Losing Weight With Cymbalta

Cymbalta is the name-brand version of the drug duloxetine, which is used to treat generalized anxiety disorder and depression, as well as to treat pain and tingling associated with certain diseases and conditions. Cymbalta may spur a variety of side effects, including weight loss or weight gain. To understand Cymbalta's effects, it helps to examine how the drug affects your body.

Cymbalta is classified as a selective serotonin and norepinephrine reuptake inhibitor, or SNRI. The medication works by increasing the amount of serotonin -- or the happiness hormone -- in the brain, helping improve mood and reduce anxiety and depression. Cymbalta also releases norepinephrine, which stops the movement of pain signals in the brain, helping to reduce sensations of pain in the body. Cymbalta is used to treat pain caused by diabetic neuropathy, fibromyalgia, and ongoing bone or muscle pain such as lower back pain or osteoarthritis.

A common side effect of Cymbalta is loss of appetite and weight loss. In addition to causing loss of appetite, taking Cymbalta may spur diarrhea and nausea, which can make patients eat less, therefore losing weight. According to eMedTV, clinical studies of Cymbalta have shown that up to 9 percent of people taking the medication reported a loss of appetite, and up to 2 percent of people reported weight loss. People lost about 1 to 3 lbs. while taking Cymbalta on average, according to eMedTV.

How Fast Do You Lose Weight On Cymbalta

Weight gain is a less common side effect of taking Cymbalta. In studies conducted on Cymbalta, weight gain was reported by about 1 percent of people taking the medicine, according to eMedTV. If you experience weight gain while taking Cymbalta, you may have another medical condition causing the weight gain. Eating a low-calorie, nutritious diet can help counteract weight gain.

Your doctor may recommend starting on 30 mg of Cymbalta once a day for a week and then increasing your dosage. This will help you body adapt to the medication. Final dosage may range from 40 mg a day to 60 mg a day. If you experience weight changes or other side effects, contact your doctor immediately.

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Antidepressants That Cause Weight Gain

To the Editor: The impact of antidepressants on body weight interferes with patients’ adherence to these medications. In the past, tricyclic antidepressants were associated with weight gain.1 In recent years, even with advances, antidepressants have still struggled solving this complex issue. Selective serotonin reuptake inhibitors (SSRIs) can cause short-term body weight loss, but long-term body weight gain can be a significant concern in this treatment strategy.2 Serotonin-norepinephrine reuptake inhibitor (SNRI) agents, such as venlafaxine and sibutramine, have different effects on body weight. Sibutramine is approved by the US Food and Drug Administration (FDA) for obesity treatment, 3 but the effect of venlafaxine on body weight is still controversial.

Duloxetine hydrochloride, another SNRI, lacks significant affinity for muscarinic, histamine-1, α1-adrenergic, 5-HT2C, and opioid receptors, which are associated with body weight homeostasis.4 An analysis of 10 clinical studies (using repeated-measurement analyses) revealed that short-term duloxetine treatment would cause an average 0.5 kg body weight loss in Western, including Caucasian, Hispanic, and African American, individuals.5 To investigate the short-term effect of duloxetine treatment on body weight in depressed Taiwanese patients and establish preliminary data for Taiwanese subjects, my colleagues and I conducted this open-label observational study.

