Does duloxetine help with anger? (3+ facts)

This article will answer the question, “Does duloxetine help with anger?” We will also talk about the research findings associated with duloxetine and aggression, along with the factors contributing to anger while taking duloxetine and some measures to manage anger issues. 

Does duloxetine help with anger? 

Yes, duloxetine can help with anger. Duloxetine is an antidepressant which is used to treat depression, anxiety and chronic pain. Psychiatric illnesses like depression, anxiety disorders, post-traumatic stress disorder (PTSD), etc, are associated with aggression. Since duloxetine is used to treat psychiatric illnesses, it can decrease the frequency and feeling of anger. (1)

Cymbalta can also be a cause of anger; individuals who are in therapy with Cymbalta can feel anger and show aggression as a side effect caused by Cymbalta. However, individual response to the drug varies. Some may benefit from Cymbalta, while some may experience side effects. 

If you notice any negative behavioural changes while taking Cymbalta, make sure you consult your physician for proper management. Avoid abrupt discontinuation of the drug, as it can worsen your condition. 

What does the research suggest?

Anger, irritability and hostility are frequently observed in patients with unipolar depression. Among depressed patients, anger attacks are commonly associated with the symptoms of increased heartbeat, sweating, hot flashes and tightness in the chest. These anger attacks can be treated with antidepressants. (2)

Violence, aggression and hostility are associated with dysfunction of serotoninergic transmission. Research states that a decrease in serotonin levels can be associated with aggression, and improper interaction between serotonin and dopamine systems in the prefrontal cortex of the brain can be an underlying cause of impulsive aggression. (3,4) A study suggests that SNRIs may be a safer treatment for aggression in people with PTSD. (5)

How does duloxetine help with anger? 

Duloxetine is an antidepressant which belongs to the class of serotonin-norepinephrine reuptake inhibitors (SNRIs). Duloxetine acts by inhibiting the reuptake of serotonin and norepinephrine from the presynaptic cleft, which increases the level of serotonin, norepinephrine and dopamine levels in the brain. (1)

These neurotransmitters play an important role in cognitive functioning. Any fluctuations in these neurotransmitters can lead to changes in behaviour and feelings. Many psychiatric illnesses, such as ADHD, PTSD, depression, anxiety, schizophrenia, etc, have been associated with aggression. (4)

The reason behind aggression in psychiatric illnesses is unclear. However, research studies suggest that a low level of serotonin or any dysregulation in the dopamine and serotonin systems in the brain can be associated with aggression. (4)

What factors should be considered while addressing anger issues?

Addressing anger issues requires a consideration of a few factors to guide the treatment and management strategies, such as 

• Identification of the root causes of anger for a proper intervention is necessary. Since anger can be associated with stress, trauma, PTSD, depression and other mental health conditions, the primary attention should be addressing these issues, which will help reduce the feeling of anger. 

• Substance abuse or addiction can also enhance the feeling of anger. Some medical conditions, such as chronic pain or any neurological disorders, can affect the behavioural and emotional state of the patient. With chronic illness and discomfort, a person can show aggression and agitation.

• Medications such as antidepressants (Lexapro, Mirtazapine, Wellbutrin), stimulants (amphetamines), opioids (tramadol), etc., can cause anger as a side effect. It is important to rule out the cause of anger before treating it. If medication is the cause of anger, the medication should be discontinued, or a low dose of the drug should be used. 

• Caution should be exercised when using antidepressants, as sudden discontinuation or increasing the dose can exacerbate existing conditions and lead to side effects. Make sure you consult your physician if you do not notice any improvement in your condition or experience any side effects.

What are the alternative treatments for anger? 

If duloxetine is not helping you with your symptoms, you can switch to other antidepressants such as sertraline, citalopram, desvenlafaxine, etc. Remember that sudden discontinuation and switching of antidepressants can be harmful; any alteration in the treatment regimen should be done under the guidance of a physician.

You can consider other nonpharmacological approaches to help you manage your anger, such as: 

• Cognitive behavioural therapy (CBT) will help you address your negative thoughts and behaviours. 
• Relaxation techniques include listening to calm music, deep breathing, guided imagery, etc. 
• Meditation can help you relax, enhance self-awareness and reduce impulsivity. 
• Participate in an anger management workshop which teaches you practical skills for recognizing and managing anger. 
• Engaging in creative activities such as art, music, or writing can help you express emotion. 
• Practice regular exercise as it can reduce stress and improve mood
• Keep a journal to write down your thoughts and emotions, which can help you know the source of your anger and help manage it. 
• Maintain a healthy and stress-free lifestyle, as stress can contribute to anger. 

What should you do if duloxetine is not treating your symptoms? 

Duloxetine takes approximately 2-4 weeks to start working, and its full effects are observable in 6-8 weeks. If you do not notice any improvement in your symptoms even after months of treatment, that means you are not responding to duloxetine. Consult your physician if your symptoms are not resolving; your physician will switch duloxetine with another antidepressant. 

Do not alter the course of treatment on your own, as it can worsen your condition. It is important to address the underlying condition contributing to anger, as treating the cause can reduce the intensity of the emotion. You can also consider a few nonpharmacological approaches to help manage your emotions.

If you experience any unwanted side effects after taking duloxetine, make sure to consult your physician for proper management. 

In my opinion, duloxetine can help you with your anger issues by treating the underlying psychiatric illnesses. Duloxetine is effective against depression, anxiety disorders and pain, but if you have other underlying psychiatric conditions such as ADHD, PTSD or schizophrenia, then it needs proper treatment with drugs like stimulants and antipsychotics. Consult your physician for a thorough evaluation of the cause and proper management. 

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