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{"id":556746309705,"title":"Duloxetine Review: The Most Effective Antidepressant?","created_at":"2022-07-15T23:46:21-04:00","body_html":"\u003cscript type=\"application\/ld+json\"\u003e\/\/ \u003c![CDATA[\n{\n \"@context\": \"https:\/\/schema.org\",\n \"@type\": \"Article\",\n \"headline\": \"Duloxetine Review: The Most Effective Antidepressant?\",\n \"keywords\": \"duloxetine, duloxetine review, duloxetine reviews, duloxetine side effects, duloxetine hcl, duloxetine brand name, what is duloxetine used for, side effects of duloxetine, duloxetine dosage, duloxetine withdrawal, duloxetine class, duloxetine withdrawal symptoms, duloxetine other names\",\n \"description\": \"Our research team reviews medical studies on duloxetine to determine if it's effective for treating depression, anxiety and chronic pain. We highlight some severe side effects of the medication, share real user reviews and suggest some natural alternatives.\",\n \"url\": \"https:\/\/illuminatelabs.org\/blogs\/health\/duloxetine-review\",\n\"author\": {\n \"@type\": \"Person\",\n \"name\": \"Calloway Cook\",\n \"url\": \"https:\/\/illuminatelabs.org\/pages\/calloway-cook\",\n \"sameAs\": \"https:\/\/www.linkedin.com\/in\/calloway-cook\/\",\n \"jobTitle\": \"President\",\n \"knowsAbout\": \"entrepreneurship, dietary supplements, herbal supplements, eCommerce, medical research\",\n \"alumniOf\": {\n \"@type\": \"EducationalOrganization\",\n \"name\": \"S.I. Newhouse School of Public Communications at Syracuse University\"\n },\n \"memberOf\": {\n \"@type\": \"Organization\",\n \"name\": \"Illuminate Labs\"\n }\n},\n\"creator\": {\n \"@type\": \"Person\",\n \"name\": \"Calloway Cook\",\n \"url\": \"https:\/\/illuminatelabs.org\/pages\/calloway-cook\",\n \"sameAs\": \"https:\/\/www.linkedin.com\/in\/calloway-cook\/\",\n \"jobTitle\": \"President\",\n \"knowsAbout\": \"entrepreneurship, dietary supplements, herbal supplements, eCommerce, medical research\",\n \"alumniOf\": {\n \"@type\": \"EducationalOrganization\",\n \"name\": \"S.I. Newhouse School of Public Communications at Syracuse University\"\n },\n \"memberOf\": {\n \"@type\": \"Organization\",\n \"name\": \"Illuminate Labs\"\n }\n},\n\"editor\": {\n \"@type\": \"Person\",\n \"name\": \"Taylor Graber MD\",\n \"url\": \"https:\/\/illuminatelabs.org\/pages\/taylor-graber\",\n \"sameAs\": \"https:\/\/www.linkedin.com\/in\/taylor-j-graber-md-81351642\/\",\n \"jobTitle\": \"Content Partner\",\n \"knowsAbout\": \"medicine, health, anesthesiology, iv therapy, science, drugs, pharmaceutical, medical research, scientific research, medical journals, entrepreneurship, healthcare, orthopedic surgery, biomedical engineering\",\n \"alumniOf\": {\n \"@type\": \"EducationalOrganization\",\n \"name\": [\n \"University of California San Diego\",\n \"Arizona University\",\n \"University of Arizona College of Medicine\"\n ]\n },\n \"memberOf\": {\n \"@type\": \"Organization\",\n \"name\": \"Illuminate Labs\"\n }\n},\n\"image\": {\n\"@type\": \"ImageObject\",\n\"url\": \"https:\/\/cdn.shopify.com\/s\/files\/1\/0047\/1524\/9737\/files\/Duloxetine_Thumbnail.jpg?v=1657943430\",\n\"width\": \"1769\",\n\"height\": \"1769\"\n},\n\"citation\": [\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/16845641\/\", \n\"https:\/\/link.springer.com\/article\/10.2165%2F00023210-200923060-00006\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19821395\/\",\n\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK549806\/\",\n\"https:\/\/illuminatelabs.org\/blogs\/health\/cymbalta-review\",\n\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2010\/022516lbl.pdf\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18559291\/\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/16266753\/\",\n\"https:\/\/www.drugs.com\/comments\/duloxetine\/\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28064110\/\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27589952\/\",\n\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6979308\/\",\n\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4270108\/\",\n\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3918523\/\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27533649\/\",\n\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29722036\/\"\n],\n\"mentions\": [{\n \"@type\": \"Thing\",\n \"name\": \"Cymbalta\"\n },\n {\n \"@type\": \"Thing\",\n \"name\": \"Generalized Anxiety Disorder\"\n },\n {\n \"@type\": \"Thing\",\n \"name\": \"SNRI\"\n },\n {\n \"@type\": \"Thing\",\n \"name\": \"Drugs.com\"\n }\n],\n\"datePublished\": \"2022-07-15\",\n\"copyrightHolder\": {\n \"@type\": \"Organization\",\n \"name\": \"Illuminate Labs\"\n},\n\"publisher\": {\n \"@type\": \"Organization\",\n \"name\": \"Illuminate Labs\",\n \"url\": \"https:\/\/illuminatelabs.org\/\",\n \"description\": \"Illuminate Labs is the most transparent supplement company in the U.S., and is a leading publisher of research-based health information.