Drug and Alcohol

Duloxetine: Everything You Need to Know About This SNRI

What is Duloxetine?

Duloxetine, better known as Cymbalta, is a popular SNRI used to treat many conditions. Learn all about duloxetine in our blog.

Duloxetine (brand name Cymbalta) is an antidepressant medication of the SNRI class used to treat depression, anxiety, fibromyalgia, and chronic pain. The drug works by increasing the levels of serotonin and norepinephrine in the brain, which helps improve mood.

Duloxetine has been found to be effective for many people who use it, although side effects such as nausea and headache may occur.

Duloxetine is usually taken orally in capsule form, but it can also be administered through injections for those who cannot take it orally due to gastrointestinal issues or allergies. The dosing schedule can vary depending on the patient's condition; some people may require more frequent doses while others may need less. Patients should talk to their doctor or pharmacist about the best way to take duloxetine for their condition.

It is important to note that duloxetine can interact negatively with certain other medications, so it's critical to tell your healthcare provider all the medications you are taking before starting treatment with duloxetine. Additionally, patients should not abruptly stop taking duloxetine without consulting their doctor, as doing so may cause withdrawal symptoms such as nausea, headache, and fatigue.

What Is Duloxetine?

Duloxetine belongs to a class of medications known as selective serotonin-norepinephrine reuptake inhibitors. Doctors frequently prescribe it to patients suffering from various medical disorders. But what exactly does Duloxetine do?

Duloxetine works by influencing brain chemicals known as serotonin & norepinephrine. These chemicals play an essential part in mood and emotion regulation. When someone is depressed or anxious, their chemical levels may be out of balance. 

Duloxetine contributes to restoring this balance by boosting the levels of these substances in the brain. It can help enhance mood, lessen emotions of despair or stress, and make individuals feel better overall by doing so.

Duloxetine is used to relieve chronic pain and treat mental health issues. Fibromyalgia, diabetic neuropathy, and musculoskeletal pain are several examples of chronic pain. Duloxetine helps in these cases by influencing pain signals in the brain. It can lessen the severity of discomfort and increase one's ability to do everyday tasks.

Is Duloxetine Addictive?

The short answer is no, duloxetine is not considered addictive. While it can cause withdrawal symptoms when suddenly stopped, this is usually mild and can be managed with a gradual decrease in dose. Additionally, there are no known cases of people becoming physically dependent on the medication or having compulsive behaviors related to its use.

However, it's important tobe aware that some people may become psychologically dependent on duloxetine, which means they may feel a need to take the medication in order to cope with their mental health symptoms. If you find yourself feeling this way, it's important to talk to your doctor or therapist as soon as possible so they can help you address the underlying issues and develop a plan for safely reducing your dose of duloxetine.

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How Long Does It Take for Duloxetine to Work?

The effects of duloxetine may start to be felt within a few days, but it can take several weeks before the full benefits are experienced. Everyone's reaction to medication is different, so the length of time required to reach peak effectiveness can vary from person to person. It is important to continue taking duloxetine as prescribed even if you don't notice any changes in your symptoms right away, as it can take several weeks for the full effects to be felt.

What Is Duloxetine Used For?

In the field of medicine, Duloxetine is used for various applications. Listed below are the most common Duloxetine uses.

Depression

Duloxetine is used to treat major depressive conditions. Depression is characterized by persistent sadness, low mood, and loss of interest in activities. It helps in the restoration of the balance of certain brain chemicals. These chemicals have a role in mood regulation.

Anxiety Disorders

Duloxetine is also used to treat generalized anxiety disorder. It is a long-term illness characterized by excessive worry and anxiety. Duloxetine can help reduce anxiety symptoms and promote relaxation by changing the chemical levels in the brain.

Chronic Pain

Duloxetine is beneficial in the treatment of chronic pain. It is frequently used to treat fibromyalgia, diabetic neuropathy, and persistent musculoskeletal pain. Duloxetine reduces pain intensity and improves everyday functioning in chronic pain by targeting pain signals in the brain.

Stress Urinary Incontinence

Duloxetine can be used to treat stress urinary incontinence. It is a disorder that causes involuntary urine leaking during strenuous activities that increase strain on the bladder. It strengthens the muscles surrounding the bladder and urethra, minimizing the likelihood of urine leakage.

