Depression: Cymbalta Now FDA-Approved

New Agent toCombat DepressionDuloxetine (Cymbalta), from EliLilly and Company, has beenapproved by the FDA for the treatmentof both the emotional and thephysical symptoms of major depressivedisorders. This drug inhibitsreuptake of both serotonin andnorepinephrine.Duloxetine capsules are availablein 20-, 30-, and 60-mg strengths.The recommended daily dose is40 mg (given as 20 mg bid) to 60mg (given either once daily or as30 mg bid).This drug has been tested onlyin adults; no studies have been performedto determine efficacy andsafety in children. Duloxetine is contraindicatedin patients who take amonoamine oxidase inhibitor; orwho have hepatic insufficiency, endstagerenal disease, or uncontrollednarrow-angle glaucoma. This drugis usually not prescribed to patientswith a history of substantial alcoholuse. Advise patients and their familiesto be alert for--and to report--the following symptoms, particularly at the start of therapy or when thedose is changed: worsening of depressionand/or suicidal ideationand behavior; sudden, severe anxiety;irritability; hostility; aggression;impulsive behavior; restlessness;overexcitability; hyperactivity; ordifficulty with sleeping.