Come tell me your experiences of duloxetine for pain

[MollyBloomYes]

Just finished at pain clinic. Dr is suggesting I try going on duloxetine to manage my chronic pain. I'm open to trying anything but do have concerns.

I'm currently tapering off venlafaxine for depression as my head is doing a lot better. It's an SNRI, the same as duloxetine. One side effect I really haven't enjoyed with venlafaxine is how much of a challenge it is to orgasm! The spirit is so so willing (so no loss of libido) but achieving orgasm has been incredibly difficult.

I'm worried duloxetine will have the same effect. It seems silly to consider not taking something that could help my pain for that one reason but it's been about two years now of struggling and I was quite looking forward to having an easier time of it

Any experiences? Not just sexual side effects, any other bastard side effects? I know it doesn't necessarily mean I'll have them but it would be good to be forewarned!

I take duloxetine as well as a few other pain killers for nerve pain. Side effect wise, I generally get on pretty well, but have some issues with urinary hesitancy (slow flow) and constipation. However, my doctors think this is because it is an anti-muscarinic, as is the pregabalin and topiramate I take, so the added effect is worse.

Is it a nerve issue? I have lidocaine infusions 8-12 weekly and I have found them really good for nerve pain (I am currently cutting down on medication), and the side effects are really low besides the inconvenience of the infusion.

I found duloxetine awful tbh, though I know it’s a miracle cure for some so worth trying, but worth going in with your eyes open all the same.

Do you have people close to you who can monitor your mental state and mood? I became completely suicidal within a couple of weeks, and my pain levels increased off the charts.

Having been on and off antidepressants before, I thought I was pretty wise to the potential symptoms, but nothing prepared me for this. I was so ill so quickly I couldn’t advocate for myself and a completely useless GP decided I was naturally suicidal and already in pain so kept increasing the dose of the duloxetine rapidly. The GP also increased the doses of gabapentin, fentanyl, oral morphene, sumatriptan etc. All of which were already at their highest limits anyway, but the GP simply ploughed on increasing and increasing, without seeking any more expert advice... absolutely awful.

The whole thing was an utter nightmare which only stopped when I took myself off the duloxetene cold turkey, and a few weeks later after a very grim time indeed, regained enough mental clarity to stop the every increasing drug nonsense, and came down off the gabapentin too.

It took months for the pain to reduce, but it did in the end.

(And I also found a wonderful complex pain team some time after that who sorted a lot out. And I changed GP!).

However... pain is still not under control so I’m interested in lidocaine infusions that @lyrebird1 mentions? What are they for and how do they work?

Hi @WellThisIsShit - sounds like you had an awful time. I had depression and suicidal thoughts on nortriptyline, but luckily I noticed myself and the GP agreed with me that it was best to try something else. It does seem very individual what works best for people, so you need someone decent on your side.

The lidocaine infusion has been marvellous for me though. It is used for widespread chronic pain such as fibromyalgia and neuropathic pain. Lidocaine is a local anaesthetic (used in dental injections etc), but if they infuse a high dose into a vein slowly (mine is over 1.5 )hours, it apparently reduces pain signals (it is unclear exactly how). I have them in the day surgery unit in the morning, and feel tired and a bit irritable for a couple of days, and there is some stinging pain (I mind that much less than the nerve pain) but the pain relief effect lasts for about 8 weeks. When I had the first one done, I nearly cried because it was the first time my foot hadn't hurt in 18 months.

I got mine through my pain management consultant who is an anaesthetist. I saw him privately initially, as there was such a long waiting list, but I have the treatment on the NHS.

Sorry for hijacking your thread Molly! I agree though that it is helpful to have to have someone to keep an eye on side effects with you. My community pharmacist usually gives me a call every week or so when I am starting a new tablet which is friendly.

Wow Well that sounds absolutely horrendous I'm so sorry that happened to you! I've been on a few anti depressants over the years so am used to self monitoring but that's really useful to know that I might be impaired in that (if I choose to go on it which I'm really hesitant to after getting some more responses to this question over in Chat).

They're not sure what's going on with me at the moment-best theory seems to be fibromyalgia although my blood results came back today and show low TSH so might be thyroid (which I've been convinced of for a while but never managed to have anything show up on bloods before!) Certainly a lot to discuss with GP when I see him in a couple of weeks (earliest possible appointment). The infusions sound interesting, I'll add that to the list to consider (though god knows how I'd fit in 1.5 hours in day surgery as a lone parent to pre-schoolers. If needs must though...)

Thanks for your replies, I'm pretty sure duloxetine isn't the one for me but fortunately my GP is excellent and always happy to discuss things properly. I haven't spent this long struggling with the physical symptoms of coming off venlafaxine (and still not quite off it yet because apparently my body really wants to cling onto that last 37mg ) only to go onto what sounds like a very similar drug!