\",\n \"knowsAbout\": \"supplements, science, nutrition, exercise, health, medication, pharmaceutical, wellness, diet, weight loss, medical research\",\n \"publishingPrinciples\": \"https:\/\/illuminatelabs.org\/pages\/editorial-guidelines\",\n \"logo\": {\n \"@type\": \"ImageObject\",\n \"url\": \"https:\/\/cdn.shopify.com\/s\/files\/1\/0047\/1524\/9737\/files\/Illuminate_Labs_Logo.png?v=1641249064\", \n \"width\": 150,\n \"height\": 150\n},\n \"foundingDate\": \"2019-01-30\",\n \"Address\": {\n \"@type\": \"PostalAddress\",\n \"streetAddress\": \"50 Union Street, Unit 9\",\n \"addressLocality\": \"Northampton\",\n \"addressRegion\": \"Massachusetts\",\n \"postalCode\": \"01060\",\n \"addressCountry\": \"US\"\n},\n \"sameAs\": [\n \"https:\/\/www.instagram.com\/illuminatelabs\",\n \"https:\/\/twitter.com\/illuminatelabs\",\n \"https:\/\/www.linkedin.com\/company\/illuminate-labs-supplements\",\n \"https:\/\/www.youtube.com\/channel\/UCpgSJAsIPb-fZ25djtTxBEA\"\n ]\n }\n}\n\/\/ ]]\u003e\u003c\/script\u003e\n\u003cp\u003e\u003cimg src=\"https:\/\/cdn.shopify.com\/s\/files\/1\/0047\/1524\/9737\/files\/Duloxetine_Review_Article_Header_Image_Optimized.png?v=1657943409\" alt=\"\"\u003e\u003c\/p\u003e\n\u003cp\u003e\u003ci\u003e\u003cspan style=\"font-weight: 400;\"\u003eDisclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s) and published for informational purposes only. We recommend that patients follow their doctor’s guidance in regard to prescription medication.\u003c\/span\u003e\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003e\u003cspan class=\"dc\"\u003eD\u003c\/span\u003euloxetine is a prescription drug used to treat a variety of conditions including depression, anxiety and chronic pain. The full name of the compound is duloxetine hydrochloride or duloxetine hcl for short. These all refer to the exact same drug. Duloxetine is the generic version of a branded drug called Cymbalta.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThese two drugs (duloxetine and Cymbalta) contain the exact same active ingredient, so we’ll refer to them interchangeably throughout this article.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eIn this article we’ll review medical research on duloxetine to determine if it’s an effective antidepressant. We’ll also highlight some of its side effects. Towards the end of the article we’ll provide some natural alternatives for mental health conditions that patients may wish to discuss with their doctor, as they may confer a lower side effect risk.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eDoes Duloxetine Work?\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDuloxetine is primarily used to treat depression, and it’s proven to be effective for that outcome in clinical trials. An extensive \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/16845641\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emedical review\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e on the efficacy of duloxetine for treating Major Depressive Disorder (MDD) was published in 2007 in the \u003c\/span\u003e\u003ci\u003e\u003cspan style=\"font-weight: 400;\"\u003eDepression and Anxiety\u003c\/span\u003e\u003c\/i\u003e\u003cspan style=\"font-weight: 400;\"\u003e journal.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe researchers found that the drug decreased average depression scores by over 50%, and average scores related to suicidal thoughts or ideation by over 50% as well. Patients took around 9 weeks on average to achieve maximal benefit from the drug, but depression scores decreased by the end of week one.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eAnother \u003c\/span\u003e\u003ca href=\"https:\/\/link.springer.com\/article\/10.2165%2F00023210-200923060-00006\"\u003e\u003cspan style=\"font-weight: 400;\"\u003eresearch review\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e of duloxetine for treating Generalized Anxiety Disorder (GAD), which was published in the \u003c\/span\u003e\u003ci\u003e\u003cspan style=\"font-weight: 400;\"\u003eAdis Drugs\u003c\/span\u003e\u003c\/i\u003e\u003cspan style=\"font-weight: 400;\"\u003e journal, found that the medication was significantly more effective for reducing anxiety than a placebo pill. The review analyzed four different placebo-controlled studies on duloxetine and anxiety.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe same four studies also measured patients’ depression levels, and duloxetine was more effective than placebo for improving depression in all studies.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eAnother \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/19821395\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emedical review\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e assessed the efficacy of duloxetine for chronic pain management. In all three clinical trials that the researchers analyzed, duloxetine was more effective than placebo for reducing pain. Impressively, duloxetine was effective on average at treating pain caused by various medical conditions, such as diabetic neuropathy and fibromyalgia.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eWe can conclude from the available research that duloxetine is effective at treating depression, generalized anxiety and pain. The research on duloxetine for depression is the most thorough in our opinion.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eHow Does Duloxetine Work?\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDuloxetine is a member of a class of drugs called Serotonin and Norepinephrine Reuptake Inhibitors (SNRI). These medications delay or halt the body’s natural processing of the neurotransmitters serotonin and norepinephrine.