From the FDA Drug Label
Other adverse reactions that occurred at an incidence of less than 2% and were reported by more duloxetine delayed-release capsules-treated patients than placebo-treated patients in pediatric MDD and GAD clinical trials included: ... tremor
- Tremor is listed as an adverse reaction that occurred at an incidence of less than 2% in pediatric MDD and GAD clinical trials.
- The FDA drug label does mention tremor as a possible adverse reaction, but it does not specifically state that it can cause or worsen essential tremor.
- However, based on the information provided, it can be inferred that duloxetine may be associated with an increased risk of tremor in some patients, which could potentially worsen essential tremor in susceptible individuals 1.
From the Research
Duloxetine (Cymbalta) can potentially cause or worsen essential tremor in some patients. As a serotonin-norepinephrine reuptake inhibitor (SNRI), duloxetine affects neurotransmitter levels in the brain, and tremor is a recognized side effect of this medication, as noted in a study on drug-induced tremor 2. Patients taking standard doses (typically 30-60 mg daily) may experience tremor as an adverse effect, particularly during the initial weeks of treatment or after dose increases. If you have pre-existing essential tremor, duloxetine might exacerbate your symptoms due to its impact on norepinephrine, which can increase sympathetic nervous system activity.
Some key points to consider:
- Essential tremor is a chronic and progressive neurologic disease characterized by a 4-12Hz kinetic tremor, as described in a recent review on the topic 3.
- The condition can also involve other tremors, such as postural, rest, intention, and additional motor features, as well as nonmotor features 3.
- Duloxetine's mechanism of action, affecting neurotransmitters that influence motor control pathways in the central nervous system, may contribute to the development or worsening of essential tremor 4.
- Management of essential tremor may involve medications like propranolol and primidone, as well as deep brain stimulation or other surgical alternatives, as discussed in a review on the diagnosis and management of essential tremor 5.
Should you notice new or worsening tremor while taking duloxetine, it's essential to discuss this with your healthcare provider rather than discontinuing the medication abruptly, as sudden cessation can lead to withdrawal symptoms. Your provider might consider adjusting your dose, switching to an alternative medication, or adding treatments specifically for tremor management. The relationship between duloxetine and tremor is based on its mechanism of action affecting neurotransmitters that influence motor control pathways in the central nervous system, and recent research has highlighted the importance of considering drug-induced tremor in patients taking medications like duloxetine 2.