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Antidepressants are prescribed to manage various conditions such as depression and other mental health disorders. They play a crucial role in minimizing suicidal thoughts and attempts while offering several therapeutic benefits. Nonetheless, a minority of individuals, particularly those under 25, may experience intensified depression, altered mood symptoms, or thoughts of self-harm when using these medications.

• It is essential to consult with a healthcare provider about the pros and cons of taking antidepressants, particularly for those under 25, regardless of whether the treatment is for a mental health condition.
• Immediately inform your doctor if you observe any deterioration in depression or other psychiatric conditions, or if there are unusual behavioral changes such as suicidal ideation, heightened anxiety, panic attacks, sleep disturbances, irritability, hostility, impulsive behavior, severe restlessness, or excessively rapid speech.
• Exercise increased vigilance for these symptoms when initiating a new antidepressant or altering the dosage.

This careful monitoring is vital to ensure the safe and effective use of antidepressant medications.

When taking this medication, you might experience common side effects such as nausea, dry mouth, constipation, loss of appetite, tiredness, drowsiness, or increased sweating. These effects are generally mild, but if they persist or worsen, it's important to consult your healthcare provider. Dizziness or lightheadedness, especially when starting the medication or adjusting the dose, can also occur. To minimize these effects, rise slowly from sitting or lying positions.

This drug may also lead to increased blood pressure, so regular monitoring is advised. In case of any serious side effects like confusion, easy bleeding or bruising, a decrease in sexual interest or ability, muscle cramps or weakness, tremors, difficulty urinating, or signs of liver issues such as persistent nausea, abdominal pain, vomiting, yellowing of eyes or skin, or dark urine, seek medical attention promptly.

Severe side effects requiring immediate medical help include black stools, vomit resembling coffee grounds, seizures, eye pain, swelling or redness, widened pupils, and vision changes like seeing rainbows around lights. Additionally, serotonin syndrome is a rare but serious condition that can occur, especially if combined with other serotonin-increasing drugs. Symptoms include a fast heartbeat, hallucinations, loss of coordination, severe dizziness, nausea, diarrhea, muscle twitching, unexplained fever, or unusual agitation.

A serious allergic reaction is rare, but if you experience a rash, itching, swelling (especially of the face, tongue, or throat), severe dizziness, trouble breathing, skin blisters, or mouth sores, seek emergency medical care immediately. While these are the main side effects, contact your healthcare provider if you notice any other unusual effects.

Certain medications can interact with this drug, potentially affecting its efficacy or safety. Here are some key interactions to be aware of:

1. Bleeding Risk: Medications like antiplatelet drugs (e.g., clopidogrel), NSAIDs (e.g., ibuprofen, naproxen), and blood thinners (e.g., dabigatran, warfarin) can increase the risk of bleeding or bruising when taken with this drug.

2. Duloxetine Metabolism: Some drugs can influence how duloxetine is removed from your body, which may impact its effectiveness. These include cimetidine, viloxazine, and certain quinolone antibiotics (e.g., ciprofloxacin, enoxacin).

3. Other Drug Metabolism: This medication can slow the removal of other drugs, affecting their function. Affected drugs include antiarrhythmics (e.g., propafenone, flecainide, quinidine), antipsychotics (e.g., thioridazine), and tricyclic antidepressants (e.g., desipramine, imipramine).

4. MAO Inhibitors: Combining MAO inhibitors (e.g., isocarboxazid, linezolid, phenelzine, selegiline) with this drug can lead to a serious, potentially fatal interaction. It's important to avoid MAO inhibitors during and for a period before and after treatment with this medication. Consult your doctor for specific timing.

5. Serotonin Syndrome Risk: The risk of serotonin syndrome, a potentially dangerous condition, increases with drugs that boost serotonin levels. These include certain antidepressants (e.g., SSRIs like fluoxetine, SNRIs like venlafaxine), street drugs (e.g., MDMA), St. John's wort, and tryptophan. Be especially cautious when starting or increasing doses.

6. Drowsiness: Inform your healthcare provider if you use other products causing drowsiness, such as alcohol, marijuana, antihistamines (e.g., cetirizine, diphenhydramine), sleep or anxiety medications (e.g., alprazolam, diazepam), muscle relaxants, and opioids (e.g., codeine). Many over-the-counter products, like allergy or cold medications, may also cause drowsiness. Consult your pharmacist for advice on safe use.

7. Aspirin Use: While aspirin can increase bleeding risk when used with this drug, continue taking low-dose aspirin for heart attack or stroke prevention if prescribed by your doctor, unless advised otherwise.

Always consult your healthcare provider or pharmacist before starting or stopping any medication to ensure safe and effective treatment.