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RSD Alert is a voluntary organisation publishing RSD/CRPS information, mostly provided by our readers. Every approved medical drug works for some people but not for others. Don't be alarmed by what you read. If in doubt consult your medical advisor.
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Drugs

Drugs on RSD Alert

(notes and comments from correspondents)

Cymbalta
Description
 Cymbalta (Generic Name: duloxetine) is designed to inhibit the uptake of serotonin and norepinephrine (chemicals that naturally occur in the brain and spinal cord). Imbalance of these two chemicals can cause depression. They are believed to be associated with mood and to regulate bodily pain sensations. Cymbalta is available in 20 mg, 30 mg and 60 mg capsules and is not classed as a narcotic.
Side effects

(Don't be unduly alarmed. All drugs cause side effects for some patients)

 Agitation, aggressiveness, anxiety, clay-coloured stools, coma, constipation, dark urine, decreased sex drive, diarrhoea, dizziness, drowsiness, fainting, fast heartbeat fever, hallucinations, headache, increased sweating, impotence, insomnia, irritability, jaundice (yellowing of the skin or eyes), loss of appetite, loss of coordination, low fever, mania (mental and/or physical hyperactivity), mood changes, nausea, overactive reflexes, panic attacks, restlessness, sleeping problems, sore throat, stomach pain, suicidal thoughts, the desire to self-harm, vomiting, weight changes.
Warnings

(These are standard cautions but may not apply in your case)

 This medication is not recommended for under 18's or for expectant or nursing mothers. The doctor will need to check you regularly for at least the first 12 weeks after starting to take Cymbolta. Avoid drinking alcohol while taking Cymbalta. Contact your doctor if you begin to experience mood changes, anxiety, panic attacks, insomnia, irritability, agitation, aggressiveness, severe restlessness, mania or thoughts of suicide or self-harm. Avoid using other medicines that make you drowsy (including cough or cold medicines). Do not use Cymbalta or if you have untreated or uncontrolled glaucoma. Before taking Cymbalta tell your doctor if you are using any of the following medicines: almotriptan (Axert), , amitriptyline (Elavil), amoxapine (Ascendin), cimetidine (Tagamet), clomipramine (Anafranil), desipramine (Norpramin), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), frovatriptan (Frova), imipramine (Janimine, Tofranil), isocarboxazid (Marplan), linezolid (Zyvox) , lithium (Lithobid, Eskalith), naratriptan (Amerge), nortriptyline (Pamelor), paroxetine (Paxil), phenelzine (Nardil), protriptyline (Vivactil), rasagiline (Azilect), rizatriptan (Maxalt), selegiline (Eldepryl, Emsam), sertraline (Zoloft), St. John's wort, sumatriptan (Imitrex), thioridazine (Mellaril), trimipramine (Surmontil), tramadol (Ultram), tranylcypromine (Parnate). tryptophan (L-tryptophan), or venlafaxine (Effexor), warfarin (Coumadin) or zolmitriptan (Zomig).

Comments

At a Pain Clinic in San Diego, a doctor prescribed me Cymbolta as a replacement for Neurontin, which I was taking every 6 hours. He said Cymbolta works on the nerves, too, though its main use is for depression. He may have been experimenting on me, I don't know. I was in a car accident and broke the femur of the same leg where I had RSD (you couldn't really tell much by looking at it, as the visual symptoms come and go). He refused to believe that I had RSD, citing that the definition for CRPS now says that you have to show grey nails and so on. I was surprised and disappointed in him, as he is a young doctor in his 30's. I had to cut his dose down; though he was planning to increase the pills taken each week.
(Editor's note - RSD/CRPS cannot be diagnosed from just one secondary symptom. The primary symptom is extreme pain, generally reported at "burning pain". Diagnosis normally depends on that pain being accompanied by at least two out of a list of secondary symptoms)
After a while I got off Cymbolta, because it was causing constipation. Anyway, back came the "buzz" on my formerly injured leg and then the other one started the same electrical type buzz. So I got back onto Neurontin and knocked off that pain. What I found out is that the Cymbolta does work on nerve pain, or whatever it is that is stinging near what feels like the skin level. I didn't like the sleep that Cymbolta knocked me into and if I cut it down, along came a bad headache. It may be worth somebody else with RSD trying it. It takes a couple weeks, so it says, to pull a person out of depression.
Dorothea - California, USA

I contracted RSD about five months ago after having rotator cuff surgery on my right shoulder. A saline block was used which may or may not be what cause my RSD. When I was removed from my morphine drip after a few days, I noticed numbness, swelling, and color change in my right hand and a burning in my right arm. It took a couple of months (less than most I understand) to diagnose RSD and I was given Lyrica (75mg twice a day) and Cymbalta (60mg once a day). The combination worked well to virtually eliminate all the symptoms but the numbness remains. There is also slight swelling and I find it hard to close my right hand. With therapy things have improved. My problem has been that the Cymbalta makes me very sleepy and so I have stopped taking it. I have not noticed things getting worse since I stopped but my doctor would like me to go back on it because he feels it will help. He has recommended my taking it at night. So that if I feel tired, I just go to sleep and hopefully it won't affect my work during the day-I will try it. Russell - Dallas, Texas, USA
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