sometimes the temperature is just the body’s reaction to the presence of a tumor: bit.ly / FB280221. Diarrhea (bit.ly/FB100919), nausea (bit.ly/FB150820) and fatigue (bit.ly/FB170121) also occurred in more than half of the participants, including in severe form – in 9%, 4% and 4% respectively. Slightly less than half of the patients began to lose hair (sometimes it happens forever: bit.ly/FB200719). As a result, seven people (which is 6% of participants) were forced to interrupt Trodelwey therapy due to side effects. Including, three – just due to febrile neutropenia.

We said that Trodelwey might work for other types of cancer, right? Yes, and it seems to be quite for many.Thus, in a study for hormone-positive HER2-negative breast cancer, the drug caused a response to treatment in 31% of patients, and “on average in the hospital” delayed progression by almost 7 months. Now Trodelwey is being investigated in large trials of the final, third phase, for those who have already passed two “chemistry”, not counting antihormonal and targeted therapy (Ibrans, or better this: bit.ly/FB131220). It is possible that soon not only thrice-negative, but also hormone-dependent breast cancer will begin to be treated with the help of Trodelvi.

For a number of indications, experiments with Trodelwey are in earlier stages. To combat the same inoperable urothelial carcinoma, they try to combine the drug with Tecentrik immunotherapy or with targeted therapy with Rubrak, as well as with Padsev, which we wrote about above. Trodelwey is also being studied as a drug against metastatic, hormone-resistant prostate cancer, which has stopped responding to second-generation antihormonal therapy (this one: bit.ly/31Gyo8U).The aforementioned Trodelvi + Tecentrik cocktail is being studied for triple-negative and hormone-dependent breast cancer, as well as against non-small cell lung cancer (all at the metastatic stage). There is an attempt to fight non-small cell lung cancer without the help of immunotherapy. This approach should not be surprising, because just the other day we wrote about an experimental competitor Trodelvey, which has already achieved success against lung cancer “without mutations” (read closer to the end of the article: bit.ly/FB100421).Uterine and ovarian cancer are also among the tumors studied. Moreover, cancer of the uterine body was isolated in separate trials from a more general set, which is a good sign. Finally, oncologists plan to study the combination of Trodelvy with the as-yet-not-for-sale drug Berzosertib for a specific subgroup of patients with extremely aggressive small cell lung cancer (we wrote about all its innovations here: bit.ly/FB050121).

Perhaps the most unusual and promising is the use of Trodelwey against brain tumors.We are talking about both glioblastomas and metastases. In a small experiment, patients with recurrent glioblastoma or breast cancer metastases received one infusion the day before surgery. The extracted tumors showed that the drug really penetrates the barrier that separates the blood flow from the brain (we described it here: bit.ly/FB230121), and reaches the cancers. Not all surgeries were equally successful, and in four patients with metastases, as in seven people with glioblastoma, part of the tumor remained unreported.This made it possible to monitor the effectiveness of Trodelwy, which continued to be administered after the operation. Twelve weeks later, the scans showed that under the action of the drug, the cancer began to shrink significantly in two people in each group. That is, the answer was recorded in 50% of cases of brain metastases of breast cancer and in 28% of patients from the glioblastoma group. Will it work? We really hope so.
***
Did you find something useful in this article? If so, please like it and share it with other cancer patients.Progress in cancer treatment continues without interruption!

The chances of a successful treatment, among other things, depend on the correct use of the right medicines. Not necessarily new: in the treatment of many types of cancer, the improved effect is achieved largely due to the existing drugs according to new schemes. But in order to keep up to date, a doctor needs to read a lot, and in English, and attend leading conferences. All this is done by Israeli doctors iOncolog. How to get to their consultations without leaving your home, and how much it costs, you can read here: bit.ly / wspFAQ

[Based on materials to be updated]
# iO_biliary_bladder_scan # iO_Trodelwy # iO_brain_scan # iO_glioblastoma # iO_BRM # iO_metastasis_in_the_brain

Antidepressant Simbalta can relieve pain1

13.06.2012

Cancer patients receiving certain types of chemotherapy often experience painful tingling sensations in their extremities, called peripheral neuropathy, and a new study has now shown that the antidepressant Simbalta may be the first drug to relieve this condition.In a small study, 59% of patients who developed peripheral neuropathy reported relief after taking Simbalta (duloxetine), compared with 39% of those taking placebo pills.

