Duloxetine

Introduction To Duloxetine

Duloxetine is used in the treatment of depression, anxiety disorder, diabetic nerve pain, fibromyalgia (a condition in which there are generalized pain and tenderness in the body), neuropathic pain, and stress urinary incontinence.

Duloxetine works by increasing the level of chemical messengers (serotonin and noradrenaline) in the brain that have a calming effect on the brain and relax the nerves, thus treating your illness. It may be taken with or without food. It is advised to take this medicine at a fixed time each day to maintain a consistent level in the blood. If you miss any doses, take it as soon as you remember. Do not skip any doses and finish the full course of treatment even if you feel better. This medication mustn't be stopped suddenly as it may worsen your symptoms.

Some common side effects of this medicine include nausea, headache, and dry mouth. It even causes dizziness and sleepiness, so do not drive or do anything that requires mental focus until you know how this medicine affects you. However, these side effects are temporary and usually resolve on their own in some time. Please consult your doctor if these do not subside or bother you.

Before taking Duloxetine, inform your doctor if you have any problems with your kidneys, heart, liver, or have a history of seizures (epilepsy or fits). Inform your doctor if you develop any unusual changes in mood or behavior, new or worsening depression, or if you have any suicidal thoughts.

Uses of Duloxetine

  • Treatment of Depression
  • Treatment of Anxiety disorder
  • Treatment of Diabetic nerve pain
  • Treatment of Fibromyalgia
  • Treatment of Neuropathic pain
  • Treatment of Stress urinary incontinence

Benefits of Duloxetine

Treatment of Depression
Duloxetine increases the levels of certain chemicals in the brain that improve our mood and behavior. This creates a feeling of wellbeing, relieves anxiety, reduces tension, helps you sleep better, and increases your energy levels. It is an effective antidepressant but may cause drowsiness. You need to take it regularly as it is prescribed for it to be most effective and should not stop taking it suddenly, even if you feel better, as it may worsen your condition.

Treatment of Anxiety disorder
Duloxetine stops your brain from releasing the chemicals that make you feel anxious so it can reduce the symptoms of excessive anxiety and worry. It can also reduce feelings of restlessness, tiredness, difficulty concentrating, feeling irritable, and sleep problems that often come with Anxiety Disorder. It will therefore help you go about your daily activities more easily and be more productive. Keep taking this medicine even if you feel well. Stopping suddenly can cause serious problems.

Treatment of Diabetic nerve pain
High levels of blood sugar (glucose) levels in diabetic patients can cause damage to nerves and this can cause pain sensation. Duloxetine helps reduce this damage by affecting chemicals in the brain called neurotransmitters. By relieving pain, it helps improve your quality of life.

Treatment of Fibromyalgia
Duloxetine may also be used to treat pain in people with fibromyalgia. It reduces pain and also the mood changes, sleep problems, and tiredness that can be caused by the pain. It interferes with pain messages traveling through the brain. Taking this medicine regularly will have an impact on your overall quality of life. Keep taking the medicine until your doctor advises you to stop.

Treatment of Neuropathic pain
Duloxetine is used to treat long-lasting (chronic) pain caused by nerve damage due to diabetes, shingles, or spinal cord injury. It interferes with pain signals that travel through the damaged nerves and the brain. Taking this medicine regularly will improve your physical and social functioning and overall quality of life. It takes a few weeks to work so you need to take it regularly even if you feel it is not doing any good.

Treatment of Stress urinary incontinence
Stress urinary incontinence refers to the loss of urine without conscious intention. It may occur due to a disturbed state of mind and thoughts. Duloxetine helps in increasing the activity of those nerves in the brain that control muscles in our bladder that are responsible for passing urine. This helps in improving bladder control.

Side effects of Duloxetine

Most side effects do not require any medical attention and disappear as your body adjusts to the medicine. Consult your doctor if they persist or if you’re worried about them

Common side effects of Betaxetine

  • Nausea
  • Headache
  • Dryness in mouth
  • Sleepiness
  • Dizziness

How to use Duloxetine

Take this medicine in the dose and duration as advised by your doctor. Duloxetine may be taken with or without food, but it is better to take it at a fixed time.

How Duloxetine works

Duloxetine works by increasing the levels of chemical messengers (serotonin and noradrenaline), natural substances in the brain that help maintain mental balance and stop the movement of pain signals in the brain.

