Latest research on Duloxetine

Duloxetine (brand names Cymbalta, Yentreve, and in parts of Europe, Xeristar or Ariclaim) is a drug which primarily targets major depressive disorder (MDD), generalized anxiety disorder (GAD), pain related to diabetic peripheral neuropathy and in some countries stress urinary incontinence (SUI). It is manufactured and marketed by Eli Lilly and Company. Duloxetine has not yet been FDA approved for stress urinary incontinence or for fibromyalgia. Duloxetine is a selective SNRI (selective serotonin-norepinephrine reuptake inhibitor). Duloxetine is a systemic drug therapy which affects the body as a whole. Known also under the code name LY248686, it is a potent dual reuptake inhibitor of serotonin (5-hydroxytryptamine, 5-HT) and norepinephrine (NE), possessing comparable affinities in binding to NE- and 5-HT transporter sites. It is a less potent inhibitor of dopamine reuptake.

Duloxetine dosage

The anticonvulsants Pregabalin and Gabapentin, low-dose TCAs, SSNRIs Duloxetine and Venlafaxine, and topical Lidocaine showed efficacy for the management of NP and were recommended as first-line and second-line medications, respectively. [source, 2016]
In Japan, the daily dose of Duloxetine is limited to a maximum of 60 mg/day for the treatment of MDD. [source, 2016]
Although our study did not include Japan, we also limited the maximum dose of Duloxetine to 60 mg/day to ensure that our results have broader implications across East Asia including Japan. [source, 2016]
The present analysis included only those patients who initiated either Duloxetine with a daily dose of ≤60 mg (Duloxetine cohort) or an SSRI (SSRI cohort) at approved therapeutic dosages, both as monotherapy at baseline. [source, 2016]
This study included a total of 452 patients who 1) initiated either Duloxetine with a daily dose of ≤60 mg or an SSRI as monotherapy at baseline for the treatment of MDD and 2) who did not have missing data on the QIDS-SR16 score at baseline with at least one nonmissing QIDS-SR16 score during follow-up (n=227 in the Duloxetine group and n=225 in the SSRI group). [source, 2016]
Of the 452 patients, 227 initiated Duloxetine with a daily dose of ≤60 mg at baseline and the rest (n=225) initiated an SSRI antidepressant at baseline. [source, 2016]
The median daily doses of these medications at baseline were 20.0 mg/day for Paroxetine, 10.0 mg/day for Escitalopram, 50.0 mg/day for Sertraline, 20.0 mg/day for fluoxetine, and 60.0 mg/day for Duloxetine. [source, 2016]
Patients treated with Duloxetine with a daily dose of ≤60 mg achieved higher levels of functioning (ie, global, work, social life, and family life), compared to those treated with SSRIs for the management of MDD in actual clinical practice settings in East Asia. [source, 2016]
Although two SNRIs (Milnacipran and Duloxetine) and four selective serotonin reuptake inhibitors (Fluvoxamine, Paroxetine, Sertraline, and Escitalopram) have been approved in Japan as of August 2015, the maximum dosages for most of these are considerably lower than those used in western countries on the basis of balance between the benefits and risks in the Japanese population. [source, 2016]
For example, the maximum dosages approved in the US and Japan, respectively, for the treatment of MDD are as follows: Milnacipran (200 mg/100 mg), Duloxetine (120 mg/60 mg), Fluvoxamine (300 mg/150 mg), Paroxetine (50 mg/40 mg), Sertraline (200 mg/100 mg), and Escitalopram (20 mg/20 mg). [source, 2016]