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThis causes an artificial increase in the circulating levels of these compounds. While it hasn’t been conclusively proven, researchers theorize that patients suffering from depression may have lower levels of these neurotransmitters than healthy patients, which is why this type of medication may be effective on average.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eAccording to \u003c\/span\u003e\u003ca href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK549806\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003eStatPearls\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e, which is one of the largest free medical databases in the U.S., duloxetine also increases dopamine levels in the brain, and does so to an even greater degree in the prefrontal cortex which directly influences mood.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eDuloxetine Side Effects\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDuloxetine has a side effect profile that patients should definitely speak with their doctor about, as we described initially in our \u003c\/span\u003e\u003ca href=\"https:\/\/illuminatelabs.org\/blogs\/health\/cymbalta-review\"\u003e\u003cspan style=\"font-weight: 400;\"\u003eCymbalta side effects\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e article.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe first side effect worth noting is the increased risk of suicidal behavior and thinking in children, adolescents and young adults as documented on the medications Food and Drug Administration (FDA) \u003c\/span\u003e\u003ca href=\"https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2010\/022516lbl.pdf\"\u003e\u003cspan style=\"font-weight: 400;\"\u003elabel\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e. This side effect is listed as a “black box” warning which is the most severe type of warning issued by the FDA.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eIt indicates a medication side effect that may cause life-threatening effects.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe medical study of duloxetine for anxiety cited in the “Does Duloxetine Work” section found that nearly 25% of patients taking the drug experienced nausea. Dry mouth, headache, constipation and dizziness were the next four side effects reported in order of frequency. Around 10-15% of participants reported these effects.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eNearly all side effects were found to be higher in the patients taking duloxetine than placebo, suggesting that the medication caused the side effects.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eOne of the \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/18559291\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emedical trials\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e on duloxetine and anxiety reported on a number of side effects presumably caused by the drug.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThey were: acute alcoholic intoxication, alcohol dependency, anxiety, arrhythmia, cellulitis, cerebral hemorrhage resulting in death, depression, diverticulitis, mania, nephrolithiasis, two attempted suicides, one completed suicide, stress, and syncope.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eIn our opinion this is a relatively severe side effect profile for an antidepressant, especially considering that there are antidepressants on the market without such severe risks. Of course, most patients won’t experience extreme side effects, but we believe it’s worth discussing these side effects with your doctor prior to using this medication, even as prescribed.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eDuloxetine Dosage\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe dosage of duloxetine prescribed depends on the condition it’s prescribed for.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eAccording to StatPearls, the typical dosage for treating fibromyalgia ranges from 30 milligrams (mg) to 60 mg per day.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe typical dosage for anxiety is 60 mg, and the dose for depression tends to range from 40 to 60 mg per day.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eWe believe it’s logical to start at a lower dose of a pharmaceutical with a side effect profile like duloxetine, because lower doses tend to cause lower risk of side effects. If the dose is ineffective, a doctor will often suggest that a patient increases the dose within the effective range. Of course, only a doctor can prescribe dosage to an individual patient.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eDoes Duloxetine Cause Withdrawals?\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDuloxetine does appear to cause withdrawal symptoms based on medical research.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eA 2005 \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/16266753\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003estudy\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e documented symptoms experienced after immediate discontinuation of the drug. Dizziness was the most common withdrawal symptom, experienced at a frequency of 12.4%. Nausea was experienced at a rate of 5.9% and headache at a rate of 5.3%.