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 indications

In particular, in line with its pain-related indications, the effects of Duloxetine, compared to other classes of antidepressants, have been found to be more apparent in a subgroup of MDD patients with PPS. [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]
A higher level of functioning in the Duloxetine cohort was also observed in all three SDS domains (work, social life, and family life) with the effect sizes of −0.46 (social life) to −0.62 (work). [source, 2016]
The mean SDS total score at 24 weeks was 1.95 (SD =4.19) in the Duloxetine cohort and 5.48 (SD =5.61) in the SSRI cohort in this subgroup (P<0.001), resulting in the effect size of −0.75. [source, 2016]
Similarly, a higher level of functioning in the Duloxetine cohort was also observed in all three SDS domains, with the effect sizes of −0.62 (social life) to −0.85 (work). [source, 2016]
No published research has examined the comparative effectiveness of Duloxetine (or SNRIs) and SSRIs on functioning in patients with MDD. [source, 2016]
More interestingly, they also presented the results of path analysis, which indicated that the effects of Duloxetine on functioning is mainly mediated through its effect on depressive symptoms, as measured using the Hamilton rating scale for depression (HAMD),47 and PPS, as measured using a visual analog scale for pain severity (each ~40% of the total effect on functioning). [source, 2016]
The effects of Duloxetine on functioning in patients with MDD were, however, challenged in an analysis of two clinical trials having similar protocols and comparable patient populations. [source, 2016]
First of all, the findings of the previous study with the same data as those employed here demonstrated greater effects of Duloxetine than SSRIs in terms of remission, response, and depressive symptoms, especially in patients with PPS at baseline. [source, 2016]
A case–control comparison of Milnacipran and the SSRI Fluvoxamine in 202 outpatients with major depression in Japan found that although the overall response rates were similar between the two groups, there were significantly more responders in the Milnacipran group than in the Fluvoxamine group in more severely depressed patients (a HAMD17 score of >19) as well as in patients with high scores on the “agitation” and “insomnia” items of the HAMD17.49 In addition to these comparative studies, several placebo-controlled Duloxetine studies have demonstrated its effects on controlling depression-related PPS,22–24 as also reflected in its treatment indications, such as fibromyalgia, DPNP, and chronic musculoskeletal pain approved in the United States as well as in many other countries worldwide. [source, 2016]