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Case Report: Mouth Lesions Caused By Duloxetine !

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#1 FiveNotions



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Posted 27 August 2015 - 08:18 AM

This is the "first report" of duloxetine (Cymbalta) causing lesions in the mouth (fancy name -- "oral lichenoid reaction") ...

If I recall, we've had a number of members report sores in the mouth / gums ... :angry:
The man in this case report was 57 years old, and had been taking duloxetine, 60 mg / day, for 2 years.

Duloxetine Hydrochloride-Induced Oral Lichenoid Reaction: A Case Report
Medical Principals & Practice (2014, published online 2015, full text)

Objective: To report the first case of duloxetine hydrochloride (DH)-induced oral lichenoid [mouth lesions] drug reaction (OLDR).

Clinical Presentation and Intervention: A 57-year-old male patient presented with painful ulcerative lesions on the bilateral buccal mucosa of 2-year duration. The patient was on multiple drug therapy for his systemic ailments.

After thorough evaluation for possible medical ailments and with the physician’s consent, withdrawal of DH [duloxetine hydrochloride] was done. The oral lesions were resolved after 2 weeks.

Conclusion: In this case, DH [duloxetine hydrochloride] induced OLDR [mouth lesions].

From the article:

For the diagnosis of OLDR, recent or chronic exposure to a drug is essential. The latent period for the onset of lesions varies from weeks or months to years from the commencement of medication.


OLDR lesions resolve after drug cessation. . . It is important for the clinician to keep OLDR patients
under periodic observation, since malignant transformation is higher in OLDR (0.4–6.5%) compared to OLP
[a different type of mouth lesion, with a different cause, article says they are sometimes confused in diagnosis] (0–5.3%).


#2 brzghoff


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Posted 29 August 2015 - 01:27 PM

no surprise about this one! a side effect of most all antidepressants, especially the ssri/nri variety is dry mouth, which in turn leaves you more susceptible to mouth lesions/ulcers/canker sores. a toothpaste and mouthwash designed for dry mouth helps a ton! the primary feature in those are NO SLS's - sodium laureth/sodium laurel sulfate. i am sensitive to the SLS found in most toothpastes so i've always been predisposed to canker sores anyway, but anti-d's made them worse until i discovered biotene. while there are other brands without SLS, i can't find another that still has fluoride without the SLS. it made a world of difference for me. also, just because a brand calls themselves all natural doesn't mean they don't have SLS, which is derived from coconut. but it is a detergent that helps make products more foamy

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