Duloxetine-related acute dysphoria.

Duloxetine is the newest addition to the US antidepressant market. In this case series, we describe what appears to be an unusual adverse reaction to duloxetine: an acute dysphoric response. This response occurred in five patients (four women and one man, all outpatients, ages 37-73 years) and manifested with either the initiation of the medication or during a dosage increase (all doses were 60mg per day or less). Among all patients, this unexpected response promptly subsided with either a dosage reduction or discontinuation of the medication. These observations suggest that a small minority of patients taking duloxetine may develop acute and dysphoric responses to the medication, which may be addressed with either a dosage reduction or discontinuation of duloxetine.