Understanding Insomnia Medications (cont.)
IN THIS ARTICLE
What Causes Insomnia?
Almost everyone experiences occasional or short-term insomnia (less than three weeks). Causes of short-term insomnia are typically related to environmental factors such as too much noise or light, temperature extremes, or an uncomfortable bed. Other possible causes include stress (for example, new job or school, deadlines, or examinations) or relationship concerns or losses (for example, death of a family member or friend).
Causes of chronic insomnia (greater than three weeks) are more variable and include the following:
- Medical disorders
- Chronic pain
- Severe emphysema
- Menopause
- Chronic kidney disease (especially if undergoing dialysis)
- Chronic fatigue syndrome
- Fibromyalgia
- Chronic pain
- Neurologic disorders
- Parkinson disease
- Other movement disorders
- Cluster headaches
- Parkinson disease
- Psychiatric disorders
- Depression
- Schizophrenia
- Anxiety disorders
- Depression
- Drug-related insomnia
- Stimulants (for example, caffeine)
- Alcohol
- Addictive substance abuse or withdrawal (for example, attempting to quit smoking)
- Overuse of sedative-hypnotic drugs
- Stimulants (for example, caffeine)
- Restless leg syndrome (RLS) is characterized by the urge to move the legs usually accompanied by an uncomfortable sensation in the legs such a crawling, burning, aching or cramping sensations. RLS often occurs at night while sitting and relaxing, and the sensation and the urge to move is often relieved by movement.
- Periodic limb movement disorder (PLMD) occurs during sleep and involves periodic movements of the lower legs, causing brief mini-awakenings (arousals from sleep). Severe cases can cause significant sleep interruption and insomnia.
- Sleep apnea is a less common cause of insomnia. This condition is associated with loud snoring and frequent brief awakenings during the night. Many factors, including abnormal structures in the nose or throat, may cause this condition.
- Circadian rhythm disorders (disruption of an individual’s “biological clock”) may occur when a person stays up later and sleeps later, then has difficulty returning to a more normal sleep schedule. People who work during the night (“graveyard shift”) frequently have problems with insomnia.
Next: What Are the Risks of Insomnia? »
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Cymbalta is approved for the treatment of depression.
Important Safety Information
Cymbalta® (duloxetine HCl) is approved for the treatment of depression and generalized anxiety disorder, and for the management of diabetic peripheral neuropathic pain and fibromyalgia.
What should I talk about with my healthcare provider?
Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.
You should also know that:
- ·Suicide is a known risk of depression and some other psychiatric disorders.
- ·Antidepressants may increase suicidal thoughts or behaviors in some children, adolescents, and young adults especially within the first few months of treatment or when changing the dose. No increased risk has been shown for adults over age 24, and risk decreased for those over age 65.
- ·All patients starting therapy should be monitored appropriately and observed closely for new or worsening depression symptoms, suicidal thoughts or behavior, or unusual changes in behavior.
- ·Cymbalta® is not approved for use in patients under age 18.
Who should NOT take Cymbalta?
You should not take Cymbalta if:
- ·You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
- ·You have uncontrolled narrow-angle glaucoma (an eye disease)
- ·You are taking Mellaril® (thioridazine)
What other important information should I discuss with my healthcare provider?
Before starting Cymbalta, tell your healthcare provider:
- ·about all of your medical conditions, including kidney problems, glaucoma, or diabetes
- ·about your alcohol use
- ·if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life threatening condition
- ·if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
- ·if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant
While taking Cymbalta, tell your healthcare provider:
- ·if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
- ·if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
- ·before stopping Cymbalta or changing your dose
- ·if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose. Your healthcare provider may periodically check your blood pressure while you are taking Cymbalta
If you have any questions, talk to your healthcare provider before taking Cymbalta.
What are the possible side effects of Cymbalta?
The most common side effect of Cymbalta was nausea. For most people who had it, the nausea was mild to moderate. Other common side effects included dry mouth, sleepiness, constipation, decreased appetite, and, increased sweating. This is not a complete list of side effects.
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Insomnia »
Insomnia is defined as repeated difficulty with the initiation, duration, maintenance, or quality of sleep that occurs despite adequate time and opportunity for sleep that results in some form of daytime impairment.
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