Duloxetine linked to serotonin syndrome

The serotonin and noradrenaline reuptake inhibitor duloxetine (Cymbalta) could be associated with serotonin syndrome, the latest ADRAC bulletin reports. The Australian Adverse Drug Reactions Committee has received 108 reports of suspected adverse drug reactions associated with duloxetine (Cymbalta) between June 2008, when it was added to the PBS for major depressive disorder, and May 2009. Commonly reported reactions included dizziness (10 cases), suicidal ideation (10), tremor (8), agitation (8) and serotonin syndrome (7). In five of the seven cases of reported serotonin syndrome, there was no evidence of other risk factors normally associated with the condition, such as concomitant use of other serotonergic agents or excessive dosing, the bulletin said. In one case, a 40-year-old woman developed the syndrome after one dose of duloxetine. “She was admitted to hospital and a MRI scan showed no abnormalities. In the opinion of the treating physician, the events were causally related to duloxetine therapy,” the bulletin stated. Based on this early post-market information, it appears that serotonin syndrome can occur with duloxetine treatment alone, even at therapeutic doses, as well as in combination with other drugs known to cause this syndrome, the bulletin concluded....