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Can Duloxetine Be Taken Along With Bupropion For Anxiety And Pain Disorders?

Posted on Tue, 4 Jul 2017

Question: My 71 year old husband is a 100% combat disabled Veteran (Vietnam), with diagnoses of combat-related: PTSD, Diabetes Mellitus Type 2 (non insulin dependent), Ischemic Heart Disease, COPD (Agent Orange Exposure has been determined to be a contributing factor), and multiple cervical, thoracic and lumbar spine "issues" resulting from surviving seven (7) documented helicopter crashes, ranging from arthritis, bone spurs, spinal stenosis, lingering discomfort (!) from a broken neck not diagnosed at time of injury and only discovered 30+ years post injury, along with bulging discs and "typical old man Degenerative Disc Disease." He has been taking Bupropion HCL 150mg qd AM for approximately 5 years for "mood." At about the same time he was prescribed Lorazepam 2mg tid for anxiety, although he typically took 1mg qhs (bedtime) only. Six months or so ago his psychiatrist weaned him off the Lorazepam due to "changes in VA policies." At the same time, also in accordance to "changes in VA policies," he was weaned from Oxycodone 30mg tid to Oxycodone 5mg qd. He is not sleeping well, is in a tremendous amount of pain and has become quite difficult to get along with much of the time. His VA psychiatrist just ordered Duloxetine HCL 30mg qhs (bedtime) for "mood and possible pain." He is scared to death to add another antidepressant and I am struggling with supporting doctor's orders at this point also... any thoughts, please?

Answered by Dr. Alexander H. Sheppe (1 hour later)

Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

Your psychiatrist is making a wise change. Benzodiazepines such as Ativan and opioids such as oxycodone are not at all safe for long-term use in people over age 65, due to the risk of falls, fractures, memory impairment, dementia, and delirium.

Duloxetine is an antidepressant that is FDA-approved for the treatment of anxiety and pain disorders, so this is an excellent medication to try to replace Ativan and oxycodone. Give it a try and hopefully, it will help him.

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Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Alexander H. Sheppe (22 minutes later)

Thank you Dr. Sheppe. Is it safe/reasonable for him to continue taking the Buproprion aling with the Duloxetine?

Answered by Dr. Alexander H. Sheppe (18 hours later)

Brief Answer:
Followup

Detailed Answer:
Yes, this is commonly done and is perfectly safe!

You are very welcome.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

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Above answer was peer-reviewed by : Dr. Prasad