Quick tips

  • Duloxetine helps in treating depression and anxiety.

  • It may also be used to treat nerve pain from diabetes and some other forms of chronic pain.

  • It may take 2 to 4 weeks for Duloxetine to start working. Keep taking it as prescribed.

  • It may cause dizziness and sleepiness. Do not drive or do anything requiring concentration until you know how it affects you.

  • Avoid consuming alcohol when taking Duloxetine as it may cause excessive drowsiness and increase the risk of liver damage.

  • It may cause a sensation of restlessness, especially when you first start taking it. Inform your doctor if this happens to you.

  • Talk to your doctor if you notice sudden mood changes or develop suicidal thoughts.

  • Do not stop taking the medication suddenly without talking to your doctor.

Safety Advice

sdsPregnancyCONSULT YOUR DOCTOR

Can I take Duloxetine if I’m pregnant?

Duloxetine may be unsafe to use during pregnancy. Although there are limited studies in humans, animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing it to you. Please consult your doctor.

sdsBreastfeedingCONSULT YOUR DOCTOR

Can I take Duloxetine if I’m breastfeeding?

Duloxetine is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby.

sdsAlcoholUNSAFE

Is drinking alcohol while taking Duloxetine safe?

It is unsafe to consume alcohol with Duloxetine.

sdsDrivingUNSAFE

Can I drive after taking Duloxetine?

Duloxetine may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.

sdsKidneyCAUTION

Can I take Duloxetine if I have/had kidney diseases?

Duloxetine should be used with caution in patients with severe kidney disease. Dose adjustment of Duloxetine may be needed. Please consult your doctor. Dose adjustment is not recommended in patients with mild and moderate kidney disease.

sdsLiverUNSAFE

Can I take Duloxetine if I have/had liver diseases?

Duloxetine is probably unsafe to use in patients with liver disease and should be avoided. Please consult your doctor.

Frequently Asked Questions

Q. How long does Duloxetine take to work?

In people with depression and anxiety, Duloxetine mostly starts working within two weeks of treatment. However, you may take 2-4 weeks to feel better. Consult your doctor if you do not see any improvement after this time. In people with diabetic neuropathic pain, you may take a few weeks to feel better. Consult your doctor if you do not feel better after 2 months.

Q. If I start feeling better, can I stop taking Duloxetine?

No, you should not stop Duloxetine suddenly and without consulting your doctor. In cases of depression and anxiety, if you have been feeling better for 6 months or more, your doctor may reduce your doses gradually. In case of pain and incontinence, if you are feeling better, continue taking it for the long term. Your doctor will keep monitoring your response to the medicine every few months.

Q. Is Duloxetine highly addictive?

No, Duloxetine is not habit-forming (addictive). This means that it does not make you physically or psychologically dependent on it.

Q. What will be the consequences if I stop taking Duloxetine suddenly?

If you stop Duloxetine suddenly, you may feel dizzy, tired, agitated or restless, anxious and irritated. You may also experience sleep disturbances (vivid dreams, nightmares, inability to sleep), nausea, vomiting, shaking, muscle pain, diarrhea, a piercing sensation (pins and needles) especially in the head, and excessive sweating or vertigo. Always consult your doctor before you stop taking Duloxetine. Your doctor will reduce the dose gradually.

Q. I am taking warfarin, does Duloxetine interfere with warfarin?

Is it safe to take both together? You should be cautious if you are taking both Duloxetine and warfarin since there is a risk of bleeding or you may experience petechiae or purpura.

Q. Is Duloxetine safe to use for long term?

Duloxetine is safe to use for a long duration, provided you follow your doctor’s advice regarding the treatment. Q. I am a hypertensive patient. I have noticed that my blood pressure has increased after I started taking Duloxetine. Is it because of Duloxetine, what should be done? Duloxetine may cause an increase in blood pressure. Therefore, regular monitoring of blood pressure is required, especially during the first month of use. If your blood pressure increase is constant, consult your doctor. It may indicate that your Duloxetine dose either needs to be reduced or discontinued gradually.

References

Written By:

Dr Advikka Ridhy

Dr Advikka Ridhy

MBBS

RMO, Aster MIMS

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