Can duloxetine cause hypnic jerks? (5 causes)

This article will explore whether duloxetine can cause hypnic jerks. It will also explain how duloxetine may increase these movements.

Furthermore, the article will explore the studies that link duloxetine to hypnic jerks. It will mention the factors that increase the occurrence of hypnic jerks and discuss possible ways to manage this side effect.

Can duloxetine cause hypnic jerks?

Duloxetine could potentially increase hypnic jerks in some individuals, especially those who already have risk factors that can also increase these movements. However, it is important to note that there have been no reported cases of duloxetine specifically increasing hypnic jerks as a side effect.

Other antidepressants that increase serotonin, such as escitalopram, have been associated with increased hypnic jerks in some patients. This may suggest that duloxetine may also have the potential to increase hypnic jerks, as it also increases serotonin levels [1].

However, it is essential to emphasize that there is currently no scientific research or literature discussing the relationship between duloxetine and hypnic jerks.

How can duloxetine cause hypnic jerks?

A hypnic jerk is a sudden, uncontrolled movement that can occur when a person is lying down and starting to sleep, or during non-rapid eye movement sleep (NREM). It is a common phenomenon experienced by most people and is not necessarily related to medication use or any specific condition [1].

The occurrence of hypnic jerks can be caused by various factors, such as anxiety, insomnia, and stress. It may also be more prevalent in individuals with NREM sleep issues or those taking medications that disrupt NREM sleep [1].

Given that duloxetine can cause insomnia and sleep problems in some individuals, it is possible that it could increase the likelihood of experiencing hypnic jerks.

Furthermore, one study suggested that duloxetine may alter the nature of most NREM sleep stages, which can potentially increase the occurrence of hypnic jerks [2].

However, it is important to note that no research study, case report, or pharmacovigilance study has directly linked hypnic jerks to duloxetine. Therefore, it is essential to acknowledge that the aforementioned theory is not proved or confirmed by research.

Furthermore, since Cymbalta is a serotonin-norepinephrine reuptake inhibitor, it increases serotonin and norepinephrine in the brain. Both of these neurotransmitters significantly affect the sleep-wake cycle and sleeping characteristics, which may affect the frequency and timing of hypnic jerks [3].

What does research suggest?

There is currently a lack of research or case reports specifically discussing duloxetine-induced hypnic jerks. One study assessed the different side effects caused by duloxetine and found that only one patient out of the 85 duloxetine-treated participants suffered from myoclonic jerks [4].

While it is unlikely for duloxetine to cause undesirable frequent hypnic jerks, and no studies or reports have indicated such side effects, there have been reports of duloxetine causing a similar side effect known as restless leg syndrome (RLS). RLS involves unwanted limb movements, particularly during the night.

There is a case report of a patient who developed restless leg syndrome two weeks after starting duloxetine (Cymbalta). The patient experienced unpleasant sensations in her extremities, which prompted frequent and involuntary limb movements, especially at night [5].

This had a significant negative impact on her sleep. In response, the frequency of the patient’s duloxetine administration was reduced to every other day instead of daily. After one month, the patient reported a complete recovery from duloxetine-induced restless leg syndrome [5].

Who is more likely to experience hypnic jerks while on duloxetine?

Several factors can potentially increase the occurrence of hypnic jerks while taking Cymbalta:

  • For instance, high stress and anxiety levels are associated with increased hypnic jerks.
  • Moreover, excessive consumption of stimulants like caffeine or nicotine increases these movements.
  • Irregular sleep patterns and insomnia can also increase their occurrence.
  • The concurrent administration of certain medications, such as escitalopram, trazodone, and Prozac, might increase the likelihood of experiencing hypnic jerks as a side effect.
  • Uncomfortable sleeping, sleeping in a noisy environment, and prolonged exposure to screens before sleeping can all potentially trigger hypnic jerks while taking Cymbalta.

What should be done if duloxetine increases hypnic jerks?

If you can’t tolerate Cymbalta-induced increased hypnic jerks, here are some tips that can help:

  • First of all, you should discuss this side effect with your doctor and listen to their recommendations.
  • Reducing your caffeine and nicotine intake may help reduce hypnic jerks.
  • Improving your sleep hygiene is recommended. Try to maintain a fixed daily bedtime, avoid using screens before sleeping, and reduce any sources of noise or light in the room you’re sleeping in.
  • Inform your doctor about any other condition you may be suffering from, and tell them about your other medications as well. They can assess your risk factors and adjust your treatment accordingly.
  • If you experience hypnic jerks frequently, your doctor may suggest reducing the dose of Cymbal or switching you to another drug.

 

In conclusion, based on my research, I found that duloxetine is not associated with increased hypnic jerks. However, I believe that certain factors can increase the likelihood of experiencing this side effect.

For example, poor sleeping patterns, increased stress and anxiety, and excessive consumption of stimulants can increase the likelihood of experiencing frequent hypnic jerks while taking duloxetine.

If duloxetine causes intolerable hypnic jerks, I recommend consulting with your doctor. You should tell them about the frequency of these movements and inform them about your sleeping patterns and medications as well.

Furthermore, I also recommend improving your sleep hygiene and decreasing your consumption of nicotine and caffeine.

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References

1.-

Kumar R, Ali SN, Saha S, Bhattacharjee S. SSRI induced hypnic jerks: A case series. Indian J Psychiatry. 2023 Jul;65(7):785-788. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_207_23. Epub 2023 Jul 12. PMID: 37645359; PMCID: PMC10461585. https://pubmed.ncbi.nlm.nih.gov/37645359/#:~:text=A%20hypnic%20jerk%20is%20an,with%20no%20further%20neurological%20sequelae.

2.-

Kluge M, Schüssler P, Steiger A. Duloxetine increases stage 3 sleep and suppresses rapid eye movement (REM) sleep in patients with major depression. Eur Neuropsychopharmacol. 2007 Jul;17(8):527-31. doi: 10.1016/j.euroneuro.2007.01.006. Epub 2007 Mar 6. PMID: 17337164. https://pubmed.ncbi.nlm.nih.gov/17337164/

3.-

Watson CJ, Baghdoyan HA, Lydic R. Neuropharmacology of Sleep and Wakefulness. Sleep Med Clin. 2010 Dec;5(4):513-528. doi: 10.1016/j.jsmc.2010.08.003. PMID: 21278831; PMCID: PMC3026477. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3026477/#:~:text=inhibitors%20(SNRI).-,Norepinephrine,cortex%20(reviewed%20in84).

4.-

Mittal M, Pasnoor M, Mummaneni RB, Khan S, McVey A, Saperstein D, Herbelin L, Ridings L, Wang Y, Dimachkie MM, Barohn RJ. Retrospective chart review of duloxetine and pregabalin in the treatment of painful neuropathy. Int J Neurosci. 2011 Sep;121(9):521-7. doi: 10.3109/00207454.2011.582238. Epub 2011 Jun 15. PMID: 21671841; PMCID: PMC4582778. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4582778/

5.-

MÃlkoÄŸlu, Cevriye & Genc, Hakan. (2021). Duloxetine-induced Restless Legs Syndrome in a Patient with Fibromyalgia Syndrome. Fiziksel TÄp ve Rehabilitasyon Bilimleri Dergisi. 24. 183-185. 10.31609/jpmrs.2020-79096. https://search.trdizin.gov.tr/tr/yayin/detay/455849/duloxetine-induced-restless-legs-syndromein-a-patient-with-fibromyalgia-syndrome

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