“Taking Simbalta daily reduces the symptoms of chemotherapy-induced neuropathy and the severity of pain in most patients, and improves body function and quality of life,” said study author Ellen Loveo Smith, senior lecturer at the University of Michigan School of Nursing.According to her, most patients “tolerate the drug very well”. On Sunday, Smith spoke at a press briefing at the American Society of Clinical Oncologists’ annual meeting in Chicago. The results of the study were officially presented on Monday.

One of the experts in this field is very inspired by the findings. “Patients undergoing chemotherapy have to deal with a lot of changes, both physically and mentally, so improving the quality of life in such a difficult period is extremely important,” says Dr. Stephanie Bernik, head of the Department of Surgical Oncology at Lenox Hospital Hill ”in New York.”It is very encouraging that we can now offer a drug that can mitigate this dire side effect and make chemotherapy better tolerated.”

Chemotherapy-induced peripheral neuropathy, involving tingling and numbness in the hands and feet, is usually a side effect of chemotherapy drugs such as platinum or taxanes (Taxol or Taxotere). It is estimated that neuropathy occurs in 30% of patients receiving these drugs, and this side effect contributes to the fact that patients can stop treatment.

“In the most severe cases, some patients have to endure neuropathy for months, and sometimes for several years after completing treatment,” says Smith. “Therefore, the condition is considered chronic, distressing and incapacitating. And on top of all this, today there are no tools that would be effective in solving this problem. ”

The new study, sponsored by the US National Cancer Institute, included 231 patients.All participants developed peripheral neuropathy after taking the anticancer drug platinum, Oxaliplatin, or after taking the taxane Paclitaxel (Taxol). They were randomly assigned to receive placebo pills for five weeks, or half the dose of Simbalta – 30 milligrams per day – for the first week, and then the full dose of the drug – 60 mg – for the remaining four weeks.

According to Smith, Simbalta is thought to help alleviate neuropathy by altering the level of neurotransmitters related to nervous system function in the brain.As noted in the study, the drug is already being used to treat diabetic peripheral neuropathy. The study found that, compared to the placebo group, the Simbalta group had more patients reporting an improvement in neuropathy symptoms. Smith says that “33% of patients taking duloxetine experienced at least 30% pain relief and 21% of patients experienced at least 50% relief.” These numbers are much higher than those among patients taking placebo.

“The patients taking Simbalta also had fewer important aspects that were affected by pain; it is general activity, movement, walking, normal workflow, relationships with people, sleep and enjoying life, ”says Smith.However, not all study participants felt the positive effects of the drug, and some even felt an increase in tingling / numbness during the course of the trials. However, the authors of the study say that among those who took Simbalta, this happened less often (11%) than among those who took placebo (28%).

Simbalta may itself cause side effects, in particular fatigue. 11% of patients taking Simbalta reported moderate to severe fatigue, compared with 3% among those taking placebo.Smith says her research team is now working to try to identify patients who will respond to the drug so that Simbalta can be targeted to those people who are most likely to benefit.

Another oncologist also said he was very encouraged by the preliminary results. “There are really few good treatments for neuropathy, a common side effect of some of the chemotherapy drugs we use to treat the most common cancers of the lung, colon, and breast,” says Dr. Cardinale Smith, Hematology / Medical Oncologist, Cancer Research Center. the Tisch Institute and Mount Sinai School of Medicine in New York City.”This study provides evidence that there is a drug that has good efficacy in treating what may be a debilitating toxicity.”

The American Society of Clinical Oncologists, Dr. Nicholas Vogelzang, who was the head of the briefing for journalists, says that he sees many cases of neuropathy among his patients, many of whom are receiving platinum chemotherapy drugs.“I definitely intend to try this method as a treatment for these patients as soon as I get back to my office,” says Vogelzang, who is the medical director of the Therapy Development Committee of the Nevada Comprehensive Cancer Centers.

Data and results presented at a medical conference are generally considered preliminary until published in a peer-reviewed medical journal.

