Duloxetine in the neurologist’s practice. Questions and answers Review article
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Published:
Sep 30, 2018
Keywords:
duloxetine, analgesia, neuralgia, polyneuropathy
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Abstract
Duloxetine is a drug well described in the therapy of psychiatric disorders. Its analgesic effect in neurology based on increasing serotonin and norepinephrine concentrations and its impact on the activity of descending pain inhibition pathways at the level of the spinal cord. Main neurological indication for its use in Poland is painful diabetic polyneuropathy. It is also first-line drugs for neuropathic pain. Clinical observations indicate the superiority of duloxetine over gabapentin in the treatment of diabetic polyneuropathy, and over carbamazepine and other drugs in trigeminal neuralgia. It also has very good results in the treatment of painful polyneuropathy in the course of chemotherapy. Duloxetine can be added to the drugs with a different mechanism of action (eg. gabapentinoids) to obtain a stronger analgesic effect. It should not be added to MAO inhibitors. Due to the reduction in the severity of depression, it is used to treat pain with coexisting depression.
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How to Cite
Białecka, M. (2018). Duloxetine in the neurologist’s practice. Questions and answers. Medycyna Faktow (J EBM), 11(3(40), 232-237. https://doi.org/10.24292/01.MF.0318.11
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References
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3. Smith T., Nicholson R.A.: Review of duloxetine in the management of diabetic peripheral neuropathic pain. Vasc. Health Risk. Manag. 2007; 3(6): 833-844.
4. Wong D.T., Bymaster F.P.: Dual serotonin and noradrenaline uptake inhibitor class of antidepressants potential for greater efficacy or just hype? Prog. Drug Res. 2002; 58: 169-222.
5. Beal B.R., Wallace M.S.: An Overview of Pharmacologic Management of Chronic Pain. Med. Clin. North Am. 2016; 100(1): 65-79.
6. Finnerup N.B., Attal N., Haroutounian S. et al.: Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol. 2015; 14(2): 162-173.
7. Goldstein D.J., Lu Y., Detke M.J. et al.: Duloxetine vs. placebo in patients with painful diabetic neuropathy. Pain 2005; 116(1-2): 109-118.
8. Raskin J., Pritchett Y.L., Wang F. et al.: A double-blind, randomized multicenter trial comparing duloxetine with placebo in the management of diabetic peripheral neuropathic pain. Pain Med. 2005; 6(5): 346-356.
9. Wernicke J.F., Pritchett Y.L., D’Souza D.N. et al.: A randomized controlled trial of duloxetine in diabetic peripheral neuropathic pain. Neurology 2006; 67(8): 1411-1420.
10. Flatters S.J.L., Dougherty P.M., Colvin L.A.: Clinical and preclinical perspectives on Chemotherapy-Induced Peripheral Neuropathy (CIPN): a narrative review. Br. J. Anaesth. 2017; 119(4): 737-749.
11. Kim P.Y., Johnson C.E.: Chemotherapy-induced peripheral neuropathy: a review of recent findings. Curr. Opin. Anaesthesiol. 2017; 30(5): 570-576.
12. Smith E.M., Pang H., Ye C. et al.: Alliance for Clinical Trials in Oncology. Predictors of duloxetine response in patients with oxaliplatin-induced painful chemotherapy-induced peripheral neuropathy (CIPN): a secondary analysis of randomised controlled trial – CALGB/alliance 170601. Eur. J. Cancer Care (Engl.) 2017; 26(2).
13. Qaseem A., Wilt T.J., McLean R.M., Forciea M.A.; Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann. Intern. Med. 2017; 166(7): 514-530.
14. Bouhassira D., Wilhelm S., Schacht A. et al.: Neuropathic pain phenotyping as a predictor of treatment response in painful diabetic neuropathy: data from the randomized, double-blind, COMBO-DN study. Pain 2014; 155(10): 2171-2179.
15. Okuma K., Shiraishi K., Kanai Y., Nakagawa K.: Improvement in quality of life by using duloxetine for chemotherapy-induced peripheral neuropathy (CIPN): a case report. Support. Care Cancer 2016; 24(11): 4483-4485.
16. Białecka M., Sławek J.: Interakcje leków w neurologii. Via Medica, Gdańsk 2014.
17. Spina E., de Leon J.: Clinically relevant interactions between newer antidepressants and second-generation antipsychotics. Expert. Opin. Drug Metab. Toxicol. 2014; 10(5): 721-746.
18. Wernicke J., Lledó A., Raskin J. et al.: An evaluation of the cardiovascular safety profile of duloxetine: findings from 42 placebo-controlled studies. Drug Saf. 2007; 30(5): 437-455.
19. Keks N., Hope J., Keogh S.: Switching and stopping antidepressants. Aust. Prescr. 2016; 39(3): 76-83. DOI: 10.18773/austprescr.2016.039.
20. Wasan A.D., Ossanna M.J., Raskin J. et al.: Safety and efficacy of duloxetine in the treatment of diabetic peripheral neuropathic pain in older patients. Curr. Drug Saf. 2009; 4(1): 22-29.
21. Szczudlik A.: Rozpoznanie i leczenie bólu neuropatycznego – Polskie Towarzystwo Badania Bólu. Ból 2014; 15(2): 8-18.
22. Snyder M.J., Gibbs L.M., Lindsay T.J.: Treating Painful Diabetic Peripheral Neuropathy: An Update. Am. Fam. Physician. 2016; 94(3): 227-234.
23. de Heer E.W., Dekker J., Beekman A.T.F. et al.: Comparative Effect of Collaborative Care, Pain Medication, and Duloxetine in the Treatment of Major Depressive Disorder and Comorbid (Sub)Chronic Pain: Results of an Exploratory Randomized, Placebo-Controlled, Multicenter Trial (CC:PAINDIP). Front. Psychiatry 2018; 9: 118.