Do Duloxetine side effects settle?

[terceira]

I've been put on Duloxetine partly for neuropathic pain and partly to calm my temperamental bladder (am also on Vagifem and HRT). I started it last night and for most of today I have been horribly anxious, shaky, nauseous (was almost sick twice), shivering then hot, upset stomach and have a headache. I've had similar in the distant past with Citalopram, Fluoxetine, Venlafaxine and Vortioxetine (all for depression) - couldn't tolerate any of them and had to come off after a couple of weeks. I did tell the doctor this but she thought I would be able to tolerate it as I have been on Mirtazpine for years without problems. I'm wondering whether to try and give it some more time and see if it settles or to just stop now. My anxiety is through the roof and I feel very panicky. I am on my own at the moment (partner should be back this evening) and scared.

I had similar when I started it & huge dilated pupils too. The worst of it wore off within a week & completely gone within about a month.

Are you still taking the mirtazepine and what dose? If so, it may be that because both medicines increase serotonin levels those levels have become too high and that's making you feel unwell.

Yes I am still on the Mirtazapine. I was on 30mg and the doctor said to cross taper so as of last night take 15mg Mirtazapine and 30mg Dulox together and discontinue the Mirtaz after 7 days and up the Dulox to 60mg. So it could well be too much serotonin but I do have a history of similar problems with SSRIs and SNRIs when only taking one thing at a time.

At the moment I feel I don't want to take any more Dulox - my anxiety was making me feel suicidal earlier but I think it's wearing off now. I am wondering whether to stay with the Mirtazapine 15mg phone the doctor next week and consider another attempt when I am off Mirtaz completely or just to give up on Dulox. 30mg is the smallest dose and if I can't tolerate that...

There are other options for the pain such as pregabalin or gabapentin - I've no idea whether I would find those more tolerable.

A chat with your doctor sounds like a good plan to work through your options. But coming off the mirtaz and then having another try with duloxetine is certainly something you could try.

Still really anxious and agitated and nauseous. I have just read though that it takes 2.5 days for Dulox to leave your system so I've got about 24 hours more.