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Aug 16, 2022

Mental Health

Antidepressant

8 Important Facts About Duloxetine

1. Duloxetine Works by Increasing Serotonin and Norepinephrine in Your Brain.

Duloxetine is a type of antidepressant medication called a serotonin norepinephrine reuptake inhibitor (SNRI). Serotonin is often known as the “happy chemical” as it works to improve mood and decrease anxiety. Norepinephrine, on the other hand, is involved in the “fight or flight” reaction, increasing your motivation and energy.

Many mental illnesses are characterized by a low mood, increased anxiety, and lack of energy and/or motivation. Therefore, being able to increase concentrations of those chemical is able to alleviate some symptoms of mood or anxiety disorders.

NRIs work by stopping some of the reuptake of these two chemicals after they have been released. Typically, after norepinephrine and/or serotonin get released from one cell in the brain, they go to another cell to send signals for mood regulation. However, in some mental health conditions it is thought that serotonin and norepinephrine may be dysregulated and not sending enough signals. Therefore, increasing the amount of serotonin and norepinephrine that is around send more signals to regulate mood and increase motivation can have a very positive impact on these conditions.

2. Duloxetine has been approved for use in treating 2 mental health conditions, and 3 non-mental health conditions.

Even though duloxetine is classified as an antidepressant, it has actually also been approved to treat 3 non-mental health related conditions.

The two mental health conditions that duloxetine has been approved to treat are:

  • Major depressive disorder (MDD)
  • Generalized anxiety disorder (GAD)

The three non-mental health related conditions that duloxetine is prescribed to treat are all pain related. The three conditions are:

  • Diabetic peripheral neuropathic pain
  • Fibromyalgia
  • Chronic musculoskeletal pain

While duloxetine works well to improve mood and increase motivation in mental health conditions it has also shown efficacy in reducing chronic pain. It is thought that duloxetine works for pain in the same way it works for mental health; by increasing the amount of circulating serotonin and norepinephrine. The increase in these two chemicals is thought to affect your nerve cells in a way that leads to a decrease in pain conduction. However, the dosages for these different conditions will vary, as there is a varying concentration required to produce the desired effect for mental health conditions as opposed to pain conditions.

3. Duloxetine May Take a Few Weeks to Start Working

The first 1–4 weeks on duloxetine will be the worst, but it is important to wait that out in order to reach a point where the medication can be beneficial. It takes about a week for the medication to get to a steady concentration in your blood to start having an effect. It then takes another 1–3 weeks, depending on each individual, for your body to “get used to” the medication. Therefore, it is important to wait at least a couple weeks of taking the medication before deciding if duloxetine is working well for you.

In addition, the first couple weeks are usually the worst for side effects. The most severe side effects most often occur as you first begin taking duloxetine as your body gets used to the new medication. However, these effects typically improve or completely resolve after a few weeks.

Learn more about the first few weeks on antidepressants.

4. Duloxetine Has 6 Common Side Effects

Like all medications, there is a risk of experiencing side effects when you take duloxetine. While the side effects are usually the worst for the first few weeks on duloxetine, they don’t always resolve completely. Most of these adverse events are not severe and can be tolerated, but some people may find they are impacting their lives too much and may decide to switch to another antidepressant that may have less bothersome effects. The most common side effects experienced with duloxetine include:

  • Nausea
  • Dry mouth
  • Fatigue
  • Constipation
  • Increased sweating
  • Decreased appetite
  • *increased thoughts of hurting yourself or suicide

5. People who are pregnant or breastfeeding should avoid taking duloxetine if possible

Studies in animals have shown that there may be some possible risk to the fetus when a pregnant mother is taking duloxetine. However, the doses that caused ill-effects were much higher than any dose that would be prescribed to a human. There are also no adequate studies that have been completed in humans, due to the possible risk to the mother and/or fetus when being given possibly risky medications for. study. The danger to people is likely low, but due to the possible risk it’s generally recommended to avoid taking duloxetine if you are pregnant or planning to become pregnant. However, this is a decision between you and your doctor in order to weigh the pro of staying on a medication that works for you against the possible risk to the fetus

The same logic applies to taking duloxetine while breastfeeding. The medication crosses over into breastmilk, though it is most likely not in high enough concentration in the breastmilk to be dangerous the infant. However, it is still recommended to avoid duloxetine if possible while you are breastfeeding.

6. People with certain medical conditions should not take duloxetine

It is very important for your healthcare provider to be aware of all of your medical conditions before you are prescribed duloxetine. This is because people with certain medical conditions should not take this medication. Two of the main medications that are contradicted with the use of duloxetine include:

  • Liver disease
    Duloxetine will be poorly metabolized in those with liver disease, and therefore should not be used in those with hepatic insufficiency.
  • Severe kidney disease
    Duloxetine also relies on the kidneys for metabolism and therefore should not be used in those with renal failure.
  • Narrow-angle glaucoma (uncontrolled)
    Duloxetine may cause pupil dilation, which is usually not harmful. However, for those with uncontrolled narrow-angle glaucoma, this can worsen the glaucoma.

Your healthcare provider will be able to prescribe a different antidepressant for you if you have any conditions contraindicated with duloxetine.

7. Some Medications Cannot be Taken in Combination with Duloxetine

There are very many medications that interact with duloxetine. These interactions can range from minor concerns that just need extra monitoring to very strict orders to NOT take certain medications in combination with duloxetine. The medications that absolutely must be avoided while taking duloxetine are:

  • Monoamine oxidase inhibitors (MAOIs)
    —Combining duloxetine with any MAOI can cause very serious, even fatal, drug interactions. If you are switching from a MAOI to duloxetine, you must wait at least 14 days after stopping the MAOI before starting duloxetine to ensure there is no overlap of the medications in your body.
  • Thioridazine
    —Combination of duloxetine and thioridazine (an antipsychotic medication) can lead to heartbeat irregularities and even possible sudden death and therefore must absolutely be avoided.

There are a number of other medications that also should potentially be avoided, and therefore it’s very important to be open with your healthcare provider about any and all prescription and over-the-counter medications, supplements, and natural health products you are taking.

8. You Can Buy Duloxetine at Marley Drug for as Low as $6 per month

At Marley Drug, if you have a valid prescription for duloxetine, you can get a 6-month supply of duloxetine for $37 or even a 12-month supply for only $70. This comes to less than $6 per month for your medication!

At any typical pharmacy, a 6-month supply of your standard dose of 60mg duloxetine capsules can be as high as $1,360. That is over 30x more expensive than what you would pay at Marley Drug.

Our prices are so low because we cut out the insurance company middlemen. Typically, insurance companies increase the costs of medications through negotiations with medication wholesalers and their “service fees”. This allows drug prices to be higher in pharmacies that accept insurance. However, with Marley Drug cutting out this middle step, we get out medications directly from the medication wholesalers and therefore are able to have prices competitive with even the best insurance plans.

To learn more about how you can get your duloxetine prescription from Marley Drug, just call us at 1-800-810-7790.

Prices mentioned in this article are based on average retail price at major box chain pharmacy in the U.S. as of August 12, 2022.


References:
  1. Cymbalta (duloxetine) – Access data FDA-Approved Drugs [Internet]. Amended 12/2008; accessed 08/2022.
  2. Cymbalta: generic duloxetine – GoodRx (https://www.goodrx.com). Accessed 2022-08-11.

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