In addition to the above-described primary uses, Duloxetine can also be prescribed for the conditions listed below.

Diabetic Peripheral Neuropathy

Duloxetine is used to treat diabetic peripheral neuropathy. It is a type of nerve injury common among people with diabetes. Regulating pain signals in the nerves helps relieve the pain and suffering associated with this disease.

Fibromyalgia

Duloxetine is a prescription medicine used to treat fibromyalgia. It is a chronic illness characterized by widespread musculoskeletal discomfort, tiredness, and sensitive spots. It can help people with fibromyalgia reduce pain and enhance their overall health.

Obsessive-Compulsive Disorder

Duloxetine may be administered as an off-label medication for obsessive-compulsive disorder in some situations. While it is not recommended as a first-line treatment for OCD, it may be used if other drugs have not produced adequate relief.

PTSD

Off-label usage of Duloxetine may help control symptoms of post-traumatic stress disorder (PTSD), a condition of the mind that can develop after experiencing or witnessing a traumatic incident. It can help with symptoms including depression, anxiety, and hyperarousal.

Chronic Fatigue Syndrome

Off-label use of Duloxetine may be used to treat chronic fatigue syndrome, a complex condition marked by excessive fatigue and various other symptoms. It could help to boost energy levels and reduce related symptoms.

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What Drugs Does Duloxetine Interact With?

Like many drugs, Duloxetine can interact with other substances. These can be such as medications, herbal supplements, and certain foods. These interactions can have an impact on Duloxetine functions in the body. They can also raise the chance of side effects. Understanding these interactions is essential, and also consult a doctor about them. Following are some of the most common Duloxetine interactions.

Monoamine Oxidase Inhibitors

Taking Duloxetine with MAOIs or within 14 days after stopping MAOIs can result in serotonin syndrome, a severe medical condition. Agitation, rapid heart rate, confusion, and raised body temperature are symptoms of serotonin syndrome. If an individual is presently on or has previously taken MAOIs, avoid utilizing Duloxetine.

Serotonergic Medications

Combining Duloxetine with other medications that increase serotonin levels in the brain, such as selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, or certain antidepressants, can increase the risk of serotonin syndrome. If Duloxetine is taken alongside other serotonergic drugs, it should be closely monitored.

Blood Thinners

When used with blood thinners such as warfarin, Duloxetine may increase the risk of bleeding. If an individual takes both drugs, blood clotting parameters may need to be closely monitored.

Nonsteroidal Anti-Inflammatory Drugs

Combining Duloxetine with nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen may raise the risk of bleeding or stomach ulcers.

Fluvoxamine and Ciprofloxacin

These drugs can raise the amount of Duloxetine in the body, thereby increasing the risk of side effects. 

Alcohol

Drinking alcohol while taking Duloxetine can increase the risk of sleepiness, dizziness, & impaired judgment. While using Duloxetine, it is usually recommended to avoid or restrict alcohol intake.

What Are the Most Common Side Effects of Duloxetine?

Duloxetine, like any medicine, may produce side effects in some people. It is preferable to be thoroughly aware of these potential side effects and their possible effects. Although not everyone will have side effects, it makes sense to be aware of and address them. Side effects might vary in degree and frequency from person to person. The following is a list of frequent Duloxetine side effects.

Nausea

Duloxetine might make one feel uneasy or like they want to vomit. This side effect may occur, especially when the drug is first started, although it usually improves with time. Duloxetine taken with meals might occasionally relieve nausea.

Dry Mouth

While taking Duloxetine, some people may develop a dry, unpleasant taste. This side effect can be mitigated by staying hydrated by drinking water and using sugar-free gum or tablets.

Drowsiness

Duloxetine may produce drowsiness or a sleepy sensation. Be cautious while engaging in tasks that demand attentiveness, such as driving or operating machinery, until you better understand how Duloxetine affects you.

Dizziness

As a side effect of Duloxetine, you may feel lightheaded or have a spinning feeling. Dizziness can be reduced by carefully rising from a sitting or sleeping posture and avoiding rapid movements.

