Duloxetine is used to treat depression, generalized anxiety disorder and pain from fibromyalgia, diabetic peripheral neuropathy and other chronic musculoskeletal conditions. The medication is one of many selective serotonin reuptake inhibitor (SSRI) drugs and works by increasing the concentration of the neurotransmitter serotonin by blocking its reabsorption. As duloxetine is classified as an SSRI medication, discontinuation may result in SSRI discontinuation syndrome, a temporary condition with withdrawal symptoms including dizziness, unsteadiness, headaches, nausea, insomnia, fatigue and numbness in the extremities. You might manage and minimize the symptoms of duloxetine withdrawal by slowly tapering down your therapeutic dose over a period of weeks. If this method is not an option, prepare to manage the symptoms of duloxetine withdrawal individually with temporary lifestyle changes or medications.
Sometimes, duloxetine withdrawal symptoms can begin as soon as one to three days after you discontinue use of the drug and might last as long as a month. According to some studies, about half of patients can avoid or minimize duloxetine withdrawal symptoms by slowly decreasing their dosage over a period of weeks. During a discontinuation taper for a drug, both the dosage and the drug's half-life are taken into consideration. A drug's given half-life refers to the period of time it remains active in your system and at what concentration. Speak with a doctor or pharmacist to obtain a recommended taper schedule if you feel unsure about establishing your own plan.
The severity of duloxetine withdrawal symptoms can range from mild to severe but are not typically seen in patients who have been on the medication for less than one month. For a treatment plan, the various signs and symptoms and can be sorted into five different groups: psychiatric, gastrointestinal, neurologic, motor and somatic. If at any time you feel that your withdrawal symptoms are overwhelming, restart duloxetine at your previous dose. Your withdrawal symptoms should begin to abate in approximately a day's time.
SSRI psychiatric withdrawal symptoms often include anxiety, crying, insomnia, irritability, mood changes and vivid dreams. It is important to recognize that these symptoms are duloxetine withdrawal symptoms and not a recurrence of depression symptoms. If you experience severe insomnia or anxiety, you may temporarily require an anti-anxiety medication or a sleeping pill to take as needed. For gastrointestinal withdrawal symptoms such as nausea and vomiting, stock up on fluids, juices and soups to avoid dehydration and maintain nutrition. Neurologic withdrawals symptoms — dizziness, headache and numbness — are best managed by rest, restricted activity and headache medication.
Involuntary muscle contractions, also known as dystonia, and tremors are two motor symptoms of duloxetine withdrawal. If intense or severe, these symptoms might require both sick leave and medication treatment such as anti-anxiety medications that also assist in muscle relaxation. The last type of SSRI withdrawal symptoms, classified as somatic, refer to whole-body symptoms that might seem to mimic the flu such as chills, lethargy, muscle aches and a runny nose. Again, treat these symptoms with your cold or flu drug of choice and sick leave if available.