Duloxetine: Important Information

  • Duloxetine is a selective serotonin-norepinephrine reuptake inhibitor and is employed to treat depression and anxiety. It is additionally used to help relieve nerve pain (peripheral neuropathy) in individuals with diabetes or current pain because of medical conditions such as arthritis, chronic back pain, or fibromyalgia (a condition that causes widespread pain). 
  • Duloxetine could be a potent inhibitor of neuronal serotonin and norepinephrine reuptake and a less potent inhibitor of dopamine reuptake. Duloxetine has no significant affinity for dopaminergic, adrenergic, cholinergic, histaminergic, opioid, glutamate, and GABA receptors. The antidepressant drug and pain inhibitory actions of duloxetine are believed to be associated with its potentiation of serotonergic and noradrenergic activity within the central nervous system. The mechanism of action of duloxetine in SUI has not been determined, however, is believed to be related to the potentiation of serotonin and norepinephrine activity within the spinal cord, that will increase urethral closure forces and thereby reduces involuntary urine loss. 
  • The most common side effects of duloxetine in adults include: dry mouth, fatigue, loss of appetence, dizziness, nausea, sleepiness, constipation, raised sweating and in children: decreased weight, diarrhea, nausea, dizziness, stomach pain. While Serious side effects include: problems with urination, changes in blood pressure, abnormal hemorrhage. Duloxetine might increase your risk of bleeding or bruising, particularly if you’re taking warfarin or NSAID medication, manic episodes in individuals with depression or bipolar disorder, seizures or convulsions, liver damage, serotonin syndrome, severe skin reactions, vision issues, low salt (sodium) levels in your blood. 
  • Toxicity in animal studies.Use as long as potential advantages, outweighs risk; Risk of neonatal withdrawal symptoms if used close to term. 
  • The suggested dose for treating depression is 20 or 30 mg twice daily or 60 mg once daily. Patients are also started with 30 mg once daily for one week before the dose is advanced to 60 mg daily.The suggested dose for anxiety disorder, pain associated with diabetic neuropathy, fibromyalgia, or chronic musculoskeletal pain is 60 mg daily. starting at 30 mg daily for one week before increasing to sixty mg daily might facilitate patients comply with the drug. there’s no proof that doses larger than 60 mg/day provide further advantages. However, the maximum dose for depression or anxiety disorder is 120 mg/day. 

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