Individuals grappling with depression and various similar conditions are treated from a range of prescription medications. Depending on the exact condition, and the intensity of the condition, various medications are prescribed. Duloxetine is one among the more popular medications in capsule form, prescribed for depression, anxiety and various other conditions. Medications, without exception have certain undesirable effects, in addition to the desired outcomes, attributed to the mechanism of action of the active compounds. Here is a look at the side effects of duloxetine and measures to mitigate and manage possible adverse effects.
Overview and side effects of duloxetine
To understand more about the side effects of duloxetine it is necessary to learn more about the drug and its intended uses. Belonging to the category of dual serotonin and norepinephrine reuptake inhibitor, the medication was initially prescribed for treating major depressive disorders. It is however, now being prescribed for treating multiple other conditions including, neuropathic pain and generalized anxiety disorder. Other noteworthy conditions that are either managed or treated with the medication include :
• Osteoarthritis
• Stress urinary incontinence
• Pain associated with cancer – chemotherapy-induced peripheral neuropathy
• Diabetic peripheral neuropathy
• Fibromyalgia
• Chronic musculoskeletal pain
• Chronic lower back pain
Incompatibility of the medication with individuals with certain conditions
As we delve into the side effects of duloxetine let us first be informed of the unsuitability of the medications for individuals with certain conditions. For instance, patients with pre-existing renal complications or individuals with problems in the liver need to seek special medical advice prior to taking the medication. Similarly, individuals with a history of heart problems are also considered as unsuitable for the medication and require advice regarding the same. Other issues that patients need to bear in mind prior to taking het medication includes allergic reactions in the past to duloxetine or other medications that contain the active compounds found in duloxetine.
Patients on other anti-depressants are also advised to delay treatment regimen with duloxetine till a period of two weeks. In other words, there should be a clear gap of more than two weeks between anti-depressant medication types. Similarly, patients with a history of manic episodes, or fits or conditions commonly known as bipolar disorders are also advised to stay away from the medication, to prevent complications. Side effects of duloxetine the same. Other issues that patients need to bear in mind prior to taking het medication includes allergic reactions in the past to duloxetine or other medications that contain the active compounds found in duloxetine.
Patients on other anti-depressants are also advised to delay treatment regimen with duloxetine till a period of two weeks. In other words, there should be a clear gap of more than two weeks between anti-depressant medication types. Similarly, patients with a history of manic episodes, or fits or conditions commonly known as bipolar disorders are also advised to stay away from the medication, to prevent complications. Side effects of duloxetine include possible complications or adverse reactions in individuals with glaucoma, the eye condition. The medication is known to significantly increase the pressure in the eye and this could pose a problem for individuals with the condition. Pregnant women, or women who plan a pregnancy are also advised to avoid the medication due to the possible of adverse reactions. Similarly, women who are nursing infants are also not to take the medication, as this could trigger serious health issues in infants.
Ideal dosage to prevent side effects of duloxetine
Studies clearly indicate that a considerable number of reported side effects of duloxetine are attributed to incorrect dosage or routine. The medication is intended to be taken as per the advised schedule and any changes in either the dosage or the routine could trigger unpleasant experiences. For instance, duloxetine is available in various formulations and the actual dosage depends on the condition being treated. Patients with depression, or suffering from anxiety disorders or nerve pain are typically recommended a dosage of either 30 mg or 60 mg. Patients being treated for stress urinary incontinence and a few other similar conditions, including off label uses, are typically recommended dosages of either 20 mg or 40 mg.
Ideally, patients with depression are recommended a dose of 60 mg per day and this is increased to 120 mg per day. Similarly, individuals with anxiety disorders are recommended initial doses of 30 mg, which are gradually increased to 60 mg per day. Patients seeking treatment for nerve pain are typically administered dosages of 60 mg per day which could then progress to an increase in frequency to doses of 60 mg twice per day. Patients with stress urinary incontinence are ideally given an initial dose of 20 mg twice a day, and this could gradually increase after two weeks to 40 mg twice a day. It is necessary to bear in mind that the effects of the medication are more likely to be experienced only after a period of two weeks or more depending on the condition. For instance, patients with nerve pain may experience measurable changes or desired outcomes only after four weeks of taking the medication. The dose is also not to be stopped abruptly and treating specialists typically gradually scale down the dosage before stopping it completely. This is mainly for the purpose of preventing withdrawal symptoms of side effects of duloxetine attributed to an abrupt stoppage of the medication.