Headache

Some people may develop mild to moderate headaches. These headaches are usually temporary and will disappear as the body adjusts to the medicine.

Insomnia

Duloxetine might disrupt sleep patterns and make falling or remaining asleep difficult. Creating a quiet sleep environment and establishing regular sleep habits can help encourage better sleep.

Sweating

A possible side effect of Duloxetine is increased sweating or sweating more than usual. This can happen at any time of day & can be annoying for some individuals.

Constipation

Duloxetine can occasionally cause constipation, which occurs as difficulties passing stools or infrequent bowel movements. Constipation can be relieved by eating a fiber-rich diet, staying hydrated, and engaging in frequent physical exercise.

Loss of Appetite

While taking Duloxetine, some people may notice a decreased desire or interest in eating. Maintaining a healthy diet and sharing any concerns with your doctor will help relieve this side effect.

Weight Changes

In certain people, Duloxetine might cause weight loss or increase. Monitor the weight and discuss any substantial changes with the doctor.

Sexual Side Effects

Duloxetine has the potential to harm sexual function in both men & women. Men may have decreased sexual desire, trouble achieving orgasm, or erectile dysfunction due to these side effects. 

Increased Blood Pressure

Duloxetine can cause a slight elevation in blood pressure in rare circumstances. Individuals at risk may require regular blood pressure monitoring.

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Duloxetine Withdrawal Symptoms

When the medicine is abruptly stopped, or the dosage is drastically lowered, Duloxetine withdrawal symptoms may develop. Not everyone will suffer withdrawal symptoms. Also, the duration of these symptoms may differ depending on the individual. The following are some of the most prevalent Duloxetine withdrawal symptoms.

  • Dizziness

  • Vomiting and nausea

  • Headache

  • Fatigue

  • Irritability

  • Insomnia

  • Anxiety

  • Feelings of electric shock: It is frequently characterized as a "zapping" or "shock-like" sensation in the body or brain

  • Flu-like symptoms: Body pains, chills, sweating, and flu-like symptoms may occur

  • Disturbances in the gastrointestinal tract: Some people may have diarrhea or other digestive issues

Duloxetine Withdrawal Timeline

Here's the Duloxetine withdrawal timeline:

Within 1 to 3 Days

Mild withdrawal symptoms can occur.

Within the First Week

Withdrawal symptoms may become more obvious and even worsen. Symptoms may include digestive issues, flu-like symptoms, tiredness, and mood swings.

Up to 2 Weeks

During this period, withdrawal symptoms may continue and fluctuate. Dizziness, nausea, sleeplessness, anxiety, and electric shock feelings are all possible symptoms.

Beyond 2 Weeks

Most withdrawal symptoms improve gradually and vanish within a few weeks. Some people, however, may suffer prolonged or chronic symptoms.

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Is Duloxetine a Controlled Substance?

In most countries, Duloxetine is not categorized as a controlled substance. Controlled substances are drugs with a higher potential for misuse and addiction and are more carefully monitored by law. Duloxetine is a prescription medicine. While a prescription from a healthcare physician is required, it is generally not considered a restricted drug.

Does Duloxetine Make You Sleepy?

Duloxetine can produce drowsiness or sleepiness in some individuals. This side effect, however, does not affect everyone, and the degree of sleepiness varies from person to person. 

Some may find that Duloxetine increases their alertness or does not affect their sleepiness.

Struggling With Duloxetine? The Edge Treatment Center Will Help

At The Edge Treatment Center, we understand how hard it can be to manage depression or anxiety. We're not just a drug rehab; we also offer comprehensive mental health services. They include transcranial magnetic stimulation, a drug-free way to treat the symptoms of depression, and more.

Our team of mental health experts is committed to helping you find the right treatment for your individual needs. We offer a range of therapies, from cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) to medication management with duloxetine.

No matter what your mental health journey looks like, we're here to support you every step of the way. Reach out to The Edge Treatment Center today to learn more.

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If you or a loved one is struggling with addiction, there is hope. Our team can guide you on your journey to recovery. Call us today.

Written by

brian-mooreBrian Moore

Content Writer

Reviewed by

jeremy-arztJeremy Arzt

Chief Clinical Officer

Drug and Alcohol

September 24, 2023