Does Duloxetine weaken the immune system? (3+ impacts)

In this article, we will answer the question “Does Duloxetine weaken the immune system?”. We will discuss the impact of Duloxetine on the immune system, research findings in this regard, factors affecting the immune system while taking Duloxetine and how to balance the benefits of Duloxetine against its immune system effects.

Does Duloxetine weaken the immune system?

Duloxetine may weaken the immune system. This medication tends to cause beneficial and harmful effects on the immune system. The positive or negative effects on the immune system may vary from person to person.

Duloxetine (also known as Cymbalta) is a serotonin and norepinephrine reuptake inhibitor (SNRI) used for the treatment of depressive disorders, fibromyalgia, and musculoskeletal and nerve pain (1).

The immune system is a system defending the body from infections. It is the first-line defence mechanism against germs and infections. The immune system is responsible for keeping any foreign bodies and germs out of the body and decreasing the harm caused by them if they invade the body.

Duloxetine, other SNRIs or even selective serotonin reuptake inhibitors (SSRIs) are thought to have immunostimulatory and immunoinhibitory effects. These medications can improve the immune system through the regulation of the neurotransmitters serotonin, norepinephrine and dopamine. These can also cause imbalance to such an extent that it may trigger autoimmune disease.

What does research suggest?

Not much research has been conducted on the effects of Duloxetine on the immune system. More studies assessing this matter should be planned and conducted to get a clearer picture of how Duloxetine affects the immune system.

A research study assessing the effects of various antidepressants on the immune system stated that SSRIs, SNRIs, and tricyclic antidepressants (TCAs) act on the immune system and can improve the mental health of individuals through that mechanism (2).

Another study examining the effects of antidepressants on the innate and adaptive immune systems concluded that SNRIs do affect the immune system. They have anti-inflammatory properties and affect lymphocyte gene expression and activation (3).

Another study evaluating the effects of Duloxetine on the immune system reported that any positive or negative effects that this medication causes on the immune system are dose and time-dependent. The increase in neurotransmitters causes an increase in Th1 and Th2 cytokines, which modulate the immune system (4).

A study on the effects of SNRIs on the immune system stated that these medications decrease the pro-inflammatory, and increase anti-inflammatory cytokines, thus reducing inflammation and improving health (5).

Experts also have the opinion that more research should be conducted on this matter to properly assess what effects antidepressants have on the immune systems of individuals undergoing treatment.

What is the impact of Duloxetine on the immune system?

The precise mechanism through which this medication affects the immune system is not yet understood. However, the possibility of these effects being linked to the levels of neurotransmitters is very high. Duloxetine may have the following impact on the immune system of individuals taking therapy:

Depressive disorder improvement

Duloxetine is a first-line option for depressive illnesses. As the immune and nervous systems are interrelated, improving problems in one system can positively impact the other.

Anti-inflammatory effects

SNRIs including Duloxetine have some anti-inflammatory effects so a reduction in inflammation can help improve overall health and immune responses as well.

Potential weakening of the immune system

Experts think that Duloxetine and other antidepressants can cause an excessive cytokine disturbance to the extent that it may weaken the immune system and lead to autoimmune disease.

Individual characteristics

As the effect of Duloxetine may vary from person to person, so does the response of the immune system. Some individuals may react positively to the medication while others do not.

What are the possible impacts of a weak immune system?

If Duloxetine causes a weakening of the immune system it may also produce the following problems:

  • An increased susceptibility to different types of infections like pneumonia, ear infections, bronchitis etc.
  • An increased risk for inflammation of the internal organs
  • Delayed healing and recovery from infections and diseases.
  • An increased risk for autoimmune disorders

If you think Duloxetine is causing you some side effects or has lowered your immunity, you should consult your healthcare provider for professional guidance.

What are some common side effects of Duloxetine?

Some common side effects of Duloxetine are as follows (1):

Not everyone will experience these side effects as every individual responds differently to Duloxetine. However, if you do experience any of these side effects, make sure to discuss them with your doctor.

How to manage immune system effects while taking Duloxetine?

Some tips to manage immune system effects while taking Duloxetine are as follows:

Regular healthcare consultations

Going for regular medical checkups and consultations can help your healthcare provider keep a check on your condition and also facilitate an early detection of any side effects that may occur.

Balancing the risks and benefits of Duloxetine

Your doctor will only prescribe Duloxetine if it helps your condition. However, if you experience side effects while on Duloxetine therapy, then your healthcare provider will weigh the risks and benefits of therapy, and the potential impact on the immune system and advise accordingly.

Follow prescribed dosage

Do not take Duloxetine in a lower or higher dose than prescribed. Changes in your medication can also affect your immune system.

Reduce stress

Stress reduction can improve overall health. Practicing meditation, yoga and breathing exercises can help in this regard.

Improve lifestyle and diet

Regular exercise or physical activity and a diet rich in nutrients can help improve your condition and immune functions.

Reduce alcohol

As alcohol weakens the immune system limiting the intake of alcohol can improve this state by improving the immune system.

Stay hydrated

As Duloxetine tends to cause dehydration in some individuals keeping yourself hydrated is important to improve your overall health.

To the best of my knowledge and according to research, Duloxetine may cause negative or positive impacts on the immune system. This depends on the individual response of the patient to Duloxetine.

However, some tips and strategies can be used to improve the overall health and immune function of individuals on Duloxetine therapy. If you still experience discomfort, or any other side effects while taking Duloxetine make sure to reach out to your healthcare provider for a thorough assessment and guidance.

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References

1.-

The Food and Drug Administration (FDA). HIGHLIGHTS OF PRESCRIBING INFORMATION. CYMBALTA® (duloxetine hydrochloride) Delayed released capsules for oral use. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022516lbl.pdf 

2.-

Szałach ŁP, Lisowska KA, Cubała WJ. The influence of antidepressants on the immune system. Archivum immunologiae et therapiae experimentalis. 2019 Jun 1;67:143-51. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6509093/

3.-

Eyre HA, Lavretsky H, Kartika J, Qassim A, Baune BT. Modulatory effects of antidepressant classes on the innate and adaptive immune system in depression. Pharmacopsychiatry. 2016 Jun;26(03):85-96. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548302/

4.-

Fornaro M, Rocchi G, Escelsior A, Contini P, Martino M. Might different cytokine trends in depressed patients receiving duloxetine indicate differential biological backgrounds. Journal of affective disorders. 2013 Mar 5;145(3):300-7. https://www.sciencedirect.com/science/article/abs/pii/S0165032712005769

5.-

De Berardis, D., Conti, C.M.V., Serroni, N., Moschetta, F.S., Olivieri, L., Carano, A., Salerno, R.M., Cavuto, M., Farina, B., Alessandrini, M. and Janiri, L., 2010. The effect of newer serotonin-noradrenalin antidepressants on cytokine production: a review of the current literature. International Journal of Immunopathology and Pharmacology, 23(2), pp.417-422. https://journals.sagepub.com/doi/pdf/10.1177/039463201002300204

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