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Duloxetine Side Effects: Tremors, Migraines, Liver Damage

Duloxetine is a prescription medication that’s used to treat major depressive disorder, fibromyalgia, anxiety disorders, and chronic pain. It’s sold under the brand names Cymbalta and Irenka. 

The medication is in a class of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs), which means it works in the brain by blocking a process called reuptake. Reuptake removes excess chemicals from the nervous system and recycles them. Duloxetine specifically blocks the reuptake of the serotonin and norepinephrine, which are tied to mood, motivation, and energy levels, among other functions. 

However, the drug can also cause common and uncommon side effects. If you’re exploring the possibility of taking duloxetine, it’s important to be aware of any potential adverse reactions. 

Duloxetine and Suicide

Mental health issues are complicated. Drugs that are used to alter brain chemicals to help treat mental disorders can sometimes make them worse or create new symptoms. Duloxetine can sometimes cause an increase in depression and suicidal thoughts, which may lead to suicidal actions if it’s left unaddressed. 

The drug comes with a specific warning that it could increase suicidal thoughts in people who are 24 years old or younger. For that reason, if you are taking duloxetine, it’s important to let your doctor know about any side effects you might experience. If you feel new or worsening depression or thoughts of suicide, speak to your doctor as soon as possible. 

Does Duloxetine Cause Serotonin Syndrome?

Medications that affect serotonin levels in the brain have the potential to create a side effect called serotonin syndrome.

his condition is caused by a buildup of serotonin in the brain, which leads to severe confusion, agitation, tremors, increased blood pressure, fast heart rate, and coordination loss.

Without medical intervention, severe cases of serotonin syndrome can be life-threatening.

Serotonin syndrome may be more likely if the drug is mixed with other drugs that affect serotonin levels like other SNRIs or selective serotonin reuptake inhibitors.

Yellow and blue pills spilling out of a white bottle

Can Duloxetine Make You Drowsy?

Duloxetine can cause drowsiness in some people. It’s recommended that you avoid driving or operating heavy machinery until you know how the medication will affect you. Drowsiness and sleepiness can also slow your reaction time and impair your ability to make quick decisions. If you feel persistent drowsiness that gets in the way of your daily activities, your doctor might be able to adjust your dose or switch your medication to avoid this symptom. 

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Other Potential Side Effects

Duloxetine may come with various uncomfortable effects that you may encounter when you take the drug. Some may be mild and well-tolerated, but if they are uncomfortable or consistent, you should let your doctor know. Side effects can include:

  • Nausea
  • Tremors
  • Migraines
  • Constipation
  • Fatigue
  • Sleepiness
  • Appetite loss
  • Dizziness

Duloxetine was investigated for its potential use in treating headaches in a 2007 study, but it was found to have minimal effectiveness. 

Some severe side effects may need immediate medical attention. Severe side effects are uncommon, but they may appear in some people. They may be more likely if the drug is abused or mixed with other substances. Severe side effects may include:

  • Liver damage
  • Abdominal pain
  • Changes in blood pressure
  • fainting
  • Dizziness
  • Hallucinations
  • Impaired coordination
  • Fever
  • Seizures

Sources

Mayo Clinic. (2019, October 5). Helpful for chronic pain in addition to depression. Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20044970

Mayo Clinic. (2019, December 10). Serotonin syndrome. Retrieved from https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758

National Institute of Mental Health. (2018, July). Anxiety Disorders. Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml

RxList. (2017, April 14). Duloxetine (Cymbalta): Side Effects, Dosages, Treatment, Interactions, Warnings. Retrieved from https://www.rxlist.com/consumer_duloxetine/drugs-condition.htm

Taylor, A. P., Adelman, J. U., & Freeman, M. C. (2007, September). Efficacy of duloxetine as a migraine preventive medication: possible predictors of response in a retrospective chart review. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17883526

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