Can Duloxetine exacerbate my IBS-related diarrhea?

Question

Hi doctor,

I am a 41-year-old male suffering from severe anxiety, depression, fast heartbeat, excessive sweating, IBS diarrhea, and nervous weakness for the past 15 years. I have consulted multiple psychiatrists, but not many medications have suited me. Currently, my doctor has recommended Nexito Forte (Clonazepam and Escitalopram), Pronol H (Alprazolam and Propranolol), and Prestiq 50 mg (Desvenlafaxine) at night. I have been taking these medications for the past two years, and they provide some relief. However, Prestiq causes excessive sweating during the day and does not have much control over my IBS (irritable bowel syndrome) diarrhea and anxiety. My gastroenterologist suggested adding Amitriptyline for my IBS diarrhea problem, but it also worsened my diarrhea. I tried Nortriptyline 25 mg, which helped with my IBS diarrhea, but increased heart palpitations and anxiety. My psychiatrist recommended replacing Desvenlafaxine 50 mg with Duloxetine 30 mg, as Duloxetine can address depression, anxiety, and IBS diarrhea without significant side effects. However, I have been hesitant to try it due to my concerns about IBS diarrhea. I would greatly appreciate your guidance. How effective is Duloxetine for depression, anxiety, tachycardia, palpitations, sweating, nervousness, and IBS diarrhea symptoms?

Please help me.

Answer 1

Hello

I am glad you chose icliniq for your medical-related queries.

I understand your concern.

For IBS (irritable bowel syndrome) diarrhea, anxiety, and depression, Duloxetine is known to be effective. However, it may initially increase anxiety for a few days. If available in tablet form, you can start with a half dose for the first four days and then switch to the full dose. Desvenlafaxine is also a good medication, but it has similar side effects. You can consider trying Duloxetine in a low dose. Alternatively, if you have not tried it yet, Paroxetine is another option. It is effective in controlling anxiety, depression, and IBS symptoms. Additionally, engaging in at least 45 minutes of physical exercise daily and drinking an adequate amount of water can be beneficial. It is also advisable to avoid fast food and oily food. Consult your specialist doctor, discuss with them, and take the medicines with their consent.

Hope I have solved your query. I will be happy to help you further.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Duloxetine is known to be effective in controlling anxiety and depression. However, in some patients, it may initially cause gastric problems, which could potentially worsen your diarrhea. Nowadays, there are some gastric protective medications available for Duloxetine that you can try, preferably at a low dose. Based on my clinical experience, I generally avoid prescribing Duloxetine to patients with existing gastric issues. Individual variations are always present.

I hope this has helped you.

Thank you.