Capsule 500mg

Hospital specialist initiation only for long term severe and disabling depressive illness, after trial of standard antidepressant treatment and as an adjunct to other antidepressant medication.

Tablets 25mg

Major Depressive Episodes.

LSCFT to approve all applications to use - patients currently on treatment can continue.

Capsules (Cymbalta®) 30mg, 60mg

There can be variation in the licensing of different medicines containing the same drug therefore prescribe by brand name.

Third line use within LSCFT.

CAUTION: available as another brand Yentreve for stress urinary incontinence. Recommended that prescriptions state the brand name Cymbalta.

Tablets 4mg

Not licensed in the elderly.

Tablets 37.5mg, 75mg
M/R capsules 75mg, 150mg

M/R capsules 225mg - to be prescribed as Vencarm XL in primary care
 
Immediate release tablets are first line.

Third line use only. Consider cardiovascular history e.g. uncontrolled hypertension, and risk of overdose.

Higher propensity for discontinuation.