EMEDZ.NET

Disclaimer Notice:

Dear Readers! I started this blog when my daughter was in the NICU. She had ventriculitis. Her CSF report grew E.coli. But, she was injected Teicoplanin directly into her brain. The doctors made two errors here:

Teicoplanin is for gram-positive bacteria only. It does not treat E.coli.
Teicoplanin is not for intraventricular use. The manufacturer strongly discourage injecting Teicoplanin into the brain.

My daughter bled into the brain. She lived for another two years and ultimately died.

The information provided on Emedz.net is for doctors and pharmacists only to manage their patients in the best way and avoid medications-related errors.

Still, for the general population, this should not be considered professional medical advice or a substitute for consultation with a licensed healthcare provider. The content on this blog is not intended to diagnose, treat, cure, or prevent any disease or health condition.

Always seek the advice of a qualified healthcare professional before making any changes to your diet, exercise routine, medication, or any other aspect of your healthcare. We strongly discourage self-medication and self-treatment.

Even though the primary author of emedz.net is an experienced health professional, the blog is not intended to replace medical advice sought at the Doctor’s Clinic.

The authors share personal experiences, research findings, and general knowledge about health and wellness and medications-related topics.

However, individual health situations vary, and what works for one person may not work for another. It's important to consult with a healthcare provider for personalized guidance.

We strive to provide accurate and up-to-date information, but medical knowledge is constantly evolving. Therefore, we do not guarantee the accuracy, completeness, or timeliness of the information presented in this blog.

Emedz.net is not an online pharmacy:

Online pharmacies sell medicines and pharmaceutical products. EMEDZ.net is intended to provide drug-related information to pharmacists and physicians. It is intended to provide authentic information about medicines so as to prevent errors related to prescriptions.

We do not sell medicines, so please don’t ask for them.

We are not affiliated with any pharmaceutical companies:

Emedz.net has no affiliation with any pharmaceutical companies. We do not promote any product. Sometimes brand names are also mentioned in the title of the page, but that is what is called a “Featured Image”. It has nothing to do with selling or promoting that brand. Just to make things easier, generic and brands are mentioned in the blog.

Emedz.net may contain links to external websites or resources for your convenience. We do not endorse or take responsibility for the content of these external sites.

In no event shall Emedz.net, its authors, contributors, or any related parties be liable for any damages or consequences arising from the use of the information provided on this blog.

By using Emedz.net, you acknowledge and agree to this disclaimer and our Terms of Use. If you do not agree with this disclaimer or our Terms of Use, we advise you to refrain from using our website.

Remember, your health is a valuable asset, and decisions about your health should always be made in consultation with a qualified healthcare professional.

Duloxetine 60 mg - "My mother became a Superwoman"

Duloxetine 60 mg, 40 mg, 30 mg, and 20 mg are currently being marketed by various companies. Cymbalta, being the research brand, is manufactured and marketed by Lilly. Duloxetine is a potent inhibitor of serotonin and norepinephrine. It has little effect on dopamine receptors.

The following conditions are currently listed as being indicated for treatment with it:

Fibromyalgia
Generalized Anxiety disorder
Diabetic neuropathy
Major depressive disorder
Chronic musculoskeletal pains

A brief summary of my patient who became a "Superwoman"

65 years of age female patient, Canadian-Pakistani, came for consultation regarding her diabetes. She, along with her husband, son, and daughter, visits Hunza valley each year for three months and celebrate the earth. During these three months, they totally avoid artificial foods. They have grown all kinds of fruits in their home at Hunza, which is on a mountain peak with a natural waterfall. They walk bare feet, pluck fruits from the trees to eat and enjoy nature. Along with diabetes, the patient also has hypertension, ischemic heart disease, hypothyroidism, Parkinson's disease, osteoarthritis, and osteoporosis. Her current medications included:

a statin (atorvastatin),
Aspirin,
Thyroxine,
metformin,
sitagliptin,
insulin aspart,
Insulin glargine,
Levodopa/ carbidopa,
Valsartan,
bisoprolol,
Omeprazole, and
calcium supplements.

Her blood sugars varied between 150 mg/dl and 250 mg/dl and she had glycated hemoglobin of 8.8% Apart from deranged blood sugars, she was complaining of fatigue, numbness, paraesthesia, low mood, and difficulty in getting up from bed early in the morning. Her Dexa scan (bone densitometry) suggested osteoporosis with a T-score of -3.5 at different levels.

Adding more drugs was a difficult decision ...

To avoid adding extra medicine for osteoporosis, I advised her a single injection of Zometa (Zoledronic acid), which is administered once every year. Other bisphosphonates are administered more frequently, for example:

Alendronic acid is given daily or once a week
Ibandronic acid is given monthly orally or 3-monthly when given intravenously
Similarly, Risedronate is also administered monthly.

Her insulin dose was increased according to her blood sugar record. Duloxetine 60 mg tablet was added. She was advised to take the drug after breakfast. Another option for her neuropathic symptoms was to add Pregabalin or Gabapentin. However, these drugs could have added to more sedation and fatigue. Hence, I preferred to start her on duloxetine 60 mg. Duloxetine is primarily used as an antidepressant and most patients present with fatigue, lethargy, and palpitation when they are depressed. Thus, duloxetine improved her mood along with the neuropathic symptoms. Duloxetine (Cymbalta) also has analgesic properties and is therefore used to treat patients with fibromyalgia and non-specific skeletal pains.

What happened after three months?

After three months of stay in Hunza, the patient visited me again. Her son was very excited and his comments were:

" After so many years, for the first time, I saw my mom so active. She was like a superwoman".

He was also insisting on to repeat injection Zometa (Zoledronic acid). Most of her symptoms like fatigue, lethargy, body aches, numbness, and paresthesias had improved. She was advised to continue duloxetine 60 mg along with all the other medications.

What is Duloxetine?

It is a selective and potent drug that inhibits the reuptake of norepinephrine and serotonin without affecting dopamine. It is primarily used for depression and diabetic patients with neuropathic symptoms.

Is duloxetine addictive?

Duloxetine does not cause addiction, however, rapid withdrawal of the drug may cause unpleasant symptoms.

What is the effect of duloxetine 60 mg on weight?

Unlike other antidepressants, and except for Bupropion, duloxetine has been found in studies to cause weight loss.

Common side effects of duloxetine

The most common side effects of duloxetine include:

Nausea
Vomiting
heartburn
vertigo
dry mouth
sleep disturbance
anorexia
blood pressure fluctuations

In conclusion ...

Duloxetine may cause mood elevation, improve neuropathic symptoms, and improve skeletal pains. Most diabetic patients have one or more of these symptoms and duloxetine may be indicated at some stage.

Read details about Duloxetine