Expert: Dr Alan Galbraith - 5/9/2009

Question
My doctor took me off Luvox/fluvoxamine (100 mg.@night) & prescribed Cymbalta (for GAD) @ 30 mg. the first week. I have gone 48 hours without fluvoxamine (my pharmacist recommended) and now I'm wondering if I should wait longer - what do you think? Thanks!

Answer
Dear Justine

Unfortunately, there is drug drug interaction between these two antidepressants which can lead to higher than normal amounts of the duloxetine in the blood stream. It will be approximately five days until the fluvoxamine is completely cleared from your blood but after three days I would suspect (but cannot guarantee) that the levels will be low enough not to cause any problems. I would therefore recommend that you start taking the duloxetine anytime now. The risks of an interaction will now be so slight and are outweighed by the necessity of you continuing therapy for your GAD.

Regards

Dr Alan Galbraith