Duloxetine antidepressant by Ray Sahelian, M.D.
Duloxetine, an inhibitor of serotonin and norepinephrine reuptake, is approved for the treatment of major depressive disorder. Duloxetine is used to treat mental depression and used for pain caused by nerve damage associated with diabetes. Duloxetine belongs to a group of medicines known as selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). These medicines are thought to work by increasing the activity of chemicals called serotonin and norepinephrine in the brain. Duloxetine medicine is available only with your doctor's prescription.
Serotonin noradrenaline reuptake
inhibitor
Duloxetine Cymbalta is an antidepressant of the class of serotonin noradrenaline
reuptake inhibitors. The efficacy of duloxetine 60 mg/day has been demonstrated
in the acute and long term treatment of major depression. The level of
effectiveness of duloxetine is particularly high and associated with a shorter
latency of action. Duloxetine also exhibits antinociceptive properties
independently of the antidepressant effect.
Duloxetine side effects
The side-effect profile of duloxetine is
similar to selective serotonin reuptake inhibitors with mainly nausea being
being the most common duloxetine side effect.
Duloxetine for diabetic
neuropathy pain
The drug duloxetine is useful in treating diabetes -related pain, but it may
worsen control of blood sugar levels. Duloxetine is one of only two drugs
approved for the treatment of diabetic peripheral neuropathic pain, a common
problem in diabetic patients. Dr. Thomas Hardy from Eli Lily, Indianapolis, and
colleagues pooled data from three clinical trials to investigate changes in
weight, sugar levels, and cholesterol levels in patients with diabetic
peripheral neuropathic pain treated with duloxetine. Short-term treatment with
duloxetine was associated with a modest increase in fasting sugar levels, but
not with significant increases in hemoglobin A1c, a measure of long-term sugar
control. With longer duloxetine treatment, however, there was a significant rise
in hemoglobin A1c, indicating impaired sugar control. There were also small
changes in cholesterol levels among duloxetine -treated patients. Weight
declined with short-term duloxetine treatment, but increased slightly with
long-term treatment. Diabetes Care, January 2007.
Comments: It appears that duloxetine is not an appropriate drug for
long term treatment of diabetes associated neuropathic pain.