Does duloxetine cause headaches? (+5 factors)

This article will discuss the headaches caused by duloxetine as a potential side effect. It will also discuss the research studies suggesting the prevalence and frequency of headaches caused by this medication as well as the factors that may increase the risk of duloxetine-induced headaches. Additionally, this article will discuss the alternative medications to duloxetine if it causes severe headaches.

Does duloxetine cause headaches?

Yes, duloxetine does cause headaches. It is one of the most commonly reported side effects associated with the use of duloxetine. However, duloxetine is generally considered a safe medication with moderate side effects including nausea, dizziness, tiredness, and headaches. 

Duloxetine is an antidepressant medication that is indicated in the management of various health conditions such as depression, anxiety, fibromyalgia, and choric pain. Like any other medication, it is also associated with adverse effects that may occur in some individuals after taking duloxetine, based on their individual sensitivity to medication and overall health status (1). 

What does research suggest?

According to research headaches are the frequently reported side effect of duloxetine. In a research study, the use of duloxetine for the management of symptoms of depression at a dosage of 120 mg daily was found to alleviate symptoms effectively. However, it is worth noting that some individuals reported potential side effects of duloxetine, with headaches reported by 6% of patients in the study (2).

 Another research study suggested that the use of duloxetine for the management of fibromyalgia demonstrated effectiveness in managing symptoms within a timeframe of 3 to 4 weeks of treatment. However, approximately 10% of individuals in the study reported experiencing certain side effects, with headaches being among the reported adverse reactions (3).

What factors may increase the risk of duloxetine-induced headaches?

Several factors may increase the likelihood of experiencing headaches after using duloxetine. These factors may include:

Individual sensitivity: The response of every individual to medications such as duloxetine may vary depending on their individual sensitivity to the drugs. Some patients are genetically and physiologically more susceptible to the side effects of duloxetine. 

Concurrent medications: The concurrent use of medications such as nitrates, nitrofurantoin, and lithium that can also cause a headache as a potential side effect, doubles the risk of experiencing this side effect when combined with duloxetine. 

Underlying health conditions: Individuals with underlying health conditions such as migraines and hypertension are more likely to experience headaches while using duloxetine. However, some research studies have also suggested the role of duloxetine in the management of headaches associated with migraines.

Higher dosage: A higher dosage of duloxetine is more likely to cause certain side effects including headaches, in some individuals undergoing treatment with this medication. 

Start of treatment: During the initial phase of treatment with duloxetine, the patients are more susceptible to experiencing the side effects of this medication, including headaches. However, once the body adjusts to the mediation the frequency and severity of these side effects decrease on its own, without additional interventions. 

What to do if duloxetine causes headaches?

Duloxetine may cause headaches as a side effect, but it’s usually not a serious concern and can disappear on its own as your body adjusts to the medication. However, if you experience severe or persistent headaches that impact your quality of life, you should consult your healthcare provider. 

Your healthcare provider can evaluate your condition and determine the actual cause of your headache. If it’s related to duloxetine, they may adjust your dosage to minimize the frequency and severity of headaches and other associated side effects.

They may also prescribe over-the-counter analgesics to manage the headaches, but you should not take any medication with duloxetine without your doctor’s approval to avoid drug interactions and adverse effects.

If there are any risk factors that are worsening the headache caused by duloxetine, your healthcare provider will address or mitigate them to promote a comprehensive and tailored approach to your treatment plan.

What are the alternatives to duloxetine if it causes headaches?

Headaches caused by duloxetine are generally not severe, however, if you experience persistent and unbearable headaches after taking duloxetine, your healthcare provider may recommend you some alternative to duloxetine, that are less likely to cause headaches. These medications may include (4,5,6):

  • amitriptyline 
  • nortrytine
  • desipramine
  • phenelzine
  • mirtazapine 

It is important to note that the choice of medication should be based on individual factors and underlying medical conditions, keeping in mind the risks and benefits associated with the treatment. 

In my opinion, headaches caused by duloxetine are not severe enough to compromise the quality of life. This is a mild to moderate side effect associated with this medication, that normally subsides after the body adjusts to the medication. The decision to switch from duloxetine to another antidepressant should only be made if the risks of therapy outweigh its benefits. 

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Dhaliwal JS, Spurling BC, Molla M. Duloxetine. 2023 May 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31747213.


Perahia DG, Kajdasz DK, Desaiah D, Haddad PM. Symptoms following abrupt discontinuation of duloxetine treatment in patients with major depressive disorder. J Affect Disord. 2005 Dec;89(1-3):207-12. doi: 10.1016/j.jad.2005.09.003. Epub 2005 Nov 2. PMID: 16266753.


Smith HS, Bracken D, Smith JM. Duloxetine: a review of its safety and efficacy in the management of fibromyalgia syndrome. J Cent Nerv Syst Dis. 2010 Dec 22;2:57-72. doi: 10.4137/JCNSD.S4127. PMID: 23861632; PMCID: PMC3661232.


Turkewitz LJ, Casaly JS, Dawson GA, Wirth O. Phenelzine therapy for headache patients with concomitant depression and anxiety. Headache. 1992 Apr;32(4):203-7. doi: 10.1111/j.1526-4610.1992.hed3204203.x. PMID: 1582841.


Jackson JL, Shimeall W, Sessums L, Dezee KJ, Becher D, Diemer M, Berbano E, O’Malley PG. Tricyclic antidepressants and headaches: systematic review and meta-analysis. BMJ. 2010 Oct 20;341:c5222. doi: 10.1136/bmj.c5222. PMID: 20961988; PMCID: PMC2958257.


Colombo B, Annovazzi PO, Comi G. Therapy of primary headaches: the role of antidepressants. Neurol Sci. 2004 Oct;25 Suppl 3:S171-5. doi: 10.1007/s10072-004-0280-x. PMID: 15549531.

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