What are the Benefits of Cymbalta? What are its Equivalents in Ayurveda?

Abstract

SNRIs or Serotonin-norepinephrine reuptake inhibitors are a class of antidepressants that are used to manage anxiety disorders, social phobia, obsessive-compulsive disorder (OCD), chronic neuropathic pain, attention-deficit hyperactivity disorder (ADHD), major depression etc. Serotonin-norepinephrine reuptake inhibitors are monoamine reuptake inhibitors which inhibit the reuptake of norepinephrine and serotonin. The neurotransmitters are known to play an important role in mood regulation. In this article we will discuss the usage, effects and side effects of the drug Cymbalta (Duloxetine) and what Ayurvedic herbs are good enough to replace this drug with its great mind relaxing or calming properties.

Introduction

Cymbalta (Dulexetine) is an antidepressant belonging to the class of serotonin-norepinephrine reuptake inhibitors (SNRIs). Cymbalta (Duloxetine) inhibits reuptake of serotonin and norepinephrine.   Its chemical designation is (+)-(S)-N-methyl-γ-(1-naphthyloxy)-2-thiophene propylamine hydrochloride. The empirical formula is C18H19NOS•HCl, which corresponds to a molecular weight of 333.88. Duloxetine increases dopamine particularly in the prefrontal cortex where there are few dopamine reuptake pumps via the inhibition of norepinephrine reuptake pumps which is considered to mediate reuptake of dopamine and and norepinephrine. Let’s discuss now, the uses, contraindications and adverse effects of the drug ‘Cymbalta’!!

Medical Uses

The main indications of duloxetine are generalised anxiety disorder, major depressive disorder, fibromyalgia, musculoskeletal pain and major depressive disorder.

Generalised Anxiety Disorder

Duloxetine is one of the first line drug treatments along with escitalopram, paroxetine, sertraline, venlafaxine and citalopram. Duloxetine has been found to be more dutiful than placebo.

Major Depressive Disorder

Duloxetine was approved in 2004 to be used for the management of major depression. Duloxetine reduces tolerability and has increased side effects. So the drug is not a first choice of drug in the major depression disorder.

Diabetic Neuropathy

Duloxetine got approval for the pain management in the person with peripheral neuropathy Duloxetine decreases pain approximately 50 percent. But opioids and anticonvulsants have better efficacy than duloxetine. Still it is regarded as it is adequate help in managing the painful diabetic neuropathy.

Chronic Pain and Fibromyalgia

Duloxetine can be used in osteoarthritis, chronic pain and fibromyalgia. It reduces fatigue and boosts mental and physical performance compared to placebo. The US (FDA) has given permission to use Cymbalta in chronic pain, fibromyalgia and osteoarthritis.

Contraindications of Cymbalta (Duloxetine)

• Hypersensitivity to duloxetine is one of the main contraindications.
• Monoamine oxidase inhibitors (MAOIs)
• Cymbalta increases mydriasis (dilation of pupil), therefore, use of Cymbalta is contraindicated in the patients suffering from uncontrolled narrow-angle glaucoma.
• Thioridazine and duloxetine should not be co-administered.
• Duloxetine should not be co-administered with triptas and other drugs that act on serotonin pathways.

Adverse Effects of Cymbalta

• Nausea, insomnia, dizziness and somnolence are the major side effects reported in ten to twenty percent patients. Further drying of the mouth, headache, sexual dysfunction in men, difficulty in arousal, trouble achieving orgasm and lack of interest in sex and ejaculatory anhedonia is also seen.
• Discontinuation Syndrome Adverse events that occurs after discontinuation of duloxetine includes crying, anger, suicidal ideation and dizziness.

Other Side Effects Include

• Palpitations
• Lightheadedness
• Vision changes (Blurry vision)
• Burning micturition or dysuria
• Maniac episodes
• Hallucinations
• Increased heart beat
• Loss of appetite
• Increased sweating
• Constipation

What are the Ayurvedic Herbs that are a Better Alternative to Cymbalta?