Adapted from medicinenet.com
Source: Med123.ru

Cymbalta (duloxetine): Uses and precautions

It is used to treat major depressive disorders, generalized anxiety disorders, painful peripheral neuropathy, especially diabetic neuropathy, and osteoarthritis pain.

It can also help fibromyalgia patients.

Cymbalta is also sold under the brand names Duzela, Yentreve, Xeristar and Ariclaim.

Use of Simbalta

Cymbalta has been approved for use in the treatment:

depression
neuropathic pain associated with diabetes
generalized anxiety disorder
fibromyalgia
muscularis how and why Simbalta works, but it can lead to changes in the activity of serotonin and norepinephrine.
Serotonin is a natural neurotransmitter that plays an important role in the regulation of mood, gastrointestinal function, pain perception, and several other physical functions.
Norradrenaline, or norepinephrine, is both a hormone and a neurotransmitter. It acts primarily in the area of the brain stem known as the macula blue.
Norepinephrine plays a role in the fight-or-flight response, which is the body’s biological response to stress. It also affects how people perceive pain, mood, emotion, movement, blood pressure, cognition, or thinking.
How does Cymbalt treat depression and pain?
One of the triggers of depression may be an increase in the level of proinflammatory cytokines in the central nervous system (CNS).Experts believe that Cymbalt blocks the re-consumption of serotonin, and most likely norepinephrine, in the central nervous system.
It is believed that cymbalt reduces the activity of pro-inflammatory cytokines and at the same time increases the activity of anti-inflammatory cytokines. However, no scientific studies have confirmed this.
Cymbalt has an analgesic effect. It helps control the pain symptoms present in fibromyalgia, bone pain, and diabetic neuropathy.Scientists believe this is due to a blockage of the active ingredient’s sodium ion channel.
The active ingredient in Cymbalt is duloxetamine hydrochloride. Inactive ingredients include FD&C Blue # 2, gelatin, hypromellose, hydroxypropyl methylcellulose succinate, sodium lauryl sulfate, sucrose, sugar spheres, talc, titanium dioxide, and triethyl citrate.
How is Simbalta perceived?
Cymbalta is available as a capsule or delayed release capsule.The doctor will inform the patient of the required dosage. This will depend on the age and condition of the patient.
For anxiety, the patient may start taking 60 milligrams (mg) once a day. For some of them, the doctor may prescribe 30 mg per day for 7 days and then accumulate up to 60 mg per day.
The maximum dose is usually 120 mg per day.
For children, the elderly and people with other medical conditions, the dosage may be different.
Cymbalta can be taken with or without food, but it should not be crushed or crumbled into food.
Adverse effects
Common side effects include
- Dizziness
- Drowsiness
- Insomnia
- Nausea
Patients may also experience headache and dry mouth.
Like many other SSPs, Cymbalt can cause sexual side effects in both men and women.
The FDA notes that it has been associated with colitis and cutaneous vasculitis, sometimes with systemic involvement.
Manufacturers, Eli Lilly, warn that this can lead to liver damage, abnormal bleeding and skin reactions.
It can also lead to serotonin syndrome, a potentially fatal illness that includes, among other symptoms, agitation, hallucinations, or coma.
They also indicate that hypotension or low blood pressure may occur. This can lead to loss of consciousness and fall, especially in the first week of use, but possibly at any time.
Women should not take Simbalta during pregnancy or lactation, as animal studies show that it can negatively affect fetal development in early childhood.
Precautions
Symbalt may interact with some other drugs.
It should not be used in conjunction with any drug known as monoanimase inhibitors (MAOIs).
MAOIs include transylcypromine (Parnat), selegiline (Eldepril, Emsam, Zelapar), furazolidone (Furoxon), rasagilin (Azilect), phenelzine (Nardil), isocarboxazid (Marplan), intravenous methylene blue, and antibiotics.
The use of Simbalta with these drugs can lead to serious side effects.
Patients, and especially children and adolescents, may first think about suicide when they start using Simbalta. The physician should closely monitor patients during the first 4 months of treatment for mood changes and other side effects.
