How to Use Cymbalta for Diabetic Neuropathy

Pain from diabetic neuropathy is often debilitating, and not all sufferers respond to the same treatments. In addition to traditional pain killers, doctors can offer patients new drugs or established drugs used for new purposes. One of these drugs is Cymbalta, an antidepressant that can also ease the suffering of some diabetic neuropathy patients.

How does Cymbalta treat Diabetic Neuropathy?

Cymbalta (duloxetine) is a selective serotonin and a selective norepinephrine re-uptake inhibitor approved by the FDA as both an antidepressant and as a treatment for the pain caused by diabetic polyneuropathy. It works by blocking the re-uptake of two neurotransmitters, serotonin and norepinepherine, so that their levels in the spinal cord and brain increase. In theory, high levels of serotonin and norepinephrine in the central nervous system should help block ascending pain signals, resulting in decreased neuropathy pain. In trials, patients taking Cymbalta reported significant decreases in pain compared to those not taking Cymbalta. The drug takes time to produce pain control, however. For this reason, patients on Cymbalta will need to use other drugs for pain control for the first few weeks of Cymbalta treatment. In studies, patients achieved the full benefit of Cymbalta use by the end of the third week of the treatment course.

Dose, Safety and Side Effects

The starting dose for Cymbalta is 60 mg per day taken by mouth in pill form. Because the drug is relatively new in treating diabetic neuropthay, doctors may reserve Cymbalta use for patients who cannot achieve pain control with more established drugs. Common side effects of Cymbalta include nausea, fatigue and dizziness. If these symptoms are severe, you may need to discontinue the drug. Other more serious side effects include suicidal thoughts. Because Cymbalta is an anti-depressant and affects neurotransmitter levels, withdrawal symptoms do occur. You should only start or stop taking Cymbalta on a doctor's advice.