Cymbalta Pain relief for woman with Fibromyalgia (study)

Discussion in 'Fibromyalgia Main Forum' started by carebelle, Oct 6, 2006.

  1. carebelle

    carebelle New Member

    Cymbalta Provided Sustained Pain Relief for Women with Fibromyalgia
    Main Category: Depression News
    Article Date: 19 Oct 2004 - 11:00am (PDT)

    Study shows improvement in pain unrelated to effect on mood and presence of major depression

    The antidepressant Cymbalta® (duloxetine HCl; pronounced sim-BAWL'-tuh), a dual-reuptake inhibitor of serotonin and norepinephrine, 60 mg once or twice daily, significantly reduced pain in more than half of women treated for fibromyalgia, with and without major depression, according to 12-week data presented this week at the annual meeting of the American College of Rheumatology.

    These data are being presented one month after another study, in which Cymbalta also significantly reduced pain in women with fibromyalgia versus placebo, was published in Arthritis and Rheumatism.

    "The results in these study patients were very striking in the degree of reduction of pain, which is the primary symptom of fibromyalgia. In addition, Cymbalta significantly improved these patients' quality of life and overall functioning, as measured by quality of life and disability scales," said Lesley M. Arnold, M.D., University of Cincinnati College of Medicine, Cincinnati, Ohio, who presented the study. "For many, the pain of fibromyalgia makes them so sensitive to being touched that even a hug from a loved-one can be intolerable."

    In the study, Cymbalta's effect on pain was independent of any effect on mood, and there was no significant difference in response rates between patients in the study with and without major depression.

    Fibromyalgia is a chronic disorder that causes widespread pain and tenderness in the muscles and soft tissue of nearly 6 million Americans, predominantly women.1 According to the National Fibromyalgia Association, patients often experience a deep muscular aching, throbbing, twitching, stabbing and shooting pain that "knows no boundaries, migrating to all parts of the body and varying in intensity." Neurological complaints, such as numbness, tingling and burning, are often present and add to the discomfort of the patient.

    While the cause of fibromyalgia remains unknown, it has been linked to abnormalities in the brain's neurotransmitters, serotonin and norepinephrine, the same neurotransmitters believed to play a role in major depressive disorder, diabetic peripheral neuropathic pain and stress urinary incontinence.1

    There is no approved treatment for fibromyalgia. Cymbalta, a balanced and potent serotonin and norepinephrine reuptake inhibitor, is proven to help treat the emotional and painful physical symptoms of depression. It also is the only approved treatment for management of pain caused by diabetic peripheral neuropathy, a type of nerve damage. Cymbalta is not approved for the treatment of fibromyalgia.

    Study Findings

    More than half of patients treated with 60 mg of Cymbalta, once or twice daily, responded to treatment after 12 weeks, compared with one-third of those taking a sugar pill.

    Patients treated with 60 mg of Cymbalta, once or twice daily, were significantly more likely to experience a sustained treatment response than those treated with a sugar pill (44 percent, 43 percent and 19 percent, respectively).

    Patients treated with 60 mg of Cymbalta, once or twice daily, had functional improvements on the Sheehan Disability Scale which measures disability at work, in family life and in social life, that were significantly greater than those of patients taking a sugar pill.

    Cymbalta 60 mg once or twice daily directly reduced pain (75.7 and 87.5 percent, respectively) more than the indirect effect attributed to improvement in depressive symptoms (24.4 percent and 12.5 percent, respectively).

    Cymbalta 60 mg twice a day also relieved the pain associated with tender points often associated with fibromyalgia.

    Treatment-emergent adverse events were more common in patients treated with Cymbalta 60 mg once or twice daily, than in those treated with a sugar pill (79.2 percent). Events were typically mild to moderate in severity.

    Patients taking Cymbalta 60 mg once or twice daily were more likely to discontinue because of side effects than those taking placebo (21.2 percent, 23.3 percent and 11.7 percent respectively).

    The most common side effects for patients taking Cymbalta (occurring in at least 5 percent of patients and at twice the rate for those receiving placebo) were nausea, dry mouth, constipation, diarrhea, decreased appetite, nasopharyngitis, increased sweating and anorexia. In addition, for patients taking Cymbalta 60 mg twice daily, sleepiness and feeling jittery were common side effects.

    Methodology

    In a 12-week, double blind study, patients were randomized to receive Cymbalta 60 mg once (n=118) or twice daily (n=116), or placebo (n=120). The primary outcome measure was Brief Pain Inventory (BPI) 24-hour average pain severity score (score range: 0 [no pain] -10 [pain as bad as you can imagine]). Response to treatment was defined as a 30 percent reduction in the BPI 24-hour average pain score. Secondary outcome measures included remaining BPI pain and interference scores, Fibromyalgia Impact Questionnaire (FIQ), the tender point pain threshold and tender point number, Clinical Global Impression of Severity (CGI-Severity), Patient Global Impression of Improvement (PGI-Improvement), and the 17-item Hamilton Rating Scale for Depression.