If any of the following symptoms or situations occur, the patient should immediately report it to the doctor:
- worsening symptoms of depression
- persistent thoughts of self-harm or suicide.
- hyperactivity
- anxiety
- aggressive
- dislike
- agitation
- irritability
- impulsivity
Patients should avoid alcohol and smoking while taking Simbalta. Smoking can reduce the effect of the drug by a third.
They must also exercise caution when performing activities that require a clear and alert mind, such as using heavy machinery or driving a vehicle.
Before using Cymbalta, the patient should inform the doctor about the following diseases, conditions or situations:
- liver disease
- kidney disease
- epilepsy or any other type of seizure.
- glaucoma
- history of suicidal thoughts.
- bleeding or bleeding disorder.
- history of drug abuse.
Patients should be screened for bipolar disorder as Cymbalta can cause an episode of mania.
The patient must also inform the doctor if they are using drugs:
- diuretic or water tablets.
- non-steroidal anti-inflammatory drugs (NSAIDs)
- medicine for arthritis
- treatment of heart rhythm disorders
- treatment of migraine
- St. John’s wort
- amphetamines
- other antidepressants should not be stopped
9 They should talk to their doctor first, as the dosage must be gradually reduced.
Some users have sued, claiming that Cymbalta is very difficult to stop using, citing withdrawal symptoms such as tunnel vision and “brain tears”. Plaintiffs argue that manufacturers have mitigated these effects.
However, the courts ruled that a warning had been issued.
It is important that patients and doctors work together and are aware of the risks associated with taking different medications.
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To whom the question is addressed The question is addressed to:
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Consultant being asked:
Everyone…Agabekyan Nonna Vachaganovna (Obstetrician, Gynecologist) Aizikovich Boris Leonidovich (Pediatrician) Akmalov Eduard Albertovich (Allergologist, Physician of sports medicine) Aleksandrov Pavel Andreevich (Venereologist, Hepatologist, Infectionist, Parasitologist, Epidemiology) Aristova Anaistova Armashov Vadim Petrovich (Surgeon) Afanasyeva Daria Lvovna (Cardiologist, Therapist) Belyaeva Elena Aleksandrovna (Gynecologist, Neurologist, Reflexotherapist) Bushaeva Olga Vladimirovna (Pulmonologist, Therapist) Vrublevskaya Elena (Pediatrician) Gensetik Olga Vladimirovna (Genn. , General practitioner, Dermatologist) Grigorieva Alla Sergeevna (General practitioner, Therapist) Demidova Elena Leonidovna (Psychologist, Psychotherapist) Denischuk Ivan Sergeevich (Andrologist, Urologist) Dimina Tamara Olegovna (Obstetrician, Allergologist, Angiosurgeon) Dovgalev Anastasia (Obstetrician, Allergologist, Angiosurgeon) Dovgalev Anastasia , Radiologist) Dolgova Yulia Vladimirovna (Pediatrician) Dyakonova Maria Alekseevna (Geriatrician, Therapist) Zagumyonnaya Anna Yurievna (Doctor Sports medicine, Hirudotherapist, Nutritionist, Cosmetologist, Therapist) Zverev Valentin Sergeevich (Orthopedist, Traumatologist) Zgoba Maryana Igorevna (Oculist (Ophthalmologist)) Zinchenko Vadim Vasilievich (Radiologist, Surgeon) Zoriy Evgen Vladimirovich, Neurologist, Psychologist Vladislavovna (Gastroenterologist, Dermatologist, Immunologist, Infectionist, Pulmonologist) Ilona Igorevna (General practitioner, Gastroenterologist, Therapist, Endocrinologist) Kalyavina Svetlana Nikolaevna (Obstetrician, Gynecologist) Ekaterina Viktorina (Other specialty) Karpenko Kalyatov ogly (Oncologist, Surgeon) Kireev Sergey Aleksandrovich (Psychiatrist, Psychologist, Psychotherapist) Kirnos Marina Stanislavovna (Dentist, Dentist for children, Dentist-therapist) Kopezhanova Gulsum (Obstetrician, Gynecologist) Kravtsov Aleksandr Vasilievich (Narcologist, Psychiatrist) Krasnoyarsk diagnostics, Medical Director, Phlebologist, Surgeon) Kryazhevskikh Inna Petrovna (Therapist, Gastr Oenterologist) Kudryashova Svetlana Petrovna (Endocrinologist) Kurtanidze Irakliy Malkhazovich (Oculist (Ophthalmologist)) Kushch Elena Vladimirovna (Dietitian, Therapist) Lazareva Tatyana Sergeevna (ENT (Otorhinolaryngologist)) Lapteva Maksimskaya Larisa Ivanovna Ps. Leonidovich (Venereologist, Dermatologist) Leonova