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eFor withdrawal symptoms, these are relatively minor.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe risk of withdrawal symptoms is why it’s so important for patients to speak with their doctor prior to stopping a medication. Stopping abruptly rather than tapering off can cause worse side effects and may be unsafe. A doctor can create a personalized tapering schedule that makes the drug discontinuation process safer and more pleasant.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eDuloxetine User Reviews\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDuloxetine has been reviewed over 2,000 times \u003c\/span\u003e\u003ca href=\"https:\/\/www.drugs.com\/comments\/duloxetine\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003eon Drugs.com\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e which is a website where patients can publish reviews of prescription medication. We cannot verify the accuracy or legitimacy of any reviews on the site.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eIn line with our remarks on the drug based on a research review, the reviews for duloxetine as an antidepressant are more favorable than the reviews on duloxetine for chronic pain. The medication scores 6.2\/10 as an antidepressant but only 5.6\/10 for chronic pain.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe top positive review of duloxetine for depression comes from a user named “Singer” who claims the drug improved their mental state:\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e“This was the first time I had taken an SNRI and I feel better--I'm calmer, I think more clearly, and things that bothered me a lot seem much more manageable now. If your provider prescribes this medication, at least give it a try.”\u003c\/b\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe top negative review of duloxetine for depression is written by a user named “jules” who claims the drug caused unpleasant side effects:\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e“I took a 30mg [duloxetine] capsule at 9am at 9.30am it was like someone threw a brick at my head then I started to get brain zaps. I thought it would wear off but I started to get cramps, became very thirsty, vomiting, became uncoordinated and then called an ambulance. My sodium level dropped to 118 and I got hyponatremia. they took me straight to emergency dept and gave me a brain scan and a salty drink.”\u003c\/b\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eNatural Alternatives to Duloxetine\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eAs stated in the disclaimer at the top of the article, we don’t recommend altering use of any prescribed drug without a discussion with a doctor.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eFor patients considering duloxetine but not currently taking it, we believe it may be worthwhile to talk to your doctor about some research-backed natural alternatives which may have less risk of side effects.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDietary supplements and prescription medications can have life-threatening synergistic effects like serotonin syndrome when taken together, so it’s important that patients speak with their doctor prior to taking any new dietary supplement while also taking medication, to ensure the two don’t cause an unfavorable interaction.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eDepression - St. John’s Wort\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eSt. John’s Wort is a plant that’s been used medicinally for thousands of years, and studied extensively. Most medical studies on the compound use a standardization ratio of 2-5% hyperforin and 0.3% hypericin, as these are the active chemical compounds. This means that these active compounds in the plant are sold at a guaranteed potency.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eA \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28064110\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emeta-study\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e on St. John’s Wort found that for mild and moderate depression it was as effective as prescription medication, and had a much safer risk profile. There were no studies with a duration longer than 12 weeks, so we hope to see future medical research on St. John’s Wort that’s more long-term.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eAnother \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27589952\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emeta-study\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e on St. John’s Wort concluded the same: that its supplementation was as effective for depression as pharma drugs with less side effects.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eIt’s important to note that St. John’s Wort does not appear to be as effective as pharmaceutical medications for major depression, which is what prescription medication is typically used to treat.