Older adults may be more sensitive to the side effects of this drug, especially bleeding, dizziness, lightheadedness, or loss of coordination. Older adults may also be more likely to develop a type of salt imbalance (hyponatremia), especially if they are taking “water pills” (diuretics).
Conclusions: Duloxetine improved cognition, depression, and some pain measures and was safe and well tolerated in elderly patients with recurrent major depressive disorder.
The incidence of 1 or more discontinuation-emergent adverse events was not significantly different between the duloxetine and placebo groups (17.3% vs 11.3%). Conclusions: This study suggests that duloxetine is safe and well tolerated in elderly patients with major depressive disorder.
Serotonin norepinephrine reuptake inhibitors such as duloxetine may have the potential to cause drug-induced movement disorders, confusion and high blood pressure and should be used cautiously especially in elderly.
Cymbalta is a commonly prescribed Antidepressant used to treat generalized anxiety disorder and depression. Although generally considered nonaddictive, Cymbalta presents a high risk for abuse and dependence.
Tell your doctor right away if any of these serious side effects occur: confusion, easy bruising/bleeding, decreased interest in sex, changes in sexual ability, muscle cramps/weakness, shaking (tremor), difficulty urinating, signs of liver problems (such as stomach/abdominal pain, persistent nausea, vomiting, yellowing
Increased blood pressure and heart rate have been reported in duloxetine trials. The proposed mechanism for duloxetine-induced tachycardia is its effects on norepinephrine, which impact the cardiovascular system.
Human research to suggest benefits to patients with dementia: No studies have shown benefits with duloxetine in dementia patients.
Studies have found that while antidepressants can be helpful in older adults, they may not always be as effective as in younger patients. Also, the risk of side effects or potential reactions with other medicines must be carefully considered.
Duloxetine normally takes 2 to 4 weeks to work. It may take longer if you’re taking it for nerve pain. Common side effects include feeling sick, a dry mouth, headache, constipation and feeling sleepy. These side effects are usually mild and go away after a couple of weeks.
This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A. Clinical studies have shown that antidepressants such as Cymbalta increase the risk of suicidal thoughts and behaviors in children and young adults ages 24 years or younger.
SSRIs considered to have the best safety profile in the elderly are citalopram, escitalopram, and sertraline.  These have the lowest potential for drug-drug interactions based on their cytochrome P-450 interactions.
Eye problems aren’t a common side effect of Cymbalta. But this drug may increase the risk of serious eye problems, such as glaucoma (a buildup of pressure within the eye). Cymbalta can cause a person’s pupils to dilate.
Some people may find themselves more frustrated, irritable or lacking in patience when taking the drug. Occasionally this can escalate to open hostility towards others, extreme agitation and even mania. These effects may be more apparent early on in treatment or after discontinuation.
Cymbalta (duloxetine) can also increase your blood pressure so your doctor may monitor your blood pressure more regularly.
How Does Cymbalta Work? Cymbalta inhibits the reuptake of serotonin and norepinephrine in the central nervous system. It also increases dopamine by acting on dopamine reuptake pumps, thus increasing the diffusion of dopamine in the brain.