IRFANA PARVEEN
By Irfana Parveen

B.Sc (Psychiatry Ward)

25 April 2022
Medically reviewed by
Sumayya Salam
Pharm D
Duloxetine In The Treatment of Neuropathic Pain
Table of Contents

Duloxetine for Nerve Pain

Duloxetine is an antidepressant drug used for the treatment of major depressive disorder and anxiety. It belongs to the SSNRI drug class and works by maintaining the balance of the chemicals such as serotonin and norepinephrine in the brain.

Along being used as an antidepressant, Duloxetine is also widely used to treat nerve pain. It helps to cure the nerve pain caused in people who have diabetes and fibromyalgia. (Smith, T., & Nicholson, R. A. 2007)

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Forms and Strength

Duloxetine is an oral medication available in the form of delayed-release capsules.

Duloxetine capsules are available in the strengths of 20 mg, 30 mg, 40 mg, and 60 mg. The capsule should be taken without crushing, breaking, or chewing.

Dosage

Duloxetine can be taken with or without meals. It should be taken according to the doctor’s guidance only. Taking a higher dose than prescribed to make it more effective would not help but rather worsen the situation and risk of side effects.

Adult dose for nerve pain:

The initial daily dose of Duloxetine is 30-60 mg once a day, while the maintenance dose is 60 mg once a day.

Adult dose for fibromyalgia:

The initial dose is 30 mg taken daily for at least a week, and the maintenance dose for fibromyalgia is 30-60 mg to be taken once daily.

The dosage for children above the age of 13 is exactly that of the adult dosage for fibromyalgia.

The doctor can adjust or change your dose according to your weight, health conditions, and response to the treatment. One should consult the doctor if he is facing any side effects or before stopping the medication.

What if you overdose

Trouble in breathing, dizziness, vomiting, seizures are the symptoms of Duloxetine overdose. One should seek emergency medical help as it can be harmful to health.

What if you miss the dose

As soon as you remember, take the missing dose only if the next dose is after 12 hours. You should not take 2 doses at a time to cover the missed dose. This can increase the chance of overdose and can affect health.

Who should not take Duloxetine

One should not take Duloxetine if he has:

  1. other medications for mental health problems.
  2. Liver problems
  3. Kidney disorders
  4. Below the age of 7
  5. Heart-related diseases
  6. Bleeding problems
  7. Glaucoma
  8. Sexual problems

People suffering from depression should consult the doctor before taking Duloxetine as it can lead to Serotonin syndrome, which can be harmful.

Pregnant women may face the risk of bleeding due to Duloxetine and can harm the unborn baby too. It should be taken only after the doctor’s advice.

It is fine to take Duloxetine for breastfeeding women unless any side effects harm you or your baby.

Side effects of Duloxetine

Following are the common side effects observed after the medication of Duloxetine:

  1. Nausea
  2. Drowsiness
  3. Increased sweating
  4. Headaches and tiredness
  5. Dry mouth
  6. Decrease in appetite
  7. Lack of sexual interest
  8. Blurred vision

Following are some of the severe side effects associated with Duloxetine which one may experience:

  1. Suicidal thoughts
  2. Loss of co-ordination
  3. Difficulty in breathing
  4. Skin allergies and rash
  5. Unusual bleeding and bruising
  6. Seizures
  7. Eye pain
  8. Increase in heart rate

After observing any of these side effects, one should immediately get emergency medical help and stop taking medicine in order to prevent any further risk.

Interactions:

Duloxetine can interact with other drugs, which can affect the working of the Duloxetine and increase the risk of side effects. Following are the drugs with whom Duloxetine can interact:

  1. NSAID drugs such as aspirin, ibuprofen, naproxen.
  2. MAO inhibitors
  3. Blood thinners such as Warfarin
  4. Tramadol
  5. Diazepam and Chlorphenamine
  6. Herbal products and supplements

Effectiveness of Duloxetine for nerve pain

Aim: The research was conducted by Lunn MP et al. to study the benefits and harms of Duloxetine for nerve pain and other chronic pains.

Method: The research was done on 2220 participants in 6 trials where 3 trials were on participants suffering from diabetic nerve pain, and the other 3 trials were on participants with fibromyalgia.

Results: 60 mg and 120 mg dose of Duloxetine is effective in treating diabetic nerve pain and fibromyalgia. 20 mg is not much effective. Some participants faced side effects, but the effects were minor and common, and severe side effects were rare. Thus, Duloxetine is a much efficient drug for nerve pain than other antidepressant medications. (Lunn MP, Hughes RA, Wiffen PJ. 2009 Oct 7)

Synopsis

Though being an antidepressant, Duloxetine is used as an effective medication for nerve pain. It has provided better results and is widely used against nerve pain. Consult your doctor before taking the drug in order to prevent the risk of side effects.

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