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eAnxiety - Ashwagandha\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eAshwagandha is a root native to India and its extract has been studied extensively as an anxiolytic, which refers to a compound used to reduce anxiety levels. Many medical studies on ashwagandha utilize a standardization ratio of 1-5% withanolides, as this is the active chemical compound.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003ca href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6979308\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003eA medical study\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e testing ashwagandha against placebo in stressed adults found that supplementation with ashwagandha significantly reduced stress levels, improved sleep and improved quality of life overall.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eA \u003c\/span\u003e\u003ca href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4270108\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emedical review\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e published in the \u003c\/span\u003e\u003ci\u003e\u003cspan style=\"font-weight: 400;\"\u003eJournal of Alternative and Complementary Medicine\u003c\/span\u003e\u003c\/i\u003e\u003cspan style=\"font-weight: 400;\"\u003e in 2014 analyzed five clinical trials on ashwagandha for anxiety. The study authors found that in all five trials, ashwagandha supplementation reduced anxiety, and that none of the trials reported significant adverse effects.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003ePain - Turmeric Extract With Black Pepper Extract\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eTurmeric is a spice that can be found in grocery stores, but its extract is used medicinally as an anti-inflammatory agent. Many medical studies on turmeric use an extract that’s standardized to 95% curcuminoids, which is the active chemical compound. \u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eBlack pepper extract improves turmeric bioavailability by 2000% \u003c\/span\u003e\u003ca href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3918523\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003ebased on medical research\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e, so we recommend this combination. Many turmeric supplements also contain black pepper extract, which is alternatively referred to as piperine.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eA \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27533649\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003emedical review\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e from 2016 found that turmeric extract at a dosage of 1,000 mg per day was effective in decreasing arthritic pain. This review assessed 8 individual studies on the topic so it was quite thorough.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eAnother, more recent \u003c\/span\u003e\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29722036\/\"\u003e\u003cspan style=\"font-weight: 400;\"\u003estudy\u003c\/span\u003e\u003c\/a\u003e\u003cspan style=\"font-weight: 400;\"\u003e found that “Turmeric has consistently been demonstrated to produce analgesic and anti-inflammatory effects in animal models and in clinical trials”.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eAnalgesic is a medical term for a compound which can relieve pain.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eWe don’t believe there is as strong evidence for turmeric’s role as a standalone pain supplement as there is for ashwagandha and St. John’s wort for their respective uses, but the early research is promising and we hope to see more trials on turmeric as a natural analgesic.\u003c\/span\u003e\u003c\/p\u003e\n\u003ch2 style=\"text-align: center;\"\u003e\u003cb\u003eConclusion\u003c\/b\u003e\u003c\/h2\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDuloxetine is effective for treating anxiety, depression and pain but comes at quite a high risk of side effects in our opinion.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThe side effects of duloxetine include discomforts like nausea, but a small percentage of users may experience more severe side effects like suicidal ideation and cardiovascular incidents.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eThere are natural alternatives to duloxetine which may be worth considering for patients with mild-to-moderate depression, or milder anxiety and pain. Dietary supplements aren’t as powerful as prescription medications in most cases, but may confer lower side effect risk. \u003c\/span\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cspan style=\"font-weight: 400;\"\u003eDuloxetine does appear to cause withdrawal symptoms, so it’s important for patients to speak with their doctor about a safe way to taper off the medication if they choose to stop its use.\u003c\/span\u003e\u003c\/p\u003e","blog_id":49281925193,"author":"Calloway Cook","user_id":26601750601,"published_at":"2022-07-15T23:58:23-04:00","updated_at":"2022-07-15T23:58:23-04:00","summary_html":"We review medical studies on duloxetine to determine if it's effective for treating depression, anxiety and chronic pain. We highlight some severe side effects of the medication, share real user reviews and suggest some natural alternatives.","template_suffix":"","handle":"duloxetine-review","tags":"_related:depression"}

