Can Sertraline, Divas And Duzela Be Taken Together For BPD?

Posted on Sat, 19 Mar 2016

Question: i am XXXX. i suffer from bpd for last 40 yrs. i am going through a depressive episode for last one month after a hypo-mania for two months.i have been prescribed with serta 50mg morning and night along with divas 750mg. can duzela be taken along these drugs.

Answered by Dr. Dr. Chintan Solanki (16 minutes later)

Brief Answer:
Yes duzela can be taken

Detailed Answer:
Hello,

Thanks for writing to us.

You have mentioned clear history of your illness. With sertaline and valproate you can take duloxetine (duzela). There is no significant drug interaction between them.

However duzela is also antidepressant drug from SNRI group and with sertraline it may precipitate symptoms of hypomania so just be careful. As such with valproate less likely chance of that but as a psychiatrist I think I should mention this thing to you. After improvement in depression either sertraline or duzela can be reduced.

Hope I have answered your query, I will be happy to help further.
Regards,
Dr Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Chintan Solanki (3 hours later)

thanks for the answer. if both serta and duzela are anti depressant for faster recovery is it advisable to increase dose of sertaline or add duzela. if it is advisable to add duzela what should be the doses? does duzela have any advantage over sertaline? as mentioned earlier i am taking sertaline 50mg twice daily,ie morning and night. incase it is advisable to increase does of sertaline should i make 100mg morning and 50mg night or vise versa?

Answered by Dr. Dr. Chintan Solanki (10 hours later)

Brief Answer:
adding duzela is good option but first increase the dose of serta

Detailed Answer:
Hi XXXXXXX

Thanks for follow up.

You are on 100 mg dose of sertraline. As such maximum recommended dose is 200 mg. So there is scope of increment in dose.

Duzela acts somewhat differently than serta so combining two drugs with different actions gives good results. However it is more applicable when diagnosis is depression only and not bipolar depression.

By chance if we add duzela and you get improvement and later on there are hypomanic symptoms there will be some confusion that either serta should be reduced or duzela.

I recommend increasing serta in your case up to 200 mg stepwise. By chance if you do not get response with the maximum dose we can add duzela with 20 mg. And later on if needed we can reduce dose of serta.

You can discuss recommendation with your treating doctor.

Hope this answer will help.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar