Suicide duloxetine

Suicidality in children and adolescents Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of duloxetine or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior. 

Activation and agitation may represent the induction of a bipolar state, especially a mixed dysphoric bipolar II condition sometimes associated with suicidal ideation, and require the addition of lithium, a mood stabilizer or an atypical antipsychotic, and/or discontinuation of duloxetine... 

Psychotic symptoms, including suicidal ideation, after the addition of aripiprazole to duloxetine have been reported [67 ]. 

Drag overdose Overdose with duloxetine has been described in a 38-year-old man who had become suicidal within 4 days after having switched from escitalopram 20 mg/day to duloxetine 30 mg/day [54 ]. He was unconscious and severely hypotensive but recovered after treatment in intensive care. The authors discussed the possibility that duloxetine had made him feel suicidal, although such an effect has not emerged in clinical trials. 

Reeves RR, Brister JC. Serious suicide attempt with duloxetine treatment. South Med J 2008 101(7) 769. 

Paulzen M, Hiemke C, Grunder G. Plasma levels and cerebrospinal fluid penetration by duloxetine in a patient with a non-fatal overdose during a suicide attempt. Int J Neuropsychopharmacol 2009 12(10) 1431-2. 

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