Natalya Nikolaevna (Pediatric surgeon) Litvinenko Stanislav Grigorievich (Orthopedist, Traumatologist) Lyamina Irina Alekseevna (Obstetrician) Maksimenko Tatyana Konstantinovna (Infectionist) MALKOV ROMAN EVGENETOLOGISTOVICH (Rheumatologist) ) Martirosyan Yakov Ashotovich (Pediatric surgeon, Proctologist, Traumatologist, Urologist, Surgeon) Maryashina Yulia Aleksandrovna (Obstetrician, Venereologist, Ultrasound diagnostics doctor, Gynecologist, Pediatrician) Matveeva Yaroslava Dmitrievna (Pediatrician) Mershed Khasan Imadovich, Nertebrina Neurologist) Mildzikhova ALBINA Beksoltanovna (General practitioner, Gynecologist, ENT (Otorinola ringologist), Pediatrician, Therapist) Muratova Natalya Sergeevna (General practitioner, Nutritionist) Mukhorin Viktor Pavlovich (Nephrologist) Naumov Alexey Alekseevich (Chiropractor) Nikitina Anna Alekseevna (Oculist (Ophthalmologist)) Olga Vikabilorovna, Neurologist, Neonatrologist Therapist) Pavlova Maria Igorevna (Dentist, Dentist-surgeon, Maxillofacial surgeon) Panigribko Sergey Leonidovich (Venereologist, Dermatologist, Cosmetologist, Masseur, Mycologist) Panteleeva Kristina Alekseevna (Neurologist) Pastel Vladimir Borisovich (Orthopedist), Rheumatologist, Rheumatologist Anatoly Anatolyevich (Andrologist, Urologist) Pershina Natalia Sergeevna (Neurologist) Prokofieva Anastasia Mikhailovna (ENT (Otorhinolaryngologist)) Prokhorov Ivan Alekseevich (Neurosurgeon, Surgeon) Pushkarev Alexander Voldemarovich (Gynecologist, Rehabilitation Psychotherapist, Enecologist) (Pediatrician) Radevich Igor Tadeushevich (Andrologist, Venereologist, Sexologist, Urologist) Saprykina Olga Aleksandrovna (Neurologist) St. Echnikova Anastasia Evgenievna (Dentist, Pediatric Dentist, Dentist-orthopedist, Dentist-therapist, Dentist-surgeon) Semeniy Alexander Timofeevich (General practitioner, Rehabilitologist, Therapist) Sergeychik Nikita Sergeevich (Anesthesiologist, Homeopath) Siluyanova Valeria Viktorovna (ultrasound specialist , Gynecologist) Sobol Andrey Arkadievich (Cardiologist, Narcologist, Neurologist, Psychiatrist, Psychotherapist) Soshnikova Natalia Vladimirovna (Endocrinologist) Stepanova Tatyana Vladimirovna (ENT (Otorhinolaryngologist)) Stepashkina Anastasia Sergeevna (Hematologist, Pulmonologist), Therapist, Therapist ) Sukhanova Oksana Aleksandrovna (Clinical pharmacologist, Psychologist) Sukhikh Danil Vitalievich (Psychiatrist) Tumarets Kirill Mikhailovich (Physician of physiotherapy exercises, Physician of sports medicine, Kinesitherapist, Rehabilitation physician, Physiotherapist) Turlybekova Venera Ravilievna (General practitioner) Nikolaevna Ustymatova (General practitioner), Nikolaim Therapist, Transfusiologist) Fateeva Anastasia Alexandrovna (G astroenterologist, dietitian, psychotherapist, endocrinologist) Fedotova Tatyana Vladimirovna (Ultrasound diagnostics doctor, hematologist, therapist) Fominov Oleg Eduardovich (Sexologist) Fominov Oleg Eduardovich (Sexologist) Furmanova Elena Aleksandrovna (Allergologist, Immunologist, Infectious disease specialist) Doctor of ultrasound diagnostics, Oncologist, Urologist, Surgeon) Khasanova Gulnara Sunagatullovna (Obstetrician, Doctor of ultrasound diagnostics) Chupanova Aida (Obstetrician, Gynecologist) Chupanova Aida Idayatovna (Obstetrician, Gynecologist, Reproductologist (IVF)) Shvaylikova O. Maria Alexandrovna (Nephrologist, Therapist) Shtemberg Lyubov Valerievna (Neurologist) Olga Shchepetova (Therapist) Denar Lukmanovich Yagudin (ENT (Otorhinolaryngologist)) Yarvela Marianna Yurievna (Psychologist)
Description of the problem:
/ me / – Mental Disorders thread # 26
>> 607454 (OP)
1.Male, 26.
2. No.
3. 2015.
4.
I think I am depressed. I’m apathetic, everything always sucks. I often think, even dream of getting a serious injury (for example, to be hit by a car), so that I have a reason to feel miserable, and not like now, for no reason. Sometimes I think about suicide, but not seriously.
This bullshit interferes with work. I’m afraid to screw it up, I’m afraid that I’m doing everything wrong, I’m afraid that I will be fired, I’m afraid that when I get fired, they will trumpet all over the city and hell I’ll find myself a job (programmer).The third day was not at work, said to be sick. And this is not the first time. I’m afraid to appear in front of my boss. By the way, there were no complaints about the work from the boss (except for passes). Objectively, I am a lousy programmer, but I am well versed in my field at the current place. Finding a new job will be extremely difficult.