Ayurveda has amazing herbs that work wonderfully on the targeted organs and systems. Ayurveda has herbs acting on the liver, spleen, brain, nervous system, digestive system, endocrine system and others. Herbs rectify the abnormal secretions of the glands and establish the health in the diseased person. Here we are discussing the herbs that are effective in managing the depression and can definitely take the place of Cymbalta (Duloxetine). Following are the herbs that can easily replace Cymbalta with no side effects.

1. Mandookparni

Mandookparni (Centella asiatica) is bitter in taste and pacifies the pitta and kapha doshas. It works as a potent medhya (increases retaining power) as per Charak Samhita. It alleviates the upset mood and mind. Thus helps in elevating the mood and soothing the mind. Therefore, it is helpful in managing stress and channelizes the mind in a positive direction. With its mind calming properties Mandookparni is seen as an alternative to the antidepressant such as Cymbalta (Duloxetine). It is of great use for epilepsy, hysteria, depression and weakness of the brain.

2. Shankhpushpi

Shankhpushpi (Convolvulus pluricaulis) is bitter in taste. Shankhpushpi pacifies the vata and pitta dosha. It contains active alkaloids like convolvine, shankhpushpine, convolamine, confoline palmitic acid, fatty alcohols, convozine and various others. Shankhpushpi is known to improve cognitive functioning, reduces mental fatigue, manages depression, enhances cardiac functioning, promotes digestion, make the skin look healthy, shankhpushpi helps in insomnia, anorexia nervosa, heals ulcers, maintains blood pressure, manages dementia, epilepsy, alzheimer’s disease etc.
Shankhpushpi works as the best antidepressant due to its potent anti-anxiety, anti-stress and antidepressant properties. Shankhpushpi is one the best herbs that manages certain conditions such as restlessness, dementia, depression etc. It is known for balancing the neurotransmitters or other brain chemicals and regulates the secretion of dopamine which eventually maintains the healthy levels of serotonin which helps in the mood regulation and reduces anxiety including cold hands, feet, uneasiness, restlessness. Shankhpushpi helps in relaxing the body and the mind.

3. Mulethi

Mulethi (Glycyrrhiza glabra) is also known as ‘Yasthimadhu’ which literally means ‘honey like wood’ and it tastes sweet. Mulethi is a known herb, a home remedy for sore throat and cough. Mulethi is famed as ‘Sarvarogaprashamani’ – cures all diseases. Mulethi has manifold benefits and is being used in Ayurvedic medicines extensively for treating a number of health problems related to respiratory system, digestive system, musculoskeletal system, endocrine system and various other conditions including obesity, general debility etc.
Mulethi contains potassium, vitamins and other active constituents like anethole, tannins, sterols, biotin, flavonoids, resins, iodine, niacin, volatile oils, isoflavones, saponins, chalcones, glycyrrhizin etc. Glycyrrhizin possesses sedative, synergistic, adaptogenic, alexiteric properties.
Acharya Charak has included Yashtimadhu in the medhya rasayan. Medhya means brain booster and Yashtimadhu is one of them. The antioxidants and active constituents of mulethi improve concentration, calmness, focus, alertness, memory capacity of an individual. Multehi boosts memory, reasoning, cognition and problem solving capacity. The neuroprotective nature of mulethi prevents amnesia and relaxes the mind from tension, stress and depression.
Mulethi influences adrenal glands. The phytoestrogenic bio-active elements in yashtimadhu keep the hormones in well limit thus helps with mood swings, stabilises mood, alleviates depression, stress, insomnia, sweating etc. With these immense properties of mulethi’s active components, it helps in managing depression so well.

4. Guduchi (Giloy)

Guduchi (Tinospora cordifolia) is one of the most famous herbs among people of India. Guduchi is known for antipyretic properties. Besides antipyretic properties, guduchi has rejuvenative and antioxidant properties. Guduchi pacifies all the three dosha acts marvellously in all the disorders. It works as rasayan and boosts the functioning of the brain. This also helps in managing certain diseased condition as depression, stress, anorexia nervosa, alzheimer, motion sickness, suicidal tendencies and other various psychological problems. The herb guduchi is loaded with minerals such as copper and zinc and other various nutrients.Guduchi is known for its good results in diseases of the neurological system. It works impeccably in depression. Furthermore, it promotes intellect which means it improves the thinking process. It enhances the wellness of the mind. It enhances logical and verbal abilities. It promotes skin wellness as well and acts as an anti-ageing due to its antioxidant properties.

