Acute Kidney Injury Following Duloxetine (Cymbalta) Therapy in a 43-Year-Old Female: A Case Report

Duloxetine is a commonly prescribed serotonin-norepinephrine reuptake inhibitor (SNRI) used to treat depression, anxiety disorders, and chronic pain syndromes. Renal adverse effects are considered rare. We present the case of a 43-year-old female who developed acute kidney injury (AKI) eight weeks after initiating duloxetine and escalating the dose from 30 mg to 60 mg daily, necessitating hospitalization. The patient presented with mental lethargy, disorientation, and generalized weakness and was found to have marked azotemia with a significant reduction in estimated glomerular filtration rate. Her condition improved following intravenous hydration and discontinuation of all medications, with gradual normalization of renal function over approximately six weeks. Notably, the patient had no history of dehydration, gastrointestinal losses, or reduced oral intake before presentation. Hemoglobin and hematocrit levels remained normal throughout the course of AKI. The close temporal association with duloxetine initiation and recovery following drug cessation supports a probable causal relationship. This report highlights the importance of vigilance for potential renal adverse effects associated with SNRIs.