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Duloxetine is a selective serotonin (5-HT) and norepinephrine reuptake inhibitor (SNRI) that is mainly prescribed for major depressive disorder and generalized anxiety disorder. It is our clinical experience that SNRI medication has caused severe heart failure in several patients, including one treated with Impella (LVAD). Here we present two cases of young adults treated with Duloxetine who developed acute heart failure but had different outcomes. Acute heart failure following treatment is not a registered side effect of SNRI medication. Our cases and other published case reports suggest that noradrenergic reuptake inhibitors like Duloxetine can cause catecholamine surges and result in reversible cardiomyopathies if no further complications occur.
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