Duloxetine markedly increases the AUC of desipramine. Other
tricyclics metabolised by CYP2D6, such as nortriptyline, amitriptyline and imipramine, may interact similarly. The use of
duloxetine with other serotonergic drugs, such as the tricyclics, may increase the risk of
serotonin syndrome.
The manufacturer advises caution on concurrent use. Monitor for
duloxetine adverse effects, and for signs of
serotonin syndrome.