Duloxetine

[Karenwelshx]

Hope everyone is doing ok, well as good as they can be. I've been on 60mg of duloxetine for about a yr now, 5 wks ago thought I was having a flare up but just got worse, so today gp put me up to 90mg, what dose is everyone on? Also how do u cope with the fatigue? I seem to be always sleeping or when awake to tired to do anything. Any comments/suggestions welcome.

[Hazel_Angelstar Administrator FMA UK Staff]

For me, only thing that helps the fatigue is resting when it's really bad. Pacing activities throughout the day can help manage it

[Maggie1920 in reply to Hazel_Angelstar]

I take 120 of duloxitine my dr raise the dose r weeks ago. I still cant sleep my anxiety is still no better either. Im always tired .

[1whitestar]

I am taking duloxtine 60 mg for fibromyalgia. I'm also on sulfasalazine for inflamtory arthritis. I get tired still . The last 3 nights I have not slept well. It goes like that sometimes. I hope this helps.

[Yassytina FMA UK Volunteer]

Hi there , I am in 60mg but also prescribed too have 120g (morning @evening if need be) because I have Cfs as well I differently have too rest if my fatigue goes up a level , in general I try and pace every day , best method I’ve found with pain too. I do take my tablet before bed and I know some people do feel more sleepy when starting a new med or even a higher dose, see how you go for a few days and perhaps speak to your GP for some advice over the phone if you cannot get in too surgery for an appointment . It can be trial and error along the way for sure , take care xx

[Karenwelshx]

Thank you x

[denny_the_wench]

I'm on 60 daily. recently tried to cut it down to 30 again (slowly & with Doc's support) as the head sweat side effects were messing with my self esteem but since November I've been having a major flare as well, which hopefully I'm getting to the end of now, so back up to 60 now. However I now take 2 x 30 - one morning, one evening - which has minimised the sweats AND seems to be helping the pain better. Checked with the pharmacist and there is absolutely no reason why I can't take them like this - but the Doctors apparently like to keep it to one pill daily of a greater amount (cost possibly?).

I agree with Hazel - pacing is still the best thing though. Hope you feel a bit better soon x

[Zeek2021]

I'm taking this 160 . Only reduces the pins and needles across my shoulders (which is horrendous) and a little less stiffness.

It does nothing for my pain, insomnia or

Fatigue.

Looking at other pain medication that might help. Amitriptyline hasn't helped in anyways. Non pregabalin just coping on codeine and paracetamol so hopefully we'll find something better soon.

For fatigue I have to pace myself and try not to overdo activities (which isn't much) or I'm unable to cope the next few days and end up in bed.

Hope you get some relief soon.

[Alsithee4]

I'm on 60mg taken in the morning. I also take nortyptaline 20mg at night. I suffer terribly with fatigue and ME/Chronic pain and it's taken me a long time to learn how to pace myself and say 'no' without feeling guilty. I've now reduced my hours at work to help improve my fatigue and overall mental health.I take magnesium to help sleep, take it around an hour before bed and vit d in morning x

[DULOxITIne in reply to Alsithee4]

Hey, I was also very fatigued even before starting these, I started on 30mg and soon went to 60mg. I was tired so often in the day, then I had the kind of obvious idea to move them to evening. They definitely help me sleep now I average 4 hour sleep a night which is much better than before.

So might be worth trying them of an evening,

[Blearyeyed]

I'm on a combination of low dose Pregbalin and 60 mg Duloxetine with a standard dose of Paracetamol in the morning as I also have autoinflammatory issues.The Pregbalin alone at higher doses just made me spaced out and didn't help enough on its own.

The combination therapy is one that has been medically researched and proved to produce a better reduction in pain than just one higher dose medication alone.

Just like people with inflammatory pain issues like Arthritis often forget that they may also need nerve medication as well , often people with Fibro and other nerve issues often forget that they do also get some inflammation in joints and nerves that needs daily help because of the difficulty in movement and how the change in our posture and effect the joints.

I don't take my Duloxetine in one dose , I found splitting the dose to 30 mg in the morning and 30 mg at night works better for me , but these things are individual it may not work for all. If I know I definitely have a Fibro flare I take 60 mg in the morning and 30 mg at night until I feel it is under control.

The most important things for me are Self Care . Getting the right balance of rest between activity. Avoiding or adapting the activities that trigger flares. Pacing my activity and learning it is ok to step back or say No.

Drinking the recommended water each day and taking a combined vitamin and mineral after the fattiest meal if the day , and extra Vitamin D , C and B12 helps from within .

Often internal dehydration, which you can have even if you aren't thirsty , and low vitamin levels cause more pain as our bodies are constantly struggling to heal and deal with pain we do use up more nutrients than a generally healthy person , and often don't absorb vitamins well , so supplements help.

A reduced sugar , nutrient rich diet with no artificial sweeteners also helps improves the symptoms.

Gentle exercises , within your comfort zone are vital as Fatigue breeds Fatigue and is different to tiredness which can often keep us awake. Even just a few minutes stroll in the house each hour and a little light stretching does help reduce the pain over time and reduces the Fatigue . If that is all you can manage , as long as it's consistent that's fine. The trick is to do enough to keep your muscles strong and fight Fatigue without causing a flare . It can feel a bit painful and like trying to move through cement when Fatigue hits , but that is the Fatigue trying to take over but just a little movement each hour will reduce this feeling and it gets easier to move and feel some energy return. As you continue you can build in more movements or longer walks within your comfort zone and it can improve the symptoms a lot.

Deep breathing and relaxation exercises and creating your own bed time routine is also vital . Even if you can't sleep body rest is vital . I don't get anxious if I can't sleep but enjoy knowing I'm giving my body time to repair and refresh. Setting a time to get up each day is also important in beating the Fatigue , and limiting yourself to one nap a day , setting an alarm so you don't sleep more than an hour builds up a better pattern. Magnesium lotion or spray used on arms , feet and legs at night and raising your feet can reduce peripheral neuropathy and restless leg twitches. A little morning light and fresh air each day , even sitting by an open window doing your breathing increases your oxygen levels and Vitamin D which also improves energy and Fatigue.

Basically , we often don't get 100% pain free , especially if we haven't got our activity level balanced , the aim is to be 85% pain managed each day while having a good quality of life and reducing flares. Easier said than done but we can get there , it's just a matter of finding the combination of Self Care and Activity with a little medicinal help that works best for you . Take care , Bee

[Annmarie09]

I take 60mg twice a day of duloxetine my Gp has mentioned if I need to increasing if I need to. I haven’t yet but increased other things.

Fatigue arrrr it’s a Bain of my life well firstly have u been checked for b12 & thyroid under active ?

Both of mine were terribly low so got them sorted but still have fatigue but not all the time as severe.

Sometimes I could still sleep at traffic lights but not all the time like before. Get checked out if u haven’t.

Take care xx

[Tassadar]

I'm on 120mg, only side effect I've had is dry mouth. If anything i feel like I've got a bit more energy, but maybe that's because my pain is a bit less i can do more so my fitness level may be increasing a little.

[SlothMode]

Hiya Karen,

I'm on 90mg Duloxetine which works alongside my 225 mg Pregabalin. Before that I was just taking the Pregabalin n personally feel they do work better together. My advice for the fatigue is do what u can, when u can, have lots of rests n catnap during the day when your body wants too. It's funny I'm knackered during the day then awake most of the night lol! Gotta love fibro! Gentle hugs 😊🤗