Cymbalta for Depression

Cymbalta is indicated for the treatment of major depressive disorder (MDD). The efficacy of Cymbalta has been established in 8- and 9-week placebo-controlled trials of outpatients who met DSM-IV diagnostic criteria for major depressive disorder.

A major depressive episode (DSM-IV) implies a prominent and relatively persistent (nearly every day for at least 2 weeks) depressed or dysphoric mood that usually interferes with daily functioning, and includes at least 5 of the following 9 symptoms: depressed mood, loss of interest in usual activities, significant change in weight and/or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, or a suicide attempt or suicidal ideation. The effectiveness of Cymbalta in hospitalized patients with major depressive disorder has not been studied. The effectiveness of Cymbalta in long-term use for major depressive disorder, that is, for more than 9 weeks, has not been systematically evaluated in controlled trials. The physician who elects to use Cymbalta for extended periods should periodically evaluate the long-term usefulness of the drug for the individual patient.

If depression has never been proven to be caused by neurotransmitters (or the lack of them), that question cannot obviously be answered conclusively.

Apparently, Eli Lilly and Company knows this. According to a recent news release from Eli Lilly regarding Cymbalta: " Many experts believe treating the complete spectrum of depression symptoms is intrinsic to a lasting recovery. As well, combined action through two key neurotransmitters - serotonin and norepinephrine - may provide a more rapid and sustained clinical effect."

Note the subtle uncertainties in these statements, for there is absolutely no scientific proof behind them. "Many experts believe treating the complete spectrum of depression symptoms..." "...combined action through two key neurotransmitters - serotonin and norepinephrine - may provide..."

Depression is a whole-body illness, but most modern antidepressants treat the emotional symptoms, such as crying and sadness, better than they treat the physical symptoms of depression," said Dr. Stephen Stahl, chairman of the Neuroscience Education Institute and adjunct professor of psychiatry at the University of California at San Diego School of Medicine. "Because of its dual action on serotonin and norepinephrine, Cymbalta offers physicians a new opportunity to help patients with depression, particularly those who experience the common physical symptoms of the disease, such as vague aches and pains.

"Neurotransmitters are believed to help regulate a person's emotions and sensitivity to pain. Scientists believe that if these neurotransmitters are out of balance, a person may become depressed and be more likely to feel painful physical symptoms. The combination of emotional and painful physical effects of depression can have a tremendous negative impact on a person's quality of life.

Lilly demonstrated Cymbalta's effectiveness in treating major depression with data from four placebo-controlled clinical studies, all in adults. The safety and efficacy of Cymbalta in children have not been studied.