Does duloxetine cause nightmares? (+5 factors)

In this article, we will discuss duloxetine-induced nightmares and the research studies on the effects of duloxetine on nightmares and vivid dreams. We will also discuss the factors that may increase the risk of nightmares while taking duloxetine and the management tips for vivid dreams. 

Does duloxetine cause nightmares?

Duloxetine may cause nightmares in some individuals. However, it is not frequently reported side effect of duloxetine. The occurrence of nightmares and vivid dreams in individuals taking duloxetine may depend on different factors such as the individual sensitivity to medication and underlying health conditions.

Duloxetine is an antidepressant medication, that works by interfering with the levels of serotonin and norepinephrine in the brain. The elevated levels of these neurotransmitters are involved in the regulation of mood and reduction of sadness and other symptoms associated with various mental disorders. It is commonly prescribed in the management of depression, anxiety, and fibromyalgia (1).  

Sleep disturbances are commonly associated with the use of duloxetine, however, the incidence of nightmares is low as compared to other side effects such as nausea, vomiting, dizziness, fatigue, and headaches (1).

What does research suggest?

According to research, duloxetine may decrease rapid eye movement (REM) sleep and alter sleep architecture, potentially influencing changes in dream patterns (2). 

In a research study assessing the potential of antidepressant medications to induce nightmares, the findings revealed that nightmares were a common side effect across most selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors including duloxetine. However, duloxetine was associated with a comparatively lower incidence of nightmares (3). 

It is important to note that a few research studies have also reported that duloxetine may reduce the occurrence of vivid dreams in individuals suffering from post-traumatic stress disorder (4).

What factors can increase the risk of duloxetine-induced nightmares?

Several factors may increase the risk of nightmares associated with the use of duloxetine. These factors may include:

Individual sensitivity: Individual responses to medication may vary from one person to another. Some individuals are more sensitive to the side effects of duloxetine including nightmares. 

High dosage:  The risk of experiencing side effects from duloxetine, including bad dreams, increases with the dose of the medication. Higher doses are more commonly associated with the occurrence of side effects. For this reason, healthcare providers initiate treatment with a low dose of duloxetine to minimize the likelihood of unwanted side effects. 

Concurrent medications: The concurrent use of nightmare-causing medications with duloxetine, doubles the risk of experiencing nightmares. These medications may include other antidepressants such as fluvoxamine, fluoxetine, and sertraline. 

Medical history: Individuals with underlying mental disorders such as stress, anxiety, and psychosis are more susceptible to the nightmares caused by duloxetine. 

Adjustment period: Side effects of duloxetine mostly occur in individuals during the initial phase of treatment when the body is adjusting to the medication. However, these side effects usually subside gradually after the adjustment period.

What to do if duloxetine causes nightmares?

If you experience unbearable nightmares after using duloxetine, you should consult your healthcare provider. They may evaluate your condition and determine the exact cause of your bad dreams. Sometimes, the nightmares are associated with the mental disorders for which duloxetine is prescribed. In such cases, healthcare providers recommend antidepressant medications that are less likely to exacerbate the nightmares.

If duloxetine is responsible for the nightmares that are compromising the quality of life of an individual, healthcare providers may adjust the dosage or recommend an alternative medication to duloxetine, which has a low incidence of causing nightmares. 

However, if you experience nightmares during the initial period of treatment, they may subside once your body adjusts to the medication. In such cases, you should wait for a few weeks. If the side effects persist after 3 to 4 weeks of treatment, consult your healthcare provider for a comprehensive evaluation of your symptoms.

What are the alternatives to duloxetine if it causes nightmares?

While duloxetine is generally associated with a lower likelihood of causing distressing nightmares, if you consistently experience nightmares that significantly impact your quality of life, it may be advisable to explore alternative treatments for depression, fibromyalgia, PTSD, and other conditions for which duloxetine is prescribed. These alternatives may include:

  • phenelzine
  • venlafaxine
  • prazosin 
  • gabapentin
  • trazodone

Always consult with your healthcare provider before making any changes to your medication regimen. They can provide personalized advice based on your specific symptoms, medical history, and treatment goals.

To my knowledge, duloxetine is associated with a low incidence of nightmares, and patients less commonly report this side effect in clinical settings. The medication is generally well-tolerated and less likely to cause serious side effects. However, if you experience any unusual symptoms after taking duloxetine, report it to your healthcare provider as soon as possible.

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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.


Tan, Lu & Zhou, Junying & Yang, Linghui & Ren, Rong & Zhang, Ye & Li, Taomei & Tang, Xiangdong. (2017). Duloxetine-induced rapid eye movement sleep behavior disorder: A case report. BMC Psychiatry. 17. 10.1186/s12888-017-1535-4.


Johan Natter, Taïoh Yokoyama, Bruno Michel, Relative frequency of drug-induced sleep disorders for 32 antidepressants in a large set of Internet user reviews, Sleep, Volume 44, Issue 12, December 2021, zsab174,


Walderhaug E, Kasserman S, Aikins D, Vojvoda D, Nishimura C, Neumeister A. Effects of duloxetine in treatment-refractory men with posttraumatic stress disorder. Pharmacopsychiatry. 2010 Mar;43(2):45-9. doi: 10.1055/s-0029-1237694. Epub 2009 Dec 15. PMID: 20108200. a

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