Simple tips to handle skipped dosage or overdose
Prevention of side effects of duloxetine include recommended actions to handle a skipped dose. Individuals who have skipped a dose are advised to avoid the urge to take a double dose to make up for the skipped dose. In the event that a few hours have elapsed since the stipulated time for a daily dose, the patient can still take the dose. But in the event that more than four hours have elapsed since the stipulated time, it would be best to avoid taking the medication. There needs to be a clear gap between two doses, to avoid higher concentrations of the medication in the body. Taking a double dose or taking wo doses very close to each other are to be strictly avoided, as this could result in adverse effects.
There is also a possibility of overdose related side effects of duloxetine. Here again, it is necessary to note that the actual amount that can be considered as an overdose will differ for different individuals. Various symptoms clearly indicate overdose and individuals are expected to seek medical intervention at the earliest on observing or experiencing symptoms listed herein. An abnormal feeling of restlessness, or a dizzy feeling are indications of possible overdose. Similarly, patients who have taken an overdose of duloxetine are likely to experience vomiting sensations, in addition to experiencing vigors/shivering. There is also the possibility of patients feeling drowsy/sleepy after having taken an excessive dose of the medication. A sudden increase in heart rate, profuse sweating and possible seizures are also other indications of an overdose of the medication.
Commonly reported side effects of duloxetine
The possibility of experiencing side effects of duloxetine differs from person to person. Certain individuals may not experience any side effect whatsoever, while others may experience adverse effects. The intensity, duration and nature of the adverse effects may not be the same for all, with a very small section of users possibly exposed to severe undesirable effects. Commonly reported side effects of duloxetine include mild impact on vision, bouts of constipation and a dry mouth. Surprisingly, while some patients may experience constipation there is also the possibility of patients experiencing diarrhea. Reports of individuals experiencing difficulty in falling asleep are relatively common, while an equal number of individuals report headaches as side effects. Fatigue that is not attributed to any other condition is another undesirable effect experienced by patients, while some go through a sudden lack of appetite, resulting in weight loss. Profuse sweating is experienced by a significant number of patients, while many feely dizzy while on the medication. The drug is also known to have an impact no sexual abilities of patients – with a significant number of patients reporting lesser libido, apart from finding it difficult to either achieve or sustain an erection.
Side effects of duloxetine that are regarded as serious in nature
The above compilation of side effects of duloxetine refer to the mild or moderate effects that are relatively common in nature. Most of the effects mentioned above may not require any medical intervention and may resolve naturally. In specific circumstances, patients may require some kind of medical assistance. However, the following category of undesirable effects of the medication may require some kind of medical intervention and in certain instances, there may be a need for emergency intervention. These manifestations are relatively rare in occurrence, affecting a very small section of patients on the medication. For instance, patients are known to experience an abnormal tightening sensation in the chest that may or may not be accompanied by shortness of breath.
Similarly, patients may also end up with an inability to control bleeding from cuts and bruises. Regarded as one among the serious side effects of duloxetine, this condition requires urgent treatment to stem the flow of blood. Other abnormal reactions include erections that last for a very long time, sometimes for as along as four hours, without the individual indulging in any sexual act. This could cause severe pain, in addition to affecting responsibilities and reputation in society or professional environments. Other serious side effects include a hallucination in patients, that may then aggravate to aggression or anger, resulting in undesirable outcomes. The individual is also prone to harboring suicidal thoughts or plans, resulting in possible injuries inflicted. Patients are also known to end up with blurred vision, or pain in the eye when on the medication. This requires urgent medical intervention to prevent serious consequences in the workplace or at home. A possible adverse effect on the liver cannot be ruled out, and individuals who experience a distinct discoloration of the skin or the eyes to yellow, are to seek medical assistance at the earliest. Other serious side effects include a reduction in sodium levels, that are manifested through headaches, confusion, overall weakness and cramps in the muscle.
Education: Bachelor’s in Biology from the University of California, Berkeley; Certified Health Education Specialist (CHES). Experience: 10 years as a freelance health writer and editor, contributing to blogs and magazines focused on preventive medicine and fitness.
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