The role of duloxetine in treatment of neuropathic pain Case report
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Abstract
Neuropathic pain is a complex neuropathologic condition that imposes both diagnostic and
therapeutic challenge. Its symptoms are difficult to interpret, therefore the diagnosis is postponed
and it takes months for the patient to achieve an effective therapeutic scheme. Medications
used in this condition include antidepressants, both tricyclic antidepressants (amitriptyline
and nortriptyline) and serotonin-norepinephrine reuptake inhibitors (venlafaxine or duloxetine),
antiepileptics (gabapentin or pregabaline) and in very severe pain – opioids. One of the drugs
available in treatment of neuropathic pain is duloxetine, that is a potent inhibitor of the reuptake
of serotonine and norepinephrine. According to the manufacturer’s information and registration
in Poland it is recommended in the treatment of depression, anxiety and neuropathic pain associated
with painful diabetic neuropathy. The recommended initial and maintenance dose is 60
mg, which can be increased to 120 mg in case of ineffectiveness. Research has shown that its side
effects are mild and include headaches, drowsiness, nausea and dry mouth. This article covers
four case reports of patients with neuropathic pain in whom duloxetine was initiated successfully
in the treatment of chronic pain.
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References
2. Lunn M.P., Hughes R.A., Wiffen P.J.: Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Cochrane Database Syst. Rev. 2014 Jan 3; (1): CD007115.
3. Kremer M., Salvat E., Muller A. et al.; Antidepressants and Gabapentinoids in Neuropathic Pain: Mechanistic Insights. Neuroscience 2016 Jul 8. pii: S0306-4522(16)30296-2.
4. Attal N., Cruccu G., Baron R. et al.: European Federation of Neurological Societies: EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur. J. Neurol. 2010; 17(9): 1113-1123.
5. 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. Am. Acad. Pain Med. 2005; 6: 346-356.
6. Szczudlik A., Dobrogowski J., Wordliczek J. et al.: Rozpoznanie i leczenie bólu neuropatycznego: przegląd piśmiennictwa i zalecenia Polskiego Towarzystwa Badania Bólu i Towarzystwa Neurologicznego – część pierwsza. Ból 2014; 15(2): 8-18.
7. Szczudlik A., Dobrogowski J., Wordliczek J. et al.: Rozpoznanie i leczenie bólu neuropatycznego: przegląd piśmiennictwa i zalecenia Polskiego Towarzystwa Badania Bólu i Towarzystwa Neurologicznego – część druga. Ból 2014; 15(3): 8-21.
8. Dworkin R.H., O’Connor A.B., Audette J. et al.: Recommendations for the Pharmacological Management of neuropathic pain: An Overview and Literature Update. Mayo Clin. Proc. 2010; 85(3): 3-S14.
9. Charakterystyka produktu leczniczego. Dulsevia. 18.11.2015.