This shit gets in the way. Can’t bring myself to do serious housework. I love computer games, but I don’t play online anymore. it is obvious that it is useless for me to try to compare with other players.
Unkissed virgin. I usually sit in front of the computer until I chop off in the chair. But if I go to bed normally, then from the realization that I will never have a girlfriend I want to cry. Why won’t there be a girl? Because they don’t need a man with such problems. We need to change. But I can not. I can’t go in for sports, as everyone advises. I can only sit in front of my computer, read sci-fi and fantasy, play, and browse reddit and two.
I apologize, I will now write here the story of my life, everything that I have never told anyone.I don’t know why, but we must speak out.
I think that the problems are due to the fact that I was bullied at school. They poisoned me to the point that I became antsy. He recoiled from any sudden movement, even if he knew that there was no danger. I walked along the wall. At school, I wanted to self-drunk from such a life, but then I was young, stupid, and thought that suicide was idiocy, weakness. I found solace in computer games and books. Before entering school,
I recalled my progress in Morrowind and Fallout, thought about what I would do next, I thought how I would behave in the place of the heroes of the books, and only so I stretched out the day.I passed the exam, entered the budget, the programmer, simply because it required the most points, and I rummaged in computers. It was a mistake, I don’t like programming. It would be nice to be a sysadmin like a father.
When I went to college, the persecution stopped, stopped twitching somewhere in half a year. I met great people at the university, my former group is some of the best people I know.
And when I went to college and the bullying stopped, I realized that I was shit. I can’t do anything except feel sorry for myself and play on my computer.I fucked up my childhood. I didn’t do anything, I didn’t learn anything. I didn’t know what to do, I didn’t like my specialty, I hated myself. But on the other hand, there were very good people around me, pleasant companions, good friends.
And then my father gave me one part-time job … In short, the repair of computers, administration, repair of some mechanisms. My parents put me there in my third year, so that I kind of learn to work and it doesn’t interfere with my studies. But there was no smell of part-time work, it was a full-fledged job for 8 hours, and it was practically incompatible with studies.But since I was hired there for a part-time job for 4 hours, then they paid 12K. I just put my dick on my studies and started working. I liked it, the work is not easy, but very specific. Cat apparatus. Make it work. And nibet. The bosses are in another city, I am generally one worker for the whole city, consultation with senior colleagues by phone. I was fine.
The third course somehow lasted, and from the fourth I had to take academic. Parents all this time were in blissful ignorance. When I took the academy, they were shocked.They swore. I had to quit my job. Parents insisted on graduating from the institute. But I could not return to my studies, I didn’t show up at the institute for a year, bullshit. I couldn’t just go to the lectures and beg for retakes and tests. I couldn’t bring myself to even look them in the eye. Half a year did nothing. I must say that by this time, relations with parents were in complete chaos. I’ve been lying recklessly since I started working. And although I liked the work, the constant lies to my parents were boring me.I have always been a fat man, 80 kg at the age of 18. During my work, from constant stress, I dropped 10 kilos (though now I weigh 90. I love to eat). In the end, I just screwed up my dick, and without explaining the reasons, I stopped pretending that I was trying to study and hand over debts. Parents gave up, stopped pressing. Then, through friends, I got a job at the current job – a programmer (who am I kidding, a script macaque).
