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Good Evening Doctor. I Am Continuing With Duloxetine 20. Generally

Posted on Thu, 28 Mar 2019

Question: Good evening doctor. I am continuing with duloxetine 20. Generally i take it before my breakfast and after my morning tea along with biscuits. Today, i delayed taking it, just to see how it feels and then took it after my breakfast and was feeling little sedated for sometime. I was little uneasy till i took it and felt better after taking it. Was wanting to check with you, if taking it before or after the breakfast makes any difference. Also,since i have managed to get 10mg from my chemist as well as i ordered online from netmeds, should i stay on 20mg for sometime and start tweaking amitryn? or you think 10 mg of duloxetine will help me better keeping amitryn at 310? i dont think stopping duloxetine is an option because as explained above, after i took it today, was feeling better. Whether 20 mg or 10 mg, need your guidance about that? How long should i be on 20 before making it 10? I made it 20 on Ist Feb (last friday) and I have reduced it by 10mg after every 4 days in the past and tomorrow being the fifth day of making it 20, was thinking of taking a chance of making it 10, to see if it helps better? pls advise
Sleep still breaks in between, pls help me to set it right as a good restful sleep for 7-8 hours will make a huge difference. what tweaking in the other medicines will help me with better sleep?
Pls advise
Regards,
Rajesh

Answered by Dr. Seikhoo Bishnoi (7 hours later)

Brief Answer:
Make Duloxetine 10 since next Friday.

Detailed Answer:
Hello again

I don't think taking Duloxetine just before breakfast or after breakfast makes any difference. I usually advise the drug should be taken with breakfast or after. The sedation you felt could be due to psychological reasons. Just ignore this totally. The drug should be taken at same time of the day. Slight delay resulted in slight sedation most probably.

You should start taking 10 mg Duloxetine from Friday that is 8th of March, morning. Till then continue to take 20 mg dose. No need to get worried.

After Duloxetine we will start tweaking Amitriptyline. Slight reduction of Amitriptyline would help in improving sleep quality.

Thanks.

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

Follow up: Dr. Seikhoo Bishnoi (11 hours later)

Thank you doctor for the advise. What tweaking in my medicines should I do for better sleep?
My medicines are :
Amitryn 310, quitipin 150 sr, mirtaz 15 in the night
Duloxetine 20, betacap tr 20 in the morning
Regards

Answered by Dr. Seikhoo Bishnoi (3 hours later)

Brief Answer:
No need to change medicines as of now.

Detailed Answer:
Hello again

Right now don’t make any specific change in medicines. First we will get rid of Duloxetine totally. Then we will come to Amitriptyline.

I hope you felt normal today and didn’t have much sedation in day time.

Thanks

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Seikhoo Bishnoi (37 hours later)

Thank you doctor. What I meant in the earlier question was:
Keeping duloxetine same at 20, is there anything that can be done for better sleep? Sleep still remains an issue. Pls advise

Answered by Dr. Seikhoo Bishnoi (5 hours later)

Brief Answer:
Right now we will not make much change in prescription.

Detailed Answer:
Hello again

Yes I understood the doubt. Right now we will not change anything in your prescription. If we will tweak two medicines at one time thing might result in any adverse even or exacerbation of anxiety which I don't want.

Sleep will improve in quality too with time. No need to get worried.

From tomorrow morning you've to take 10 mg Duloxetine for next 5-7 days. You will feel better with this. Then we will shift to Amitriptyline.

Thanks.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Seikhoo Bishnoi (5 hours later)

Thank you doctor. Wanted to check with you the following :
I feel fatigued during the day and sometimes feel sleepy as well. Feel slight body aches. sweat more than the normal. Don't feel fresh. This has started happening for the last one week. Are these the withdrawal symptoms of duloxetine? if yes, should i switch to 10 from tomorrow or wait for some more time. Pls advise. Regards

Answered by Dr. Seikhoo Bishnoi (35 minutes later)

Brief Answer:
No these are not due to withdrawal.

Detailed Answer:
Hello again

No I don't think these are withdrawal symptoms of Duloxetine. We have reduced the dose very gradually. You can start a good multivitamin and this will reduce the tiredness, fatigue and sleepiness.

You should make Duloxetine to 10 from tomorrow. No need to get worried.

Thanks.

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