From the Guidelines
Duloxetine (Cymbalta) can induce diaphoresis (sweating) triggered by anxiety, as it is listed among the potential adverse effects of SNRIs, including diaphoresis, according to the clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders 1.
Mechanism and Prevalence
The mechanism behind this side effect is related to duloxetine's action as a serotonin-norepinephrine reuptake inhibitor (SNRI), which can increase levels of norepinephrine. This increase can activate sweat glands through the sympathetic nervous system, potentially leading to diaphoresis. When anxiety is present, it can further trigger the sympathetic nervous system, exacerbating the sweating.
Management Options
If duloxetine-induced sweating becomes problematic, patients should consult their healthcare provider about possible management strategies. These might include:
- Dose adjustments of duloxetine
- Switching to a different antidepressant
- Adding medications like anticholinergics to reduce sweating
- Lifestyle changes such as staying hydrated, wearing breathable clothing, and using clinical-strength antiperspirants to manage symptoms
Important Considerations
It is crucial not to discontinue duloxetine abruptly, as this can lead to withdrawal symptoms 1. Healthcare providers should be consulted before making any changes to the medication regimen. The potential for drug-drug interactions, especially with MAOIs due to the risk of serotonin syndrome, should also be considered when prescribing duloxetine 1.
From the FDA Drug Label
Discontinuation symptoms have been systematically evaluated in patients taking duloxetine delayed-release capsules Following abrupt or tapered discontinuation in adult placebo-controlled clinical trials, the following symptoms occurred at 1% or greater and at a significantly higher rate in duloxetine delayed-release capsules-treated patients compared to those discontinuing from placebo: ... anxiety, hyperhidrosis, ...
- Duloxetine (Cymbalta) can cause sweating (hyperhidrosis) as a discontinuation symptom, which may be triggered by anxiety.
- The FDA drug label does not directly address whether duloxetine can induce diaphoresis (sweating) triggered by anxiety in the context of treatment, rather than discontinuation.
- However, it does mention that anxiety is a symptom that can occur during discontinuation, and hyperhidrosis (sweating) is also listed as a symptom.
- Therefore, while there is no direct answer to the question, it can be inferred that duloxetine may be associated with sweating, potentially triggered by anxiety, in the context of discontinuation symptoms 2.
From the Research
Duloxetine and Diaphoresis
- Duloxetine is a serotonin and norepinephrine reuptake inhibitor, which can cause various side effects, including diaphoresis (sweating) 3.
- The study found that duloxetine can produce mild increases in blood pressure, diaphoresis, tachycardia, tremors, and anxiety, similar to other medications in its class 3.
- However, the exact relationship between duloxetine and anxiety-triggered diaphoresis is not explicitly stated in the available evidence.
Anxiety Disorders and Duloxetine
- Duloxetine has been shown to be effective in treating anxiety disorders, including generalized anxiety disorder, and may be considered an effective treatment option for patients with anxiety disorders 4.
- The literature review found that duloxetine could be considered an effective treatment option in the treatment of anxiety disorders individually or in comorbidity with each other, or with major depressive disorder (MDD) 4.
Mechanism of Action
- Duloxetine is a potent inhibitor of serotonin and norepinephrine uptake, which can lead to increased levels of these neurotransmitters in the brain 5.
- The increased levels of serotonin and norepinephrine can lead to various effects, including increased alertness, energy, and anxiety, which may contribute to diaphoresis 5.
Clinical Trials
- Clinical trials have shown that duloxetine is effective in treating major depressive disorder and anxiety disorders, but may cause side effects such as nausea, dry mouth, and diaphoresis 6.
- The trials found that duloxetine had a similar benefit-risk profile to venlafaxine, another medication in the same class, but with some differences in side effects and efficacy 6.