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Q. I have taken duloxetine for three years for severe fibromyalgia. I am a nurse, so I was reluctant to start it, but my physician said that "It is the best medication we have on the market for your pain."
I looked it up and didn't find any information about withdrawal concerns, or I would have declined.
This drug hasn't helped my pain, but I started to have random foot and hand movements. Coming off the med is hell. I take Dramamine twice a day to help with the nausea and dizziness. I also have brain fog so bad, I can't find the words I want to say. People talking to me sound like they are a mile away.
I wouldn't wish fibro on anyone, but even more, I couldn't wish duloxetine withdrawal on my worst enemy. I am taking one day at a time and hope it will get easier!
A. Duloxetine (Cymbalta) received Food and Drug Administration approval to treat depression in 2004. Four years later, the agency approved this drug to ease symptoms of fibromyalgia.
The Cochrane Collaboration is one of the most respected organizations analyzing the benefits and risks of medications. Its review of duloxetine for the pain of fibromyalgia was disappointing. The investigators concluded, "On average, the potential benefits of duloxetine … in fibromyalgia were outweighed by their potential harms" (Cochrane Database of Systematic Reviews, Feb. 28, 2018).
Discontinuing duloxetine can be difficult, whether it was prescribed for depression or fibromyalgia. It requires careful medical supervision. Symptoms may include dizziness, nausea, headache, sweating, irritability, anxiety, insomnia and fatigue.
One physician prefers to switch patients to fluoxetine (Prozac). This longer-lasting medication can gradually be discontinued. Some patients tell us that they remove a few beads from duloxetine capsules to achieve gradual dose reductions over several months to a year.
To learn more, you may wish to read our "eGuide to Dealing with Depression." It discusses various strategies to discontinue such medications. This online resource may be found under the Health eGuides tab at www.PeoplesPharmacy.com.
Q. For many years, I suffered with chronic athlete's foot and occasional toenail fungus. Then I read in your newspaper column about soaking in original amber Listerine. I soak my feet daily for five to 10 minutes before bedtime. In the decades since I started this regimen, my feet have been problem-free. This has made a huge difference in my life.
A. Perhaps your athlete's foot wasn't caused by a fungus. Investigators using sophisticated PCR analysis have found that many cases of foot infection are caused by bacteria along with or instead of fungi (Microorganisms, Jan. 16, 2025).
Listerine has broad antimicrobial properties and can help control bacteria as well as fungi. The alcohol base and several of the essential oils, including thymol, menthol and eucalyptol, are the active ingredients.
Q. My husband frequently relies on Pepto-Bismol for indigestion. I read the label and discovered the word salicylate. Isn't that like aspirin?
He is on Eliquis to prevent blood clots in his legs. Is it safe for him to take Pepto-Bismol?
A. Pepto-Bismol contains bismuth subsalicylate, a compound that is indeed related to aspirin (acetylsalicylic acid). You are right to worry about an interaction between salicylates and apixaban (Eliquis). This may increase the risk for dangerous bleeding. He should check with his physician and pharmacist for a safer solution to ease his heartburn symptoms.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 300 W. 57th St., 41st Floor, New York, NY 10019, or email them via their website: www.PeoplesPharmacy.com. Their newest book is "Top Screwups Doctors Make and How to Avoid Them."