Duloxetine for mood and nerve disorders

  • Each time you collect your prescription, make sure the brand of your capsules is Cymbalta®. There is a another brand of duloxetine which is used for a different condition.
  • Tell your doctor if you feel that you are getting worse or if you experience any troublesome side-effects.
  • Duloxetine may make you feel dizzy or sleepy. If this happens, do not drive or use tools or machines.

About duloxetine

Type of medicine A serotonin and noradrenaline reuptake inhibitor
Used for Depression
Anxiety disorder
Pains caused by nerve damage in diabetes
Also called Cymbalta®
Available as Capsules

Depression can develop for no apparent reason or it may be triggered by a life event such as a relationship problem, bereavement, or illness. Although it is not fully understood what causes depression, an imbalance of naturally occurring chemicals in your brain is thought to be a factor. Duloxetine works by regulating the levels of chemicals in your brain, called serotonin and noradrenaline; this eases the symptoms of depression.

The symptoms of other conditions, such as some anxiety disorders and pain caused by diabetic nephropathy (nerve damage caused by diabetes), are also improved by controlling the levels of serotonin and noradrenaline. Duloxetine will ease your symptoms if you have been prescribed it for either of these conditions.

Duloxetine is also used for urinary symptoms. There is a separate leaflet called Duloxetine for urinary symptoms which gives more information about it when it is used for this.

Before taking duloxetine

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking duloxetine it is important that your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you have liver, kidney or heart problems.
  • If you have high blood pressure.
  • If you have glaucoma (an increased pressure in your eyes).
  • If you have ever had mania ('high' moods) such as in bipolar disorder.
  • If you have ever had seizures (fits).
  • If you have ever had a blood disorder that has increased your risk of bleeding.
  • If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.

How to take duloxetine

  • Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about the brand of duloxetine you have been prescribed, and a full list of possible side-effects from taking it.
  • Take duloxetine exactly as your doctor has told you. The usual dose is one capsule daily. Your dose will be on the label of the pack to remind you. When starting duloxetine, your doctor may give you a lower strength of capsules to begin with, and then increase the strength. This allows your doctor to make sure that you have the dose that helps your condition and avoids any unwanted symptoms.
  • Try to take your doses at the same time of day each day, as this will help you to remember to take them. You can take them before, during or after your meals. Swallow the capsules whole with a drink of water to help you to swallow them.
  • If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose.

Getting the most from your treatment

  • Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress and review your treatment.
  • You may feel that duloxetine is not working for you straightaway. It can take a week or two before the effect builds up, and several weeks before you feel the full benefit, depending upon the reason you are taking it. Do not stop taking it after a week or so, thinking it is not helping.
  • Duloxetine may make you sleepy or feel dizzy. If this happens, do not drive or use tools or machines.
  • If you drink alcohol, ask your doctor for advice about drinking while you are on duloxetine. Your doctor may recommend you do not drink alcohol while you are on this medicine, as it may increase the risk of unwanted effects such as dizziness and blurred vision.
  • If you buy any medicines, check with a pharmacist that they are suitable to take with duloxetine. This is because some medicines (such as St John's wort) can increase the chance you will experience unwanted effects.
  • If you are taking duloxetine for depression, you should expect that a normal course of treatment will last for around six months after your symptoms have eased. There are several types of antidepressants and they differ in their possible side-effects. If you find that duloxetine does not suit you then let your doctor know, as another may be found that will.
  • Keep taking these capsules until your doctor tells you otherwise. Stopping suddenly can cause problems and your doctor may want you to reduce your dose gradually when this is necessary.
  • If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking duloxetine.

Can duloxetine cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

Common duloxetine side-effects - these affect around 1 in 10 people who take this medicine What can I do if I experience this?
Feeling or being sick, indigestion, abdomen pain Eat simple meals - avoid rich or spicy foods
Dry mouth Try chewing sugar-free gum or sucking sugar-free sweets
Blurred vision, feeling tired, dizzy or sleepy If any of these happen, do not drive or use tools or machines
Constipation Try to eat a well-balanced diet containing plenty of fibre, and drink several glasses of water each day
Diarrhoea Drink plenty of water to replace lost fluids
Headache Ask your pharmacist to recommend a suitable painkiller
Lack of appetite, flushes, increased blood pressure, vertigo (a spinning sensation), difficulty sleeping, feeling anxious, skin tinglings, feeling shaky, reduced interest in sex, erectile dysfunction, increased sweating, muscle pains, loss of weight Discuss these with your doctor if any become troublesome

Important: If you develop any depressing or distressing thoughts or feelings, you should let your doctor know about this as soon as possible. While you are taking duloxetine (particularly if you are taking it because your mood is low), it may increase the risk that you have thoughts about harming yourself or ending your life, particularly at the start of your treatment.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store duloxetine

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.