Effects of duloxetine

October 11, 2008 7:42 AM

Information about starting to take duloxetine (Cymbalta, Yentreve).

I find it difficult to talk to my doctor about my depression. This is not about my particular doctor - I've tried others in the practice. I've been on 40mg citalopram (this was me a year ago) but side effects of dizziness and blurred vision, and a feeling that it wasn't helping - both of which I did discuss with my doctor - led me to cut down to 10mg every other day about two months ago. I wrote to my doctor six weeks ago about feelings of depression and suicidal thoughts asking whether there were other anti-depressants it would be worth trying, and I've just heard back from him with a prescription for 60 mg duloxetine.

If you have taken duloxetine, what side effects did you experience? Am I likely to need time off work whilst I become habituated to it? Should I continue taking my low dose of citalopram whilst taking duloxetine?

I am planning to go to see my doctor when I have been taking duloxetine for a month, but would like more information on what I can expect before then. Thanks for reading/commenting.

posted by anonymous to health & fitness (10 comments total)

If you're under 25, Cymbalta can increase suicidal thoughts.

I'd suggest finding a different practice, though, if your doctor didn't respond for six weeks after you wrote to him about suicidal thoughts.
posted by Ruki at 8:49 AM on October 11, 2008

I've been taking 60mg of Cymbalta for a bit more than a year now. It made me a bit constipated for a few days at the very outset, but that eased up pretty quickly (thankfully). Dry mouth is the only ongoing side effect I have to deal with, and that is also quite manageable. Other people complain of "brain zaps", but I have never experienced any.

Everybody experiences side effects differently, so YMMV, but there was absolutely nothing in my experience that required any time off. Indeed, I would say that within a week, I was feeling better physically than I did before taking the med.
posted by briank at 8:53 AM on October 11, 2008

I've been taking 60mg Cymbalta daily for over a year and haven't had any side effects at all.
posted by RussHy at 9:12 AM on October 11, 2008

If you're under 25, Cymbalta can increase suicidal thoughts.

It's not just Cymbalta; the FDA has placed that warning on almost all SSRI/SNRIs.

I've been taking 60mg of Cymbalta for several months now and the only side effects I experienced were pretty severe fatigue and sleep disturbances during the first month. I wasn't functioning at 100%, but it wasn't to the point that I required time off.

IANAD, but when switching from an SSRI to an SNRI like Cymbalta, you usually don't need to keep taking your old medication along with the new one. There are some exceptions if you were on a high dose of a medication with a long half-life, but if your doctor or pharmacist didn't discuss a special switching schedule with you, they probably expect you to discontinue the citalopram.
posted by thisjax at 10:13 AM on October 11, 2008

My roommate was on Cymbalta for a little while. He had dizzy spells and a constant headache, and had to quit. It took a while for him to make the connection with the headache. It was a shame, because Cymbalta worked about the best anything ever has for him, when he was up and functional and not in bed with his head hurting.
posted by dilettante at 10:26 AM on October 11, 2008

Before you even start taking the medication, be aware that if you ever have to quit Cymbalta, the withdrawal process is horrendous! I even wrote an AskMe to get help on how to get through it. Please read through it!

My Cymbalta dosage was the same as yours, 60 mg. That's a relatively low dosage, and it wreaked havoc with my system. People have told me since they had an easier time withdrawing from heroin. Overall, it took me three weeks before I was symptom-free, and the first week was the worst. It was, without doubt, the worst withdrawal I have ever had to go through. I've had pain surgeries and taken pain medication for weeks, had no problem quitting cold turkey. I've also been prescribed, at one time or another, Prozac and Serzone to deal with my chronic depression, and came off of each of those with no issues at all. Cymbalta withdrawal totally kicked my ass.

I'm telling you this because you will need to decide if all of that is worth it for you; do you think this is the only anti-depressant that could work for you? If so, and it's your only choice, I can understand where you are. Depression is crippling. Do what you have to do, whatever will work for you.

But if there is ANY other substitute, I would exhaust all other choices if I were you.
posted by misha at 11:43 AM on October 11, 2008

Seconding misha on the problems getting OFF the stuff -- it beat the shit out of me. It didn't help that my doc had no idea of this being a problem and basically attributed to my being delusional or whatever. He'd told me "Hey, just quit taking it" and I pretty much did, which I've done with various other medications without much if any trouble at all; Hah! Not with this stuff. I ended up having to get back on it, back to the full dose, and then SLOWLY taper off of it, and each step of the way was a horror show. It was a process, not an event -- it took a few months, and I was pretty shaky through it all.

So. That's a downside. Upside -- I think that it was a good drug for me, that it was helpful with the depression I was suffering; I was using it to augment welbutrin as I was going through some situational things in my life.

And: What others have said about dumping your doc, I cannot recommend this highly enough. Many people -- and sadly, this includes doctors -- just don't have any idea what depression is, how devastating it can be, how amazing it is if/when you can finally find the right medication to help you deal with it.

Don't stop looking for the right medication.

No, really -- don't stop until you find help. Once you DO find the right drug, my god, it's as though the whole world is brighter, you weigh so much less as you wander through the world; it was as though the background music of my life had changed from a theme from a dark horror movie to a walk in the park on a pretty spring day.
posted by dancestoblue at 12:59 PM on October 11, 2008

You should know that Cymbalta is currently being investigated by the FDA for possibly causing urinary retention. A friend of mine is on it and she has trouble urinating. Perhaps another SNRI, such as Effexor, would have a similar efficacy.
posted by IndigoRain at 8:41 PM on October 11, 2008

anonymous - Looking at your previous post, you seem to be in the UK. You really need to find a better doctor. No doctor should make you wait 6 weeks before responding. Equally, no doctor should prescribe you a new medication without discussing it with you first. In my view that falls way below the standard of care that you're entitled to. In fact, it definitely doesn't meet the ethical guidance on prescribing laid out by the GMC. You might want to think about complaining, but I know dealing with stuff like that can be difficult with depression.

You really need to change doctor; presumably you need to switch to another practice, since the other doctors you've seen haven't helped. If you don't have contact with your local mental health team, it might be a good idea to ask for a referral (this could take a while, but it would probably lead to better care).

Since your doctor doesn't seem to have taken due care in prescribing the duloxetine, if this were me I wouldn't take it until I'd seen someone else. It might be a sensible choice of medication for you, or it might not. I don't think you have any grounds to trust your doctor's prescribing decisions. If I were doing OK on a maintenance dose of citalopram, I'd probably keep taking that until I saw someone else.
posted by xchmp at 8:43 PM on October 11, 2008

I found Cymbalta to be an effective treatment. It helped me get through a rough patch.

Unfortunately, while I was getting accustomed to it, I also experienced some episodes of lightheadedness. On one of these occasions, I had the misfortune of fainting and landing on a radiator and suffering severe burns. Yep, that anonymous poster was me, and sensational as it may sound, now you know the whole story. Duloxetine or not, make sure you take lightheadedness seriously. Get in a safe position. You may only have seconds before you lose control!
posted by Chef Flamboyardee at 8:36 PM on October 13, 2008