Duloxetine Review: The Most Effective Antidepressant?

Duloxetine Review: The Most Effective Antidepressant?


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Read our Editorial Guidelines to learn more about what makes our site the premier resource for online health information.


Read our Editorial Guidelines to learn more about what makes our site the premier resource for online health information.

Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s) and published for informational purposes only. We recommend that patients follow their doctor’s guidance in regard to prescription medication.

Duloxetine is a prescription drug used to treat a variety of conditions including depression, anxiety and chronic pain. The full name of the compound is duloxetine hydrochloride or duloxetine hcl for short. These all refer to the exact same drug. Duloxetine is the generic version of a branded drug called Cymbalta.

These two drugs (duloxetine and Cymbalta) contain the exact same active ingredient, so we’ll refer to them interchangeably throughout this article.

In this article we’ll review medical research on duloxetine to determine if it’s an effective antidepressant. We’ll also highlight some of its side effects. Towards the end of the article we’ll provide some natural alternatives for mental health conditions that patients may wish to discuss with their doctor, as they may confer a lower side effect risk.

Does Duloxetine Work?

Duloxetine is primarily used to treat depression, and it’s proven to be effective for that outcome in clinical trials. An extensive medical review on the efficacy of duloxetine for treating Major Depressive Disorder (MDD) was published in 2007 in the Depression and Anxiety journal.

The researchers found that the drug decreased average depression scores by over 50%, and average scores related to suicidal thoughts or ideation by over 50% as well. Patients took around 9 weeks on average to achieve maximal benefit from the drug, but depression scores decreased by the end of week one.

Another research review of duloxetine for treating Generalized Anxiety Disorder (GAD), which was published in the Adis Drugs journal, found that the medication was significantly more effective for reducing anxiety than a placebo pill. The review analyzed four different placebo-controlled studies on duloxetine and anxiety.

The same four studies also measured patients’ depression levels, and duloxetine was more effective than placebo for improving depression in all studies.

Another medical review assessed the efficacy of duloxetine for chronic pain management. In all three clinical trials that the researchers analyzed, duloxetine was more effective than placebo for reducing pain. Impressively, duloxetine was effective on average at treating pain caused by various medical conditions, such as diabetic neuropathy and fibromyalgia.

We can conclude from the available research that duloxetine is effective at treating depression, generalized anxiety and pain. The research on duloxetine for depression is the most thorough in our opinion.

How Does Duloxetine Work?

Duloxetine is a member of a class of drugs called Serotonin and Norepinephrine Reuptake Inhibitors (SNRI). These medications delay or halt the body’s natural processing of the neurotransmitters serotonin and norepinephrine.

This causes an artificial increase in the circulating levels of these compounds. While it hasn’t been conclusively proven, researchers theorize that patients suffering from depression may have lower levels of these neurotransmitters than healthy patients, which is why this type of medication may be effective on average.

