Question regarding Cymbalta and enhanced blood flow to the limbs
 

If I remember correctly, Mrs. D. mentioned that Cymbalta can enhance blood flow to the hands, feet, ect., and that was why she thought it seemed to warm cold hands and feet.

Am I remembering this correctly, and if so then then could Cymbalta actually have a theraputic benefit via enhanced blood circulation to the extrementies?

Thanks!

I don't recall ever saying that.... In fact Cymbalta raises blood pressure in some people, which would restrict blood flow.

The norepi reuptake feature of it will constrict blood vessels.

If you can find that post, I'd like to look at it again..
I looked around a bit quickly and we did discuss drugs that might improve circulation. One of them is Cardizem.... perhaps that is the one you are thinking of?

Cymbalta is sometimes used for urinary incontinence... it works on this problem by constricting the urinary sphincter, in a similar way that stimulant drugs do. (phenylpropanolamine was the primary treatment for this, but was taken off the market for stroke risk--it is still available in the veterinary world for animals for this purpose).

... this former thread is what I was referring to. It would appear that what you wrote in it suggests that vasodilation is one of the side effects of Cymbalta:


http://neurotalk.psychcentral.com/thread139130.html

Okay...I see now. That effect is not the same as increasing blood flow to the limbs... those arteries are larger.

Serotonin can cause vaso active responses in some sensitive people. Mostly people who already have alot of serotonin genetically. The SSRIs like Prozac, Paxil, Lexapro do not have the
norepi reuptake functions. So they cause more flushing than SNRIs like Savella, Cymbalta, and Effexor.

The flushing is not predictable either, and often is mediated by emotions and/or food.

Overall Cymbalta, with its combination actions, is more vasoconstrictive than other SSRIs. It has warnings on it for
people with hypertension, for example.

None of these drugs is a potent vasodilator however, like the calcium channel blockers, Cardizem, Calan, Norvasc, or like Nitroglycerine, which is so powerful it dilates vessels in the brain causing headache.

It is a matter of degree. I would not expect Cymbalta to restore cold hands and feet therefore. In fact it might make them colder depending on the neurotransmitter balance that person has.
So don't expect that action as predictable.
The vasoactive biogenic amines also include histamine.
Here is the new histamine thread I am building, as I find new information:
http://neurotalk.psychcentral.com/thread161714.html

When histamine or serotonin is available to skin suddenly, there is tingling, burning, flushing. But blood pressure is not typically affected. The only blood pressure effects of SSRIs (not so much Cymbalta but possible) is a sudden orthostatic effect when standing up suddenly. And this varies from person to person as well. You will not find the antidepressants listed as "vasodilators" for this reason. It is more of a potential side effect than a direct drug effect.

http://highbloodpressure.about.com/o...epressants.htm
Mostly from I've read and seen, the vasoactive effects are on the skin only. Not on the receptors of all the blood vessels, leading to and including limbs themselves. Blood pressure lowering drugs dilate many larger vessels, and this is how they lower blood pressure. Massive doses of SSRIs, as in an overdose however, may be quite different.

I was just prescribed low dose norvasc for Raynaud's in my feet. It is supposed to cause vasodilation and therefore increase the blood flow by relaxing the vasospasm so my feet will be warmer. Seem to be helping. I am on Cymbalta for several months, but my feet were cold and blue with the slightest drop in temperature.

I know it is not the same problem but the pharmokinetics seem the same.

... all I can say is that my cold hands (skin or whatever) seem to warm up substantially when I am Cymbalta.

And that may be unique to you, depending on your own physiology.

Here are reported side effects to the FDA MedWatch:
http://www.drugcite.com/?q=cymbalta
click on Cardiac And Vascular Investigations
for details.