duloxetine effects

[olafa]

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A 40-ish M that is "sensitive" to medications - we added cymbalta as an adjunct to his his regular medications, titration was super-slow becasue of the sensitivity and probably some anxiety aobut a new medication on his part, 20mg-30mg-40mg-60 over the 4 weeks, he seemed to tolerate this well. The next month he comes back reporting several adverse effects including anorgasmia, so we obviously decide to stop. Another effect he was having that he liked, he reports that his normal profuse sweating on his face and chest went away, he liked that part of it because this normally causes him embarrasment. Now he wants to figure out how to stop this sweating- but without the cymbalta. 🙄
Is this a wierd pardoxical effect, one of the s/e is sweating, not stoping sweating. Have you seen this before?

 

[PMR2008]

We had a patient who had similar side effects. He had some other symptoms consistent with hypothyroidism and we sent him to endocrinologist. Turned out that SNRIs and SSRIs can cause hypothyroidism which can in turn can cause hypohyrdosis.