According to StatPearls, which is one of the largest free medical databases in the U.S., duloxetine also increases dopamine levels in the brain, and does so to an even greater degree in the prefrontal cortex which directly influences mood.

Duloxetine Side Effects

Duloxetine has a side effect profile that patients should definitely speak with their doctor about, as we described initially in our Cymbalta side effects article.

The first side effect worth noting is the increased risk of suicidal behavior and thinking in children, adolescents and young adults as documented on the medications Food and Drug Administration (FDA) label. This side effect is listed as a “black box” warning which is the most severe type of warning issued by the FDA.

It indicates a medication side effect that may cause life-threatening effects.

The medical study of duloxetine for anxiety cited in the “Does Duloxetine Work” section found that nearly 25% of patients taking the drug experienced nausea. Dry mouth, headache, constipation and dizziness were the next four side effects reported in order of frequency. Around 10-15% of participants reported these effects.

Nearly all side effects were found to be higher in the patients taking duloxetine than placebo, suggesting that the medication caused the side effects.

One of the medical trials on duloxetine and anxiety reported on a number of side effects presumably caused by the drug.

They were: acute alcoholic intoxication, alcohol dependency, anxiety, arrhythmia, cellulitis, cerebral hemorrhage resulting in death, depression, diverticulitis, mania, nephrolithiasis, two attempted suicides, one completed suicide, stress, and syncope.

In our opinion this is a relatively severe side effect profile for an antidepressant, especially considering that there are antidepressants on the market without such severe risks. Of course, most patients won’t experience extreme side effects, but we believe it’s worth discussing these side effects with your doctor prior to using this medication, even as prescribed.

Duloxetine Dosage

The dosage of duloxetine prescribed depends on the condition it’s prescribed for.

According to StatPearls, the typical dosage for treating fibromyalgia ranges from 30 milligrams (mg) to 60 mg per day.

The typical dosage for anxiety is 60 mg, and the dose for depression tends to range from 40 to 60 mg per day.

We believe it’s logical to start at a lower dose of a pharmaceutical with a side effect profile like duloxetine, because lower doses tend to cause lower risk of side effects. If the dose is ineffective, a doctor will often suggest that a patient increases the dose within the effective range. Of course, only a doctor can prescribe dosage to an individual patient.

Does Duloxetine Cause Withdrawals?

Duloxetine does appear to cause withdrawal symptoms based on medical research.

A 2005 study documented symptoms experienced after immediate discontinuation of the drug. Dizziness was the most common withdrawal symptom, experienced at a frequency of 12.4%. Nausea was experienced at a rate of 5.9% and headache at a rate of 5.3%.

For withdrawal symptoms, these are relatively minor.

The risk of withdrawal symptoms is why it’s so important for patients to speak with their doctor prior to stopping a medication. Stopping abruptly rather than tapering off can cause worse side effects and may be unsafe. A doctor can create a personalized tapering schedule that makes the drug discontinuation process safer and more pleasant.

Duloxetine User Reviews

Duloxetine has been reviewed over 2,000 times on Drugs.com which is a website where patients can publish reviews of prescription medication. We cannot verify the accuracy or legitimacy of any reviews on the site.

In line with our remarks on the drug based on a research review, the reviews for duloxetine as an antidepressant are more favorable than the reviews on duloxetine for chronic pain. The medication scores 6.2/10 as an antidepressant but only 5.6/10 for chronic pain.

The top positive review of duloxetine for depression comes from a user named “Singer” who claims the drug improved their mental state:

“This was the first time I had taken an SNRI and I feel better--I'm calmer, I think more clearly, and things that bothered me a lot seem much more manageable now. If your provider prescribes this medication, at least give it a try.”

The top negative review of duloxetine for depression is written by a user named “jules” who claims the drug caused unpleasant side effects:

“I took a 30mg [duloxetine] capsule at 9am at 9.30am it was like someone threw a brick at my head then I started to get brain zaps. I thought it would wear off but I started to get cramps, became very thirsty, vomiting, became uncoordinated and then called an ambulance. My sodium level dropped to 118 and I got hyponatremia. they took me straight to emergency dept and gave me a brain scan and a salty drink.”

