Like we did with clomipramine and imipramine, in this entry we'll take a cursory glance at two more drugs in the antidepressant category, this time a pair of more recent medications, Cymbalta and Zoloft.
Cymbalta
Cymbalta (duloxetine) is an antidepressant that is classed as a selective serotonin and norepinephrine reuptake inhibitor (SSNRI). This means that it is believed to work by allowing more of the neurotransmitters serotonin and norepinephrine into the brain in order to achieve a mental balance.
We still refer to this drug by its brand name, Cymbalta, because the drug only recently lost patent protection, and is still commonly known by the original brand name. However, it is now available as a generic, duloxetine. Cymbalta was approved for the US market by the Food and Drug Administration in 2004.
Cymbalta is used for the treatment of major depressive disorder and general anxiety disorder. It is also used to treat the chronic pain associated with fibromyalgia and osteoarthritic pain. Furthermore, Cymbalta is used to treat the pain caused by nerves that have been damaged in people with diabetes, known as diabetic neuropathy. Doctors may also prescribe this drug for conditions not listed here in what is known as off-label use.
The makers of Cymbalta attempted to get the drug approved for stress urinary incontinence, but failed to convince US regulators,. It is however approved for this indication in the United Kingdom.
Cymbalta's FDA approval did come in 2004, but its approval for fibromyalgia did not come until 2008, a year after the approval of Lyrica. How is it that an anti-depressant medication was found to treat people with nerve pain? As the story goes, people who were suffering from severe, chronic nerve pain (later termed to be fibromyalgia) were being sent from doctor to doctor and getting no relief or help whatsoever. Finally, they wound up in the care of psychiatrists, who prescribed them antidepressants. As luck would have it, Lyrica and later, Cymbalta proved to have some efficacy in relieving that nerve pain.
Like all antidepressants, Cymbalta comes with a black box warning. This warning states that there is an increased risk among people under the age of 24 from taking drugs like Cymbalta and experiencing suicidal thoughts or ideations. Although the science is up in the air in this regard, the FDA is taking no chances and strongly recommending that all doctors and parents or guardians not be prescribed drugs like Cymbalta or only under strict supervision.
More detailed information about this warning and the side effects associated with Cymbalta can be accessed at the Medline Plus page for this medication.
Zoloft
Zoloft is an extremely popular antidepressant that is very similar to Cymbalta except that it is in the class of drugs known as selective serotonin reuptake inhibitors (SSRIs). Like Cymbalta, Zoloft is believed to work by allowing more serotonin into the brain in order to achieve a chemical balance.
This drug was originally approved by the US Food and Drug Administration back in 1991 and has since become available as a generic, sertraline. It is used to treat depression, obsessive-compulsive disorder (OCD), panic disorder, anxiety disorder, post-traumatic stress disorder, and even premenstrual dysphoric disorder.
It may also be prescribed off-label, and in fact has been prescribed, unlike Cymbalta, to treat both headaches and some sexual problems. To learn more, patients are encouraged to speak with their health care provider.
Zoloft has been around for a long time and its toxicity and side effects are pretty well understood. It will work in some patients, and not in others, and the same risk for people under the age of 24 applies to this drug as applies to Cymbalta.
More detailed information about the black box warning and the side effects associated with Zoloft can be accessed at the Medline Plus page for this drug.
