Here we present a case of painful diabetic neuropathy that launched duloxetine treatment. It has central pain inhibitory operations, probably associated with its CNS serotonergic and noradrenergic activity potential. The patient's blood pressure was high after taking one-day dose of duloxetine and patient diagnosed with hypertensive emergency. It was handled with labetalol which ultimately leads to reduced blood pressure and then began with telmisartan and metoprolol which leads to resolution in increased blood pressure. In this poster, we report a case with increased blood pressure after the initiation of duloxetine that recovered by discontinuation of the medication and Anti-hypertensives.