And now, since 2015, I’m seriously in complete shit. I have no future. If I drink now, only my parents will grieve for me (or maybe they won’t – a tear finally from their neck), and about 7 friends.And nothing will change. They’ll find a new script monkey at work, and that’s it. So why live at all then? To play computer games and read. And, of course, films and TV shows. Is it worth it? Maybe I’m wrong? Maybe you need to collect the eggs into a fist and jump off the bridge? Do everyone a favor? At least once in your life to commit a volitional act? Or collect eggs into fists and continue to work and play and watch and read?
Why am I writing all this on the medach? In my opinion, I have a problem with my head. I really don’t want to commit suicide, but life is getting hard.Should I see a doctor? To which? Or am I just a rag, a subhuman, and the doctor will not help, just shrug his shoulders and advise you to go in for sports?
5. There have never been any attempts at suicide. Because when I was still in school, I decided that I only needed to commit suicide. The pills and veins – I’ll get scared and call an ambulance – don’t fit. A bullet in the forehead would be ideal, but weapons are too difficult to obtain. I don’t want to hang myself, not instant death, but I’m very afraid of pain, and I don’t want someone to remove and wash my shitty corpse and see it in general.There remains a fall from a height. I don’t want to jump from the house – I’ll suddenly fall on someone. And again, my broken body will remain. What remains is the jump from the bridge into the river. The bridge is high. The probability of instant death is quite high. As a precaution, I’ll put on a backpack loaded with bricks. And no corpse. If I don’t tell about it in a note, and I jump at night, then no one will know.
6. No diseases. I weigh 90 kg with a height of 176.
7. No.
8. Severe depression.You scored points: 33.
9. Your level of anxiety on the Sheehan scale is 22 points.
10. I don’t think social phobia is bad at all. I have 4 HDI friends, 3 online, and that would be enough for me. If there was a girl. But she’s not there. And I don’t know how to make new friends, let alone meet girls. Therefore, on the Libovitz scale: You, in all likelihood, have a moderate degree of social anxiety. You scored points: 65.
11. Never drank or used substances. Absolutely.Not a drop, not a single gram.
12. I live with my parents, I work as a programmer.
13. Should I see a doctor? To which? Or maybe I have a developmental delay, and I just have a depressive teenage phase at 26 years old, and everyone goes through it, and you just need to not be a rag? How? What should I do?
P.S. And I’m also inattentive – fucked up. First I posted this wall of text in an old thread.
instructions for use, reviews, analogs
Antidepressant: Mianserin
Active ingredient: Mianserin
Mianserin belongs to the category of antidepressants, with the help of which depressive conditions are treated, regardless of their genesis.During the period of use of the medication, the adrenergic transmission in the brain is enhanced. The drug has no anticholinergic activity. With simultaneous use with alcohol, an increase in the depriming effect is observed. Improper drug treatment can lead to disorders in the nervous, cardiovascular and lymphatic systems.
Mianserin instructions for use
The drug is characterized by the presence of antidepressant action. It also has a hypnotic and sedative effect.After taking the drug inside, its rapid inhibition from the digestive system is observed. The maximum concentration of the active substance is reached after 3 hours after taking the drug. If the medicine is taken daily, then the achievement of a uniform concentration of the active substance in the body will be observed after 6 hours.
Indications for use
The use of the drug is carried out for the treatment of depression of various origins.
Method of application
Minserin dosage is selected individually.At the initial stages of treatment, it is recommended to take 30 milligrams of medication daily. It is necessary to gradually increase the dosage to 60 milligrams per day. The tablets are taken orally and washed down with plenty of water.
Side effects
Inappropriate drug treatment can lead to the development of disorders in the central nervous system:
- Hypomania;
- Drowsiness;
- Hypokinesia;
- Convulsions.