Method. This study was approved by the ethics committee and institutional review board of the Buddhist Tzu Chi General Hospital Taipei Branch, and all patients completed consent forms. In 2008, we enrolled 24 outpatients (7 male subjects and 17 female subjects, mean ± SD age 40.8 ± 13.8 years old) who met the following criteria: age ranging from 18 to 65 years, major depressive disorder as defined by DSM-IV, no psychotropic medicine use 2 weeks (fluoxetine: 4 weeks) prior to enrollment, first-episode major depression, no concurrent significant systemic physical illness influencing body weight, no concurrent diet therapy for body weight control, no concurrent diet pill therapy, no other psychiatric diagnosis comorbidity, and Clinical Global Impressions-Severity of Illness scale (CGI-S)6 rating ≥ 4 (moderate). The mean ± SD body weight change before treatment was −2.6 ± 1.2 kg, according to the subjective description, and mean ± SD pretreatment body mass index (BMI) was 28.4 ± 3.2. All the patients received duloxetine treatment with a dose ranging from 30 to 60 mg/d, based on their clinical symptoms and clinician judgment. Concomitant medications included benzodiazepines or hypnotics. We estimated the subjects’ body weight at baseline and at the first, second, third, fourth, sixth, and eighth weeks. Body weight assessment procedures were as follows: (1) coat removal, (2) shoes off, (3) underwear remaining, (4) fasting condition, (5) concurrent body height assessment by the same rule (for the BMI), (6) no exercise 4 hours beforehand, (7) all measurements made using the same electronic scale, (8) resetting to the null point before weighing. All the body weight change data were analyzed by SPSS statistical software version 12 (SPSS, Inc., Chicago, IL) and plotted by SigmaPlot version 10 (Cranes Software International Ltd, Bangalore, India). The intraclass correlation coefficient between cardinal data of body weight (Cronbach α: .995) revealed that the reliable intraclass body weight data were consistent.

Antidepressants That Cause Weight Loss Or Increase Energy Levels

Results. The duloxetine treatment dose was classified into 2 subgroups: 30 mg and 60 mg (30 mg: 17 subjects; 60 mg: 7 subjects). Demographic data from each subgroup were compared were each other; comparisons revealed no significant difference between groups in baseline body weight, body weight change before treatment, years of education, and age (Table 1). Every patient achieved was much improved (Clinical Global Impressions-Improvement scale [CGI-I] score ≤ 2) in the eighth week. The patients’ descriptive statistics revealed a steep decline of body weight after beginning oral use of duloxetine, and the effect seemed to persist until the fourth week. The mean body weight loss from baseline was about 1.6 kg in the first week, 1.8 kg in the second week, 1.7 kg in the third week, 1.8 kg in the fourth week, 1.6 kg in the sixth week, and 1.4 kg in the eighth week. The plotting curve showed a fast body weight loss effect in the first week (Figure 1), with the effect becoming more obvious in the second week and the profile remaining the same until the fourth week. The sixth week and eighth week profile revealed gradual body weight gain after an initial duration of relatively clinically significant body weight loss. Body weight loss never exceeded 2 kg during this 8-week observational study.

In the 30 mg daily dose subgroup, body weight was maintained at a similar level with a maximum loss of 2.2 kg during the 8 weeks. A body weight return phenomenon was not observed in this subgroup. Contrary to the 30 mg daily dose subgroup result, the 60 mg daily dose subgroup showed prominent body weight loss of approximately 1.6 kg in second week followed by a body weight return phenomenon beginning in the second week, with a mild gain of around 0.3 kg in the eighth week. A difference in the proportion of patients with body weight gain more than 7% was noted between the 2 dose subgroups. (Table 2). In the plot curve, a duloxetine dose group difference in body weight was noted (Figure 2). No statistically significant difference was found between the 2 dosage groups, either by independent sample t test (Table 3) or by Mann-Whitney U test (Table 4).

Duloxetine was reported to be associated with the side effects of nausea and anorexia, which might be the confounding factors influencing body weight during duloxetine treatment. According to an analysis of 10 clinical studies, acute treatment with duloxetine in major depressive disorder patients would cause a mean body weight loss of 0.5 kg (0.2 kg with placebo).5 These were all Western, including Caucasian, African American, and Hispanic, subjects; their duloxetine dose range was 40-120 mg daily. Our Taiwanese data showed a mean body weight loss of 1.4 kg until the eighth week, and our duloxetine dose range was 30-60 mg daily. Our dose range was clearly less than that in the Western published data, but the average body weight loss of Taiwanese individuals was around 3-fold more than that of Western subjects in the acute treatment phase. Duloxetine is mostly metabolized by cytochrome P450 2D6, 7 which is believed to be more active in Western populations.8 Thus, the dramatic body weight loss of the Taiwanese subjects might be related to this variance by race in enzyme activity, but further study would be needed to confirm this supposition.

