Jose G. Veliz, M.D. M.S.A.
Medical Director
Palomar Pain Management Center
Pomerado Pain Management Center

Posted: Tuesday, December 11, 2007

Duloxetine (Cymbalta) is useful for the management of diabetic peripheral neuropathic pain. Patients with diabetes develop numerous complications including retinopathy, nephropathy, coronary artery disease and neuropathy. 

Diabetic neuropathy is a result of the progressive loss of nerve fibers. It is partly due to poor glucose levels. As many as 30% to 60% of patients with diabetes may have symptoms of diabetic peripheral neuropathy. Symptoms include pain, prickling, tingling, numbness and burning in the lower extremities. Most patients with diabetic peripheral neuropathy experience constant pain on a daily basis, with the pain being worse at night. This, obviously, has a negative impact on sleep, work and social activities.

Duloxetine (Cymbalta) is a reuptake inhibitor of both serotonin and norepinephrine. By increasing levels of serotonin and norepinephrine, the descending inhibitory pain pathways may function better. These are pathways in our bodies which lessen our perception of pain. Researchers reviewed the results of three double blind, placebo controlled, clinical trials investigating the effectiveness of Duloxetine (Cymbalta). The researchers found that, at doses of 60 mg once a day or 60 mg twice a day, the medication has significantly higher rates of treatment response when compared to patients receiving a placebo.