    About Cymbalta

    Cymbalta is indicated for the treatment of major depression and the management of diabetic peripheral neuropathic pain, both in adults. As Cymbalta has not been studied in children, Lilly discourages its use in those under 18.

    Cymbalta should not be confused with Symbyax™ (pronounced SIMM-bee-ax), a medicine for bipolar depression also marketed by Lilly. Symbyax is a combination of olanzapine, the active ingredient in Zyprexa®, and fluoxetine, the active ingredient in Prozac®. Symbyax is available in capsules of 6 mg/25 mg (olanzapine/fluoxetine), 12 mg/25 mg, 6 mg/50 mg and 12 mg/50 mg. Cymbalta is available in 20 mg, 30 mg and 60 mg capsules.

    Important Safety Information

    Patients being treated with antidepressants should be observed closely for clinical worsening of depressive symptoms and suicidality. Patients and their families should watch for these as well as for anxiety, agitation, panic, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or overexcitement and hyperactivity. Call the doctor if any of these are severe or occur suddenly. Be especially observant when starting any antidepressant therapy and whenever there is a change in dose.

    Prescription Cymbalta is not for everyone. People who are allergic to duloxetine hydrochloride or the other ingredients in Cymbalta should not take it. If you have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI), are taking thioridazine or have uncontrolled narrow-angle glaucoma, you should not take Cymbalta. Talk with your doctor before taking Cymbalta if you have serious liver or kidney problems, glaucoma or consume large quantities of alcohol. Women who are pregnant should talk with their doctor before taking Cymbalta. Nursing while taking Cymbalta is not recommended.

    In the fibromyalgia study of Cymbalta, the most common side effects were nausea, dry mouth, constipation, decreased appetite and anorexia. In clinical studies of Cymbalta for depression, the most common side effects were nausea, dry mouth, constipation, decreased appetite, fatigue, sleepiness, and increased sweating. Cymbalta is also approved for the management of neuropathic pain associated with diabetic peripheral neuropathy. In clinical studies of Cymbalta in these patients, the most common side effects were nausea, sleepiness, dizziness, constipation, dry mouth, increased sweating, decreased appetite, and muscle weakness. In all clinical trials, most people were not bothered enough by side effects to stop taking Cymbalta. Your doctor may periodically check your blood pressure. Don't stop taking Cymbalta without talking to your doctor.

  2. dononagin

    dononagin New Member

    excellent article.. thanks for sharing!
  3. JLH

    JLH New Member

    Good article--thanks for sharing.

    It stated that for patients taking Cymbalta 60 mg twice daily, sleepiness and feeling jittery were common side effects.

    Taking 60 mg just ONCE a day, early in the morning, made me extremely sleepy all day!!! Therefore, I had my doctor prescribe 30 mg capsules, and now I take one capsule in the AM and one in the PM. This corrected the sleepiness problem!!

    I do great on it now!!

    Hugs,
    Janet
  4. carebelle

    carebelle New Member

    how long have you been taking this and have you had any other side effects? My mental health Doctor and GP Doctor are thinking about putting me on this.

    I have been on celexa for about 3 months its been great for my depression but I also have severe pain .I just do not want to mess up my mental health by changing over.

    anyone else have an opinion ?
  5. 69mach1

    69mach1 New Member

    sweating in every area on my body...badly...weight gain....the witchiness...sleepy if took it at morning...i would sleep til 2 pm or later...somtimes it would wire me..

    pulse rate incresed it ws bad

    jodie

    oh the pain was always there no different today.
    jodie
  6. carebelle

    carebelle New Member

    I do not know how you can function taking all that medicine.

    I am sorry but that just seems like to much medicine. My step sister was on a lot of stuff like that but she did not even start to get well until she got a new Doctor who took her off of all of it but a couple.

    I do not mean to offend you but Hon this is just to much for one person to put into one body. Please get a second opinion about these drugs from a different group of Doctors.We just do not know what harm these drugs really do on top of this mixture of meds.
  7. bluestanglady

    bluestanglady New Member

    Wow, that's a LOT of medicine!!
  8. jtbear

    jtbear New Member

    But, Sue, I, too, wonder how you can even function with all these meds on a daily basis. My concern is not only the meds, but wonder if you have experienced breathing problems while on this much medication. I have had to change the type and strength of my pain meds over the years due to decreased effect, which sometimes happen. As a retired nurse, I question the doctors prescribing these meds. Please take this as caring advice, not critical. In my humble opinion, you need a totally independent evaluation of your condition(s) and these meds. Also, I would hope you are not operating a motor vehicle while being this medicated.
    Again, please take this post as concern not criticism.
    Take care
    jtbear
  9. carebelle

    carebelle New Member

    This is just my opinion but you are not on the right med's for your problems .Too many drugs can cause more health problems.

