Dyskinesia during Treatment with Duloxetine

Acute Dystonia after Using Single Dose Duloxetine: Case Report

“…Common adverse effects include dry mouth, nausea, insomnia, somnolence, dizziness and constipation. Reported adverse effects of EPS are rare 4,5…”

“…Although, it is believed that the dystonia results from the abnormality of the basal ganglia, the pathophysiology of acute dystonia is not clear yet. However, a few cases of duloxetine induced dystonia are reported in the literature 5-7. In this case, a patient who suffered from a neck spasm and pain which woke her up from sleep, dystonic distortion of the neck, tremor in her hands and lips after only one dose of 30 mg duloxetine is presented.…”

Adverse events, toxicity and post-mortem data on duloxetine: Case reports and literature survey

“…Further overdose cases were encountered during premarketing clinical trials, where four cases of overdose were reported. The minimum ingestion of duloxetine was 300 mg while the highest reported ingestion was approximately 1400 mg. 31 All patients survived the overdose event.…”

“…30 As such, co-administration of medications that are predominantly metabolized by CYP 2D6 which have a narrow therapeutic index should be undertaken with caution. 31 Co-administration of duloxetine with paroxetine (a CYP 2D6 inhibitor) resulted in an average AUC increase in duloxetine of 160%, however, the paroxetine dosages used in the assessment were low (20 mg) and not at steady state, and the duloxetine doses were 40 mg per day. Consequently, with maximal paroxetine dosing under steady-state conditions, the extent of duloxetine exposure would be expected to be even larger, and would be compounded by the higher doses of duloxetine that typify clinical usage.…”

“…These include various dermatologic and cutaneous manifestations, including porphyria, 32 facial flushing, 33 and rash with mild anaphylatoid reaction. 34 Reports of more unique ADRs have also been published, including disabling yawning, 35 dyskinesia, 31 and gingival bleeding. 36 Rare reports of more serious events associated with the administration of duloxetine have likewise been published.…”