Increasing duloxetine 30mg to 60mg

[milliemoo]

Hi

I started duloxetine 2 weeks ago at 30mg with no real Side effects with a view to increasing which I did today to 60mg. Last week was the best I had felt with my anxiety for ages but I started to get some anxiety again yesterday so I increased the dose and since then my anxiety has been sky high mainly this evening although today I have just felt really tired! Is this normal and should I ride it out or go back to 30mg?

Any input would be greatly received.

Thanks

[MyNameIsTerry]

Hi,

I felt the same on 30mg. I seemed to improve but then it dipped again. At this point I increased to the dose I was due to be on (60mg) and had a very rought time for about 10 days.

SNRI's are only really working as SSRI's until they reach a certain point where they start to interact with your adrenaline. This is 60mg for Duloxetine and 150mg for Venlafaxine. So, side effects are similiar to SSRI's until this point. Once you cross that threshold you get side effects based on adrenaline too and this can be a bit of a shock as it means increased levels of adrenaline which will obviously mean more anxiety, possibly high levels of aggitation, adreanline rushes, etc.

I was not prepared for any of that but I just told myself each day to stick it out as any day now it will break. It did. After 10 days the reduction was very noticeable.

This board is very quiet. I would suggest talking to the Ven guys because they go through this too and they are very supportive plus it's a more updated board. Inparticular, look for Nicola1980's large thread as she went through all this with her increase.

I've spoken to a few others on here who have had no issues with either dose (lucky devils!) but then I have come across others who suffered like me. One guy somewhere else on the Meds board posted about this and he didn't even have an anxiety disorder, he was taking it for a physical problem so that poor bloke was in no way prepared.

[nicola1980]

Hi I take venlafaxine which Terry has explained is very similar to duloxetine as it kicks in as an SRNI over 150mg. Well when I increased to over 150mg my anxiety absolutely rocketed to a level that scared the life out of me and it was thanks to Terry and the guys on here I stuck it thro as I very nearly dropped my dose back down, I found the increased anxiety from the increase unbearable at times, my gp prescribed me a low dose of Diazepam to help me which took the edge of it, if you read my thread I was ringing the crisis team, out of hours gp etc as it really was bad but they all assured me it was the increase causing it and it would level out...easy for them to say when I was literally climbing the walls with the anxiety but I stuck it out and I'm so glad I did as I feel so much better...almost normal infact lol, it took about 3 weeks for my anxiety to slowly decrease and I improved from there in so if you can hang on in there for a bit it really should improve but obviously if your worried see your gp. Hope this helps XX

[milliemoo]

Thank you both for your replies it is very much appreciated, the last two days have been okay it's just at night the anxiety is worse even though I take my tablet about 6am. I am suffering with insomnia as well which doesn't help! I know I just need to ride it out but it is hard, I also suffer from intrusive thoughts which seems to have escalated 100% since the increase. I have tried venlafaxine and got up to 225mg with no luck, not even any side effects!! So to have side effects on this one seems strange, I'm hoping that means it's going to work. Anyway 4 days down of increase!!

[MyNameIsTerry]

I have OCD and I find when my GAD increases, so do all my OCD issues. It's the same for many others I have spoken to. So, with this med ramping up your adrenaline, impacts onto OCD style issues are likely.

Isn't it strange how these meds affect people differently? I had terrible aggitation but I could sleep (god knows how!). My pattern was the opposite to yours in that my anxiety was worse the first half of the day. I would have thought Ven would have caused you the same issues, yet you had none.

If the insomnia is really bad and affecting you, your GP may help out with a short course of something to help with that.

[MindBlock]

Doc has just doubled my duloxetine from 30mg to 60mg