Antidepressant Duloxetine side effects tough, any suggestions?

Are you looking for a medication that would help with depression and also pain? Or looking for a neuromodulator (aka antidepresssant, SSRI, or SNRI), specifically for pain?

As others have probably said, it’s my understanding that duloxetine is notorious for being very difficult to wean off of if it doesn’t work well for you. My neurology NP specifically didn’t advise it for me because I have an inflammatory arthritis and central sensitization and am prone to experiencing side effects. She worried if I had side effects, I might have a very hard time getting off.

But I’ve also heard of people who had really positive experiences.

If you’re looking for something more for pain, I was advised to consider low doses of either amitryptiline or nortryptiline. She said these are “old school” antidepressants that aren’t even really used for depression anymore because the newer medications work better. But they are being used for pain.

However the doses they use for pain or GI symptoms are much lower than what would be used for depression, so it theoretically wouldn’t be effective if the goal is to treat depression alone or with pain. The side effect profile still looks scary if you look it up, but she told me to keep in mind I’d be taking it at a far lower dose than what people should take for depression.

In the end, I so far haven’t gone for any of the above. I’m really nervous about any kind of system neuromodulators—this is more of a “me” thing. I know people have a lot of success and I’m glad they have success, but I just can’t get over my anxiety about the possible side effects when I have so much else going on.

Kind of off-topic, but my PT recommended I look into an app called Curable, which focuses on a pain neuroscience approach, so using the same pain communication pathways that these medications utilize, in a way (?). I’ve had good experiences with this approach in PT, so I’m thinking of trying it out.

Wishing you all the best.

A lot of the autoimmune medications prescribed by my Doctor have major side affects. Including joint and muscle pain which is really unbelievable considering I already have joint and muscle pain! Duloxetine was prescribed for my depression from my pain, multiple issues. Fibromyalgia and Polymyalgia Rheumatic are almost identical in symptoms although PMR is much more serious and painful lasting weeks sometimes. I had a Rheumatologist misdiagnose me as having RA. I kept questioning her about my symptoms which truly did not indicate RA. I was even on injections for RA. I moved on and was very fortunate to do my research and found a Clinical Scientist specializing in RA at M.D. Anderson Houston, Dr. Maria Suarez. She agreed with me regarding my symptoms and ran tests. I came back positive for Polymyalgia Rheumatic, it also triggers Giant Cell Arthritis, a very serious issue. I strongly believe in advocating for yourself and studying as much as possible your health issues. Knowledge is power. Good luck!

Please ask your rheumatologist or any of your healthcare pros for genetic testing. Genesight is what my doctor used, and only one of the antidepressant drugs was suitable for me. My sister had been on a myriad of different drugs over a 20 year span and nothing had been optimal treatment until she was gene-tested and the best drug was found suited to her makeup. And , of course, no surprise that the same drug was best for us both. Good luck!

That’s a really great point! I forgot about that. I had pharmacogenomic testing as well, and it did highlight two popular antidepressants uses for pain that I might have difficulty tolerating. There’s more research in that area so they were able to specifically advise a much smaller dose if it ever became necessary.