    I would get another opinion from a new group of Dr.'s

    I would rather take a higher dose of a med then just keep adding to many different med's together. That just does not sound safe.Please get another opinion from new doctors.
  10. Bruin63

    Bruin63 Member

    I thank the Good Lord for leading me to some Great Dr.s who treat ALL my conditions not just the FMS/CMP.

    I take Norco 10mg, 6 times a day, that's one every 4 hr's, sometimes I can go longer, but usually I can tell when it's time of the pain meds, because my Body lets me know.

    I also take Soma, 4 times a day, for my Muscle pain and IBS.

    I also take Vistril for the Histamine problems that I have due to the FMS.

    I take Xanax 2 times a day, and it has been a Blessing, it helps me from being anxious and also with the Nausea, and it gets me to sleep. I don't stay asleep, tho because the pain wakes me up.

    I just recently went through a 6 week course of abx's for a Staff Infection.

    I also have to use an inhaler 2 times a day, Provintil.

    I can not tolerate most meds. and like someone who had a Post up about not being able to take supplements, I too have problems with taking them. ALways have.

    I know that they can be a big Plus in peoples lives, I'm not one of them, but not for lack of trying.

    For years I couldn't take any Pain med, untill the Dr's put me on Viocdin, after one of my many operations.

    I am allergic to more med's, but I won't bore you, ;o) with that list.

    I figure, I take no more than I need, to help me live a life, than the Fist full of Supplements that my SIL takes.
    She has had me try many of them, and I see the wonderful results she gets from them.

    I have also seen other Members here get better, from using the supplements, that they can get here from this website, as well, as other stores.
    At least we know, some of the profits do go back into Research,
    Thanks PH.

    But I camnot digest most meds, and supplements too, plus they can't have any Red dye in them, as I am allergic to that one.

    Anyway, what may seem like a lot of Med.s to one person, may be just what that Person needs. My Dr.s are tops in their care of me, and they don't just give them out like candy.
    I went through a lot of Pain, and finally found what helps me, the most.

    I have supported this website, for 6 years now, and I handed out their Pamphlets in the Dr.s office's and also every other Medical waiting room, because I do Believe, that Supplements can help in the treatment, for Some People, but not All people. ;o)

    We all have one goal, here to get Better, no matter, what Treatment works, that is what counts. ;o}

    sharonk


    [This Message was Edited on 10/11/2006]
  11. MsOnlyMe123

    MsOnlyMe123 New Member

    It's about 8:30 a.m. here in Florida. I'm not usually up or in the mood this early to jump on the board or do anything. It's more like, off and on sleep, take a few of my meds. for know and back to bed. Every morning of my life, for the past 9 years, being diagnosed with Fibro. and several other painful diseases - to long to mention, I feel that I just got hit and runned over by and 18" wheeler. I start my prayers for the day, begining, asking God, God when I said my prayers last night before I went to bed, I asked you if you will not relieve atleast some of ths excruciating pain, please, let me die in my sleep. Well, here I am again. Everyday, all day, I pray for my family, friends and myself. Call me crazy!!

    I was going to post about my suffering trip, had to drive myself - about 1/2, to my Primary doc. of Monday with excruciating pain throughout my ribs and chest. I do have Costo. I will post about this later, because I read this post and felt the feed to reply.

    Thank you for posting this article on Cymbalta. Many have replied on their experience taking this med. and others in question. My experience is that it did not help me. I know it is one of the newer medications that might help in depression and pain of Fibro. sufferers. I tried it about 2 years ago for about 3 months. I don't remember the doses that my doctor tried on me. I always felt sick to my stomach, nausas (sp) ect... Cymbalta did not help me in anyway, so I got off of it. From there I tried Lexapro 40 mg. and still on it. For me, it's a very smooth anti-depresant. It just seems to keep me level. I have been on many anti-depressant within 9 years and I find this one works for me. Also, I don't have any side affects which is great.

    Now, I would like to mention the post directed to Suzetal and the amount and dose of medication that she needs to take to try to live her life. I realize that we are all here to help each other through out all are terrible and disabilitating DD's. I love all the other great post like the Barn, the Porch and others that I just cannot think of right now. I have not been able to join in at this time, just to much for me to post alot, but I do here and there when my body allows me to sit at the computer. There are many of us that reach out to others with lifes challanges of family, friends, ect... I know that this board saves alot of members because we have no where else to turn. There is so much love and respect for each other. Also, I want to thank each and everyone of you for sharing all of your hard work and time consuming research on medical information. It's just outstanding. Again, thank you. Also, I want to thank all the members who try to help me and replying to my post.