Side Effects Of Taking Cymbalta

In terms of the impact of duloxetine dose on body weight, the higher dose (60 mg) subgroup seemed to display a different body weight change profile compared with the lower dose (30 mg) subgroup, though without statistical significance. Published data on long-term treatment revealed that a 60-120 mg dose would show an almost 4 kg increase

Results. The duloxetine treatment dose was classified into 2 subgroups: 30 mg and 60 mg (30 mg: 17 subjects; 60 mg: 7 subjects). Demographic data from each subgroup were compared were each other; comparisons revealed no significant difference between groups in baseline body weight, body weight change before treatment, years of education, and age (Table 1). Every patient achieved was much improved (Clinical Global Impressions-Improvement scale [CGI-I] score ≤ 2) in the eighth week. The patients’ descriptive statistics revealed a steep decline of body weight after beginning oral use of duloxetine, and the effect seemed to persist until the fourth week. The mean body weight loss from baseline was about 1.6 kg in the first week, 1.8 kg in the second week, 1.7 kg in the third week, 1.8 kg in the fourth week, 1.6 kg in the sixth week, and 1.4 kg in the eighth week. The plotting curve showed a fast body weight loss effect in the first week (Figure 1), with the effect becoming more obvious in the second week and the profile remaining the same until the fourth week. The sixth week and eighth week profile revealed gradual body weight gain after an initial duration of relatively clinically significant body weight loss. Body weight loss never exceeded 2 kg during this 8-week observational study.

In the 30 mg daily dose subgroup, body weight was maintained at a similar level with a maximum loss of 2.2 kg during the 8 weeks. A body weight return phenomenon was not observed in this subgroup. Contrary to the 30 mg daily dose subgroup result, the 60 mg daily dose subgroup showed prominent body weight loss of approximately 1.6 kg in second week followed by a body weight return phenomenon beginning in the second week, with a mild gain of around 0.3 kg in the eighth week. A difference in the proportion of patients with body weight gain more than 7% was noted between the 2 dose subgroups. (Table 2). In the plot curve, a duloxetine dose group difference in body weight was noted (Figure 2). No statistically significant difference was found between the 2 dosage groups, either by independent sample t test (Table 3) or by Mann-Whitney U test (Table 4).

Duloxetine was reported to be associated with the side effects of nausea and anorexia, which might be the confounding factors influencing body weight during duloxetine treatment. According to an analysis of 10 clinical studies, acute treatment with duloxetine in major depressive disorder patients would cause a mean body weight loss of 0.5 kg (0.2 kg with placebo).5 These were all Western, including Caucasian, African American, and Hispanic, subjects; their duloxetine dose range was 40-120 mg daily. Our Taiwanese data showed a mean body weight loss of 1.4 kg until the eighth week, and our duloxetine dose range was 30-60 mg daily. Our dose range was clearly less than that in the Western published data, but the average body weight loss of Taiwanese individuals was around 3-fold more than that of Western subjects in the acute treatment phase. Duloxetine is mostly metabolized by cytochrome P450 2D6, 7 which is believed to be more active in Western populations.8 Thus, the dramatic body weight loss of the Taiwanese subjects might be related to this variance by race in enzyme activity, but further study would be needed to confirm this supposition.

Side Effects Of Taking Cymbalta

In terms of the impact of duloxetine dose on body weight, the higher dose (60 mg) subgroup seemed to display a different body weight change profile compared with the lower dose (30 mg) subgroup, though without statistical significance. Published data on long-term treatment revealed that a 60-120 mg dose would show an almost 4 kg increase