Expert: Dr Alan Galbraith - 10/22/2009

Question
QUESTION: dear sir,
how is DULOXETINE 30 MG for depression and anxity, is it effect to liver? and what are its sexual side effect.

ANSWER: Dear Majid

The sexual adverse effects and percentage affected are as follows: erectile dysfunction (impotence), (5%); ejaculation disorder (4%); abnormal orgasm, delayed ejaculation (3%);  anorgasmia (no orgasm) (at least 1%).

It does not appear to affect the liver but should only be used with caution in persons with abnormal liver function.

Regards

Alan Galbraith

---------- FOLLOW-UP ----------

QUESTION: dear sir,
can i take nortripytilne 10 mg at bet time along with fluvoxamine 50 mg , there will be any interaction if i take fluvoxamine 50 mg in the morning and nortripytiline 10 mg at bed time or i can have it , is it safe?

Answer
Dear Majid

Fluvoxamine can increase the toxicity of nortriptyline therefore the combination must only be used under careful supervision. Check with your prescriber as to this. Personally I would not recommend this combination.

Regards

Alan galbraith