    I am sure that Suzetal realizes the many medications that she, her body and her doctors (her team) have decided what she needs to take to function her life. I have a list of medications that I take to live my life and seeing this post, I would never share on this board. I know that in some of my post that I have mentioned a few.

    I know that I have become long winded... and now I need to lie down due to my Costo. and carpel tunnel in my wrist. I'm just trying to say, many of us, including myself, never in a million years would ever think that we would come down with these DD and all the medication and supplements, etc... that we need to take to live.

    I do realize that we are all here for each other as much as possible, loving, caring and sharing. Suzetal, I hope that you are not hurt by a few of the post that you received regarding what you need to take and do to live your life. I'm sure it is all out of caring, but no one should ever tell another what to take, how much, too much. This sensitive information is between you and your (TEAM) doctors. I realize that you posted this in hopes to share and possibly help another, in just stating what helps you live. Myself, I have gotted down some of the meds. and I will ask my pain management doctor if any might help me and then maybe I won't have to take one of my meds. in turn for another. You never know.

    Suzelal, I see from your Bio. that your from RI. I lived in Mass. all my life and just can't wait to sell my Condo here in Florida and go home. Four years is enough, in the stinky, hot, humid, stinky people state.

    It took be over an hour to type this and I am exhausted and a huring puppy, so night, night until later.

    THERE IS NO PLACE LIKE HOME!!

    Eileen







  12. cstraley3

    cstraley3 New Member

    I was on celexa and have just switched to cymbalta...and wow, the pain is greatly diminished. A little nausea, but am told it will go away in a week or two. Six yrs w/ fibro and this is the first ray of hope for me.
  13. maedaze

    maedaze New Member

    Is this a new drug on the market? Am trying to get a list of drugs that might help me - when i can find a doctor that will take me on. and then discuss it with them

    My usual meds and tricks just are not working any moe and are going down in a screaming heap. Trouble is new zealand can be quite behind in new drugs, just because it has been passed in the u.s it doesn't mean it's available here.

    Also any of you taking it get headaches and migraines and is it helping?

    Cheers maedaze
  14. OK4tune

    OK4tune New Member

    I have been taking it for over a year I did not realize how much it does help until I ran out of it and thought I could wait till my next appt to get a refill. I am still tired and ache but at least I can get my but out of bed in the morining taking it. I only wish my Dr would let me take 120 a day instead I take
    60 mg Cymbalta
    150mg Welbutrin
    and tramadal 3x daily.

    I am to the point I do not know what symptoms are associated with my illness


  15. carebelle

    carebelle New Member

    Thank you for sharing with us your energy today I realize its very hard for you.

    I hope that I did not imply that I was telling anyone to add or take away meds. I am not a doctor I would never want anyone to take my advice above those better educated on the matter.

    What I do want to say is, I also have family who have been over perscribed meds and suffered from it.Some Doctors, not all will keep adding things to try and get a good mix .That can also be harmful .I think when the list goes up other opinions need to be heard (medical opinions)about the symtoms.I hope I am being understood here.

    We all need to be careful as to not be adding meds that could be adding new systoms or pain to exsisting problems.Most of us run into Doctors who are not likely to perscribe added meds or even take the time to find one good med.It only seems to me there also could be those doctors who go to the other exstream and add on instead of rethinking the problems of the exsisting .

    I also am not talking about different meds for different health problems.
    My family member was taking something like 9 meds for the same problem .She was turned into a zobie .After I realized howmany she was taking I spoke up and ask for her family to seek other medical opinions.After doing so she was taken off of most of those drugs and is back to living a much better and alert life.Her new Doctors felt she also had been over perscribed.

    I also had a mother who saw the same Doctors for a heart condition over a period of 15 years .After getting no better and worse, she left the Doctors she loved for second opinions .The second opinion saved her life ,they had been over looking new symtoms .This gave my mother an extra 20 years added to her life.If she had not changed she could have dropped dead of that problem.The new Doctors fixed it. She is gone now but I'm thankful we seeked out the second opinions it gave us many more years with her.
  16. webintrig

    webintrig New Member

    I am glad she listed and others as well all those meds. and the article was put out here with the side effects so at least I have a starting point at what I can discuss with my pain managemnt dr.

    This is my first visit and well I want to be a little prepared...not only for my well being but this will tell me something about the dr. I am going to see and what he really knows.

    I am a little hesitate about going on a nacrotic but my meds. are not working for me...so it is not a choice anymore for me...

    Thank you both for the info. and what I need to discuss with my dr. because I know what is good for one person may not be good for the other person.

    Soft hugs,

    [This Message was Edited on 10/11/2006]