Natural Alternatives to Duloxetine

As stated in the disclaimer at the top of the article, we don’t recommend altering use of any prescribed drug without a discussion with a doctor.

For patients considering duloxetine but not currently taking it, we believe it may be worthwhile to talk to your doctor about some research-backed natural alternatives which may have less risk of side effects.

Dietary supplements and prescription medications can have life-threatening synergistic effects like serotonin syndrome when taken together, so it’s important that patients speak with their doctor prior to taking any new dietary supplement while also taking medication, to ensure the two don’t cause an unfavorable interaction.

Depression - St. John’s Wort

St. John’s Wort is a plant that’s been used medicinally for thousands of years, and studied extensively. Most medical studies on the compound use a standardization ratio of 2-5% hyperforin and 0.3% hypericin, as these are the active chemical compounds. This means that these active compounds in the plant are sold at a guaranteed potency.

A meta-study on St. John’s Wort found that for mild and moderate depression it was as effective as prescription medication, and had a much safer risk profile. There were no studies with a duration longer than 12 weeks, so we hope to see future medical research on St. John’s Wort that’s more long-term.

Another meta-study on St. John’s Wort concluded the same: that its supplementation was as effective for depression as pharma drugs with less side effects.

It’s important to note that St. John’s Wort does not appear to be as effective as pharmaceutical medications for major depression, which is what prescription medication is typically used to treat.

Anxiety - Ashwagandha

Ashwagandha is a root native to India and its extract has been studied extensively as an anxiolytic, which refers to a compound used to reduce anxiety levels. Many medical studies on ashwagandha utilize a standardization ratio of 1-5% withanolides, as this is the active chemical compound.

A medical study testing ashwagandha against placebo in stressed adults found that supplementation with ashwagandha significantly reduced stress levels, improved sleep and improved quality of life overall.

A medical review published in the Journal of Alternative and Complementary Medicine in 2014 analyzed five clinical trials on ashwagandha for anxiety. The study authors found that in all five trials, ashwagandha supplementation reduced anxiety, and that none of the trials reported significant adverse effects.

Pain - Turmeric Extract With Black Pepper Extract

Turmeric is a spice that can be found in grocery stores, but its extract is used medicinally as an anti-inflammatory agent. Many medical studies on turmeric use an extract that’s standardized to 95% curcuminoids, which is the active chemical compound. 

Black pepper extract improves turmeric bioavailability by 2000% based on medical research, so we recommend this combination. Many turmeric supplements also contain black pepper extract, which is alternatively referred to as piperine.

A medical review from 2016 found that turmeric extract at a dosage of 1,000 mg per day was effective in decreasing arthritic pain. This review assessed 8 individual studies on the topic so it was quite thorough.

Another, more recent study found that “Turmeric has consistently been demonstrated to produce analgesic and anti-inflammatory effects in animal models and in clinical trials”.

Analgesic is a medical term for a compound which can relieve pain.

We don’t believe there is as strong evidence for turmeric’s role as a standalone pain supplement as there is for ashwagandha and St. John’s wort for their respective uses, but the early research is promising and we hope to see more trials on turmeric as a natural analgesic.

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Conclusion

Duloxetine is effective for treating anxiety, depression and pain but comes at quite a high risk of side effects in our opinion.

The side effects of duloxetine include discomforts like nausea, but a small percentage of users may experience more severe side effects like suicidal ideation and cardiovascular incidents.

There are natural alternatives to duloxetine which may be worth considering for patients with mild-to-moderate depression, or milder anxiety and pain. Dietary supplements aren’t as powerful as prescription medications in most cases, but may confer lower side effect risk. 

Duloxetine does appear to cause withdrawal symptoms, so it’s important for patients to speak with their doctor about a safe way to taper off the medication if they choose to stop its use.





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