Orthostatic hypotension was diagnosed in some patients after taking the drug.The occurrence of reversible leukopenia, stomatitis, agranulocytosis, jaundice, and aplastic anemia may also occur. Complications can manifest themselves in the form of allergic reactions, peripheral edema.
Contraindications
The drug should not be taken in case of manic syndrome, liver malfunction, hypersensitivity to components. If the patient’s age is less than 18 years old, then he needs to refuse to take the medicine. In the acute period of myocardial infarction, drug treatment is strictly prohibited.
Pregnancy and lactation
During the period of childbearing and breastfeeding, the medicine is prohibited.
Interaction with other drugs
If Mianserin is used simultaneously with anticonvulsant drugs, the first of them will lower the seizure threshold. After a course of treatment with MAO inhibitors, you must wait two weeks and only then use the drug.
Overdose
In case of an overdose, the patient may experience persistent sedation or severe arterial hypertension.Some patients experienced the appearance of respiratory depression, seizures, arrhythmias.
If symptoms of an overdose occur, then he needs to wash the stomach. In order to maintain the performance of vital organs, the use of symptomatic therapy is recommended.
Form of issue
Production of drugs is carried out in the form of tablets that have a film shell.
Storage conditions
It is necessary to store the tablets in dry places, to which the access of children is limited.The room temperature is no more than 25 degrees.
Composition
The main component of the drug is mianserin. It is also developed on the basis of excipients – polyethylene glycol, titanium dioxide, hypromellose, corn starch, talc, lactose, povidone, magnesium stearate.
Conditions for dispensing from pharmacies
The drug is dispensed from pharmacies only with a doctor’s prescription.
Precautions
If during the period of treatment with the drug, patients develop fever, pharyngitis, stomatitis or other infectious diseases, then a blood test is recommended.
Mianserin can affect psychomotor reactions. That is why, during treatment with the drug, patients are not recommended to drive vehicles and operate complex mechanisms. If a person has heart, renal and hepatic insufficiency, then his treatment should be carried out under the supervision of a physician.
Mianserin analogs
Mianserin reviews of patients
Most of the patients who underwent treatment with Mianserin left their feedback about it.Patients claim that this drug is used to treat depressive conditions quickly and efficiently. They say in their reviews that the condition improved significantly after the first intake of the medication. Their mood improved, their sleep stabilized, and anxious thoughts disappeared. Absolutely all patients say that Mianserin has a convenient form of release, which greatly simplifies the process of treating depression. Patients who have taken the drug say that it is characterized by a mild effect.
Reviews of doctors
Most doctors recommend taking Mianserin, as it has a high effect. Experts say in their reviews that this medicine has a fast response, which speeds up the process of treating depression. They say they are prescribing the drug to patients because it has minimal unwanted effects.
Doctors in the reviews claim that they did not notice cases of drug overdose. Experts really like that the dosage of the medication is calculated individually, which allows them to prescribe the required amount of medication in accordance with the severity of the disease.The doctors’ reviews confirm that the medicine can eliminate depressive conditions within 2 weeks.
Mianserin belongs to the category of effective drugs with which you can eliminate depression. In order to avoid the development of complications, it is necessary that the drug is prescribed by a doctor after examining the patient.

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/ me / – Mental Disorders thread # 26

instructions for use, reviews, analogs

Mianserin instructions for use

Indications for use

Method of application

Side effects

Contraindications

Pregnancy and lactation

Interaction with other drugs

Overdose

Form of issue

Storage conditions

Composition

Conditions for dispensing from pharmacies

Precautions

Mianserin analogs

Mianserin reviews of patients

Reviews of doctors

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