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Re: CYMBALTA : INFORMATION PLEASE !!!!

Posted by Phillipa on October 24, 2007, at 20:52:09

In reply to Re: CYMBALTA : INFORMATION PLEASE !!!!, posted by Phillipa on October 24, 2007, at 19:46:28

Additional info. Phillipa sounds like you're in luck.

Initial Treatment
Major Depressive Disorder
Cymbalta should be administered at a total dose of 40 mg/day (given as 20 mg BID) to 60 mg/day (given either once a day or as 30 mg BID) without regard to meals. There is no evidence that doses greater than 60 mg/day confer any additional benefits.

Diabetic Peripheral Neuropathic Pain
Cymbalta should be administered at a total dose of 60 mg/day given once a day, without regard to meals.

While a 120 mg/day dose was shown to be safe and effective, there is no evidence that doses higher than 60 mg confer additional significant benefit, and the higher dose is clearly less well tolerated. For patients for whom tolerability is a concern, a lower starting dose may be considered. Since diabetes is frequently complicated by renal disease, a lower starting dose and gradual increase in dose should be considered for patients with renal impairment (see CLINICAL PHARMACOLOGY, Special Populations and below).

Generalized Anxiety Disorder
For most patients, the recommended starting dose for Cymbalta is 60 mg administered once daily without regard to meals. For some patients, it may be desirable to start at 30 mg once daily for 1 week, to allow patients to adjust to the medication before increasing to 60 mg once daily. While a 120 mg once daily dose was shown to be effective, there is no evidence that doses greater than 60 mg once daily confer additional benefit. Nevertheless, if a decision is made to increase the dose beyond 60 mg once daily, dose increases should be in increments of 30 mg once daily. The safety of doses above 120 mg once daily has not been adequately evaluated.

Maintenance/Continuation/Extended Treatment
Major Depressive Disorder
It is generally agreed that acute episodes of major depression require several months or longer of sustained pharmacologic therapy. There is insufficient evidence available to answer the question of how long a patient should continue to be treated with Cymbalta. Patients should be periodically reassessed to determine the need for maintenance treatment and the appropriate dose for such treatment.

Diabetic Peripheral Neuropathic Pain
As the progression of diabetic peripheral neuropathy is highly variable and management of pain is empirical, the effectiveness of Cymbalta must be assessed individually. Efficacy beyond 12 weeks has not been systematically studied in placebo-controlled trials, but a one-year open-label safety study was conducted.

Generalized Anxiety Disorder
Generalized anxiety disorder is generally recognized as a chronic condition. The effectiveness of Cymbalta in long-term use for GAD, that is, for more than 10 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.

 

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poster:Phillipa thread:791174
URL: http://www.dr-bob.org/babble/20071019/msgs/791221.html