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 interactions

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]
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]
Similarly, Thase et al,26 using pooled data from six RCTs, found that although Duloxetine and the two SSRIs (fluoxetine and Paroxetine) were comparably efficacious overall, treatment with Duloxetine was associated with higher remission rate in patients with moderate-to-severe depression (a HAMD17 score of ≥19). [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]
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]
The sponsor decided (approved by the medical ethics committee) that, on the basis of the standards set by national regulations (Nederlandse Federatie van Universitair Medische Centra (NFU) standards59), no Data and Safety Monitoring Board (DSMB) will be installed, as the risk profile of Duloxetine is well known and Duloxetine is already registered as an Analgesic agent in the USA by the Food and Drug Administration (FDA) for use within patients with OA. [source, 2016]
Tramadol, Pregabalin, and Duloxetine were dissolved in distilled water (Otsuka Pharmaceutical Co., Ltd. [source, 2016]
Following baseline determination, the animals were randomized according to their withdrawal latencies and received 30 mg/kg (in 1 mL/kg, p.o.) of either Duloxetine (n = 4), Pregabalin (n = 4), or Tramadol (n = 3). [source, 2016]
On the following day, 17 days after the first Oxaliplatin injection, rats were randomized and received 30 mg/kg (p.o.) of either Duloxetine, Tramadol, Pregabalin, or an equivalent volume of vehicle (10 mL/kg). [source, 2016]