Duloxetine

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Information about Duloxetine

Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor widely used as an antidepressant and for neuropathic pain.

Liver safety of Duloxetine

Duloxetine therapy can be associated with transient asymptomatic elevations in serum aminotransferase levels and has been linked to rare instances of clinically apparent acute liver injury.

Mechanism of action of Duloxetine

Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) that is used as an antidepressant and for neuropathic pain. By blocking the reuptake of serotonin and norepinephrine in CNS synaptic clefts, the brain levels of these neurotransmitters are increased, which is associated with an antidepressant effect.

FDA approval information for Duloxetine

Duloxetine was approved for use in the United States in 2004 and is available in delayed release capsules of 20, 30 and 60 mg in multiple generic forms and under the brand name Cymbalta.

Clinical use of Duloxetine

Indications for duloxetine therapy include major depression, generalized anxiety disorders, fibromyalgia and neuropathic pain.

Dosage and administration for Duloxetine

The recommended dosage in adults is 40 to 60 mg daily, which can be raised to 120 mg daily based upon tolerance and clinical effects.

Side effects of Duloxetine

Common side effects are drowsiness,dyspepsia, nausea, headache, increased sweating, increased appetite, weight gain, urinary retention and sexual dysfunction. Rare, but potentially severe adverse events include suicidal thoughts and behaviors, mania, postural hypotension, syncope and falls, serotonin syndrome, seizures, severe skin rash, hypersensitivity reactions, hyponatremia, and glaucoma.

The following antidepressant subclasses and drug records are discussed individually:

MAO Inhibitors Isocarboxazid, Phenelzine, Tranylcypromine

SNRIs Duloxetine, Levomilnacipran, Venlafaxine

SSRIs Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Vilazodone, Vortioxetine

Tricyclics Amitriptyline, Amoxapine, Clomipramine, Desipramine, Doxepin, Imipramine, Nortriptyline, Protriptyline, Trimipramine

Miscellaneous Bupropion, Flibanserin, Mirtazapine, Nefazodone, Trazodone


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