I have been taking Duloxetine for 10 weeks now for nerve pain. Having failed to tolerate Amitriptyline and Gaberpentin my GP is keen to keep me on this drug but says the alternative is Carbamazepine. I've read up and got a bit apprehensive about this and am thinking perhaps it is case of better the devil I know!

The only side effect that has consistently bothered me - even on the lower doses - is jaw clenching. I saw an oral surgeon who has made me a mouth guard for night times and I do use it. But I find that I'm clenching all the time and my jaw is always aching now too and I've been suffering from severe headaches too for over a month.

I don't know if this is the Duloxetine or simply a coinicidence - the jaw crunching definitely started at the same time as I started this drug. But it does seem to make a difference to the nerve pain so I really need to know whether it's worth increasing the dose or if the jaw crunching is going to persist.

I don't know if it might be caused by the Cymbalta, but I have TMJ that I suspect is a side effect of my small fiber neuropathy. I have a lot of tight/clenched muscles all over my body so it wouldn't surprise me. I was not on Cymbalta at the time this set in. If your pain can tolerate it, maybe you should stop the Cymbalta for a while and see if your jaw pain changes.

You might post on our Medications forum for more specific info about meds..
http://neurotalk.psychcentral.com/forum72.html

Thanks to you both. Sorry not to respond but I've been in bed really sick with severe headache and jaw pain and gastritis - not a nice mix! I tried to come off Cymbalta but this coincided or caused my gastritis and headache to become so severe I was vomiting and off my food for 3 days - only okay in a darkened room. Not sure whether this has been my first migraine or Cymbatal or TMJ or Gastritis. I will ask on the meds support group as you suggest - haven't seen this before.

SSRI (Prozac, Zoloft, etc) and SNRI combos (Cymbalta), cause extrapyramidal side effects in some people. This is because the body senses too much serotonin, and for some reason lowers dopamine levels to compensate. The lowered dopamine release then causes Parkinsonian type symptoms of muscle dystonia. This can start in the head and neck mostly including the jaw and tongue. As time passes then it can involve other muscles in the body, and restless legs can occur.

http://en.wikipedia.org/wiki/Extrapyramidal_symptoms