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Can Mirtazapine or Duloxetine cause nausea?

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Posted on Mon, 23 Nov 2015
Question: Does Mirtazapine or Duloxetine cause nausea/sickness. I am on both?
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Answered by Dr. Ilir Sharka (2 hours later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Thank you for asking on HCM!

I understand your concern and would explain that nausea can be related to duloxetine intake as an adverse effect. This is a common effect of duloxetine, encountered in up to 30% of the patients taking duloxetine.

How long have you been taking both these drugs? When did you start duloxetine?

What doses of these medications are you taking?

Did you start them both at the same time, or you started mono-therapy with one of these drugs and then added the other?

From the other hand you should know that both mirtazapine and duloxetine both increase the plasma levels of serotonin, thus leading to a possible serotoninergic syndrome.

Do you have any other symptoms like flushing, diarrhea, muscular cramps or involuntary contractions, sweating, tremor, tachycardia, etc?

A viral infection of the gastrointestinal tract should also be taken into consideration as a possible cause of your symptoms, not related to the drugs you are taking.

I recommend going to the ER for a careful physical examination, a resting ECG, and some blood lab tests:

- complete blood count (possible infection)
- PCR, sedimentation rate (inflammation)
- blood electrolytes
- fasting glucose
- kidney and liver function tests.

Serotoninergic syndrome is a clinical diagnosis, but if suspicions are raised during physical examination, it would be necessary to stop immediately the medications you are taking.

Otherwise, if this diagnosis is excluded and all the above tests result normal, you should discuss with your doctor on the possibility of lowering the dose of duloxetine.

Hope to have been helpful!

Feel free to ask any other questions, whenever you need!

Best wishes,

Dr. Iliri



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 8595 Questions

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Can Mirtazapine or Duloxetine cause nausea?

Brief Answer: I would recommend as follows: Detailed Answer: Hello! Thank you for asking on HCM! I understand your concern and would explain that nausea can be related to duloxetine intake as an adverse effect. This is a common effect of duloxetine, encountered in up to 30% of the patients taking duloxetine. How long have you been taking both these drugs? When did you start duloxetine? What doses of these medications are you taking? Did you start them both at the same time, or you started mono-therapy with one of these drugs and then added the other? From the other hand you should know that both mirtazapine and duloxetine both increase the plasma levels of serotonin, thus leading to a possible serotoninergic syndrome. Do you have any other symptoms like flushing, diarrhea, muscular cramps or involuntary contractions, sweating, tremor, tachycardia, etc? A viral infection of the gastrointestinal tract should also be taken into consideration as a possible cause of your symptoms, not related to the drugs you are taking. I recommend going to the ER for a careful physical examination, a resting ECG, and some blood lab tests: - complete blood count (possible infection) - PCR, sedimentation rate (inflammation) - blood electrolytes - fasting glucose - kidney and liver function tests. Serotoninergic syndrome is a clinical diagnosis, but if suspicions are raised during physical examination, it would be necessary to stop immediately the medications you are taking. Otherwise, if this diagnosis is excluded and all the above tests result normal, you should discuss with your doctor on the possibility of lowering the dose of duloxetine. Hope to have been helpful! Feel free to ask any other questions, whenever you need! Best wishes, Dr. Iliri