5. Jatamansi

Jatamansi (Nardostachys jatamansi) is a flowering plant which belongs to the family valerianaceae. Jatamansi has a number of nutrients and has amazon health benefits thus acting as health and brain tonic. The compounds such as carotene, clalarenol, caralene, jatamanshinic acid, nardostachone, nardol, valeranal, elemol, violin, valeranone, coumarin etc. Jatamansi is medhya dravya that promotes good thinking, good sleep, boosts memory, manages seizures and epilepsy and also promotes functioning of the nervous system.
Furthermore, Jatamsni is known to reduce stress levels and fight depression. Jatamansi acts as a mood elevator. And also keeps the negative thoughts under and helps in a positive thinking process.
Jatamansi soothes the mind that it manages anxiety and stress very well. It helps in maintaining the normal levels of serotonin.

6. Brahmi

Brahmi (Bacopa monnieri) is one of the medhya herbs that increases cognition and various other ailments. The West describes Brahmi as ‘water hyssop’. The alkaloids of brahmi are present in its leaves. Brahmi has analgesic, anti-inflammatory and anti-poisonous properties.
Brahmi is known for its memory boosting, stress buster, anti-anxiety properties. Furthermore, brahmi has other uses such as controlling blood sugar, healing wounds and preventing asthma attacks. Moreover, it prevents and manages insomnia, headaches, stomach discomfort, fatigue, anxiety and palpitations. It is of great use in epilepsy, depression and mental retardation.

7. Ashwagandha

Ashwagandha (Withania somnifera) is one herb that everyone has heard of. Ashwagandha got its name from its horse urine-like smell. Ashwagandha is one of the herbs that boosts immunity and provides long and healthy life to an individual.
Ashwagandha contains essential amino acids, volatile oils, alkaloids, tannins, flavonoids etc. It contains a good amount of antioxidants and fights free radicals and lowers oxidative stress.
Ashwagandha provides stamina like that of a horse. It is used in a number of health conditions. Ayurvedic science has been using this herb for various health issues including asthma, infertility, insomnia, mental disorders, arthritis, mental disorders, depression, anxiety, stress etc.
Ashwagandha pacifies the pitta and vata doshas which helps in maintaining or keeping the levels of serotonin under normal limit which eventually reduces the stress levels and manages anxiety and further alleviates symptoms such as uneasiness, restlessness, cold feet and hands etc. The anxiolytic and anti-stress properties of ashwagandha helps in reducing irritability and relaxing the mind.

8. Kushmand

Kushmand (Benincasa hispida) is a medhya plant and belongs to the family ‘Cucurbitaceae’. It is of cold potency.  Kushmand is light and easy to digest. It is
Sweet in taste. Kushmand pacify pitta and vata doshas whereas ripened kushmand is considered to pacify all three doshas. Kushmand helps in insomnia and it relaxes the mind and provides strength to the brain. It is of great use in parasitic infestation such as tapeworm.
The parts which are used in different sorts of diseases include its fruit, seeds and seed oil.
Kushmand provides strength to the brain thus being a brain tonic, it is used in nervous and psychological conditions. It is of great help in amnesia (memory loss), weak brain activities, and debility, schizophrenia and maniac conditions. Furthermore, by calming the mind it results in coping up with anxiety, stress and negative thoughts.
So it works as a stress buster and manages anxiety with anti-anxiety properties.

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Conclusion

Cymbalta (Duloxetine) is an antidepressant that is used to treat major anxiety disorder, negative thoughts and stress. Cymbalta has other various health benefits but Cymbalta leads to a number of side effects and complications. Ayurveda offers some herbs that are used in a number of psychological and nervous systems. Above mentioned herbs mandookparni, shankhpushpi, guduchi, jatamansi, brahmi, ashwagandha, kushmand are helpful in the management of psychiatric, psychological and nervous disorders. These herbs regulate the hormone levels and help in keeping the serotonin levels within the normal range.  Thus all these herbs can best replace the antidepressant Cymbalta without causing any kind of addiction. Choosing Ayurveda!! Choose Herbs!! Choose Health!!