Duloxetine

Cymbalta
Duloxetine, sold under the brand name Cymbalta among others, is a medication used to treat major depressive disorder, generalized anxiety disorder, fibromyalgia, and neuropathic pain.wikipedia
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Generalized anxiety disorder

general anxiety disordergeneralized anxietyanxiety
Duloxetine, sold under the brand name Cymbalta among others, is a medication used to treat major depressive disorder, generalized anxiety disorder, fibromyalgia, and neuropathic pain. The main uses of duloxetine are in major depressive disorder, generalized anxiety disorder, neuropathic pain, chronic musculoskeletal pain, and fibromyalgia.
Medications which have been found to be useful include duloxetine, pregabalin, venlafaxine, and escitalopram.

Fibromyalgia

fibrositisFibromyalgia syndromemuscular rheumatism
Duloxetine, sold under the brand name Cymbalta among others, is a medication used to treat major depressive disorder, generalized anxiety disorder, fibromyalgia, and neuropathic pain. The main uses of duloxetine are in major depressive disorder, generalized anxiety disorder, neuropathic pain, chronic musculoskeletal pain, and fibromyalgia.
The medications duloxetine, milnacipran or pregabalin may be used.

Serotonin–norepinephrine reuptake inhibitor

SNRIserotonin-norepinephrine reuptake inhibitorSNRIs
It is a serotonin–norepinephrine reuptake inhibitor. During marketing of other SSRIs and SNRIs, there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as brain zap electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures.
The half-life of duloxetine is about 12 hours (range: 8–17 hours), and steady-state is achieved after about 3 days.

Neuropathic pain

neuropathicpaincentral neuropathic pain
Duloxetine, sold under the brand name Cymbalta among others, is a medication used to treat major depressive disorder, generalized anxiety disorder, fibromyalgia, and neuropathic pain. The main uses of duloxetine are in major depressive disorder, generalized anxiety disorder, neuropathic pain, chronic musculoskeletal pain, and fibromyalgia.
Dual serotonin-norepinephrine reuptake inhibitors such as duloxetine, venlafaxine, and milnacipran, as well as tricyclic antidepressants such as amitriptyline, nortriptyline, and desipramine are considered first-line medications for this condition.

Venlafaxine

EffexorEffexor XRVenlafaxin
A review from the Annals of Internal Medicine lists duloxetine among the first line drug treatments, however, along with citalopram, escitalopram, sertraline, paroxetine, and venlafaxine.
Some doctors may prescribe venlafaxine off label for the treatment of diabetic neuropathy (in a similar manner to duloxetine) and migraine prophylaxis (in some people, however, venlafaxine can exacerbate or cause migraines).

Major depressive disorder

depressionclinical depressionmajor depression
Duloxetine, sold under the brand name Cymbalta among others, is a medication used to treat major depressive disorder, generalized anxiety disorder, fibromyalgia, and neuropathic pain. The main uses of duloxetine are in major depressive disorder, generalized anxiety disorder, neuropathic pain, chronic musculoskeletal pain, and fibromyalgia.
Treatment differs in that studies of SSRIs have shown lesser and often inadequate effects among the elderly, while other drugs, such as duloxetine (a serotonin-norepinephrine reuptake inhibitor), with more clear effects have adverse effects, such as dizziness, dryness of the mouth, diarrhea and constipation, which can be especially difficult to handle among the elderly.

Peripheral neuropathy

neuropathyneuropathiesneuropathic
Duloxetine was approved for the pain associated with diabetic peripheral neuropathy (DPN), based on the positive results of two clinical trials.
imapramine, and desipramine, ) serotonin-norepinephrine reuptake inhibitor (SNRI) medications (duloxetine, venlafaxine, and milnacipran ) and antiepileptic medications (gabapentin, pregabalin, oxcarbazepine zonisamide levetiracetam, lamotrigine, topiramate, clonazepam, phenytoin, lacosamide, sodium valproate and carbamazepine ).

Antidepressant discontinuation syndrome

withdrawal syndromediscontinuation syndromeSSRI discontinuation syndrome
Antidepressant withdrawal syndrome may occur if stopped. During marketing of other SSRIs and SNRIs, there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as brain zap electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures.
A 2009 Advisory Committee to the FDA found that online anecdotal reports of discontinuation syndrome related to duloxetine (Cymbalta) included severe symptoms and exceeded prevalence of both paroxetine (Paxil) and venlafaxine (Effexor) reports by over 250% (although acknowledged this may have been influenced by duloxetine (Cymbalta) being a much newer drug).

Eli Lilly and Company

Eli LillyLillyEli Lilly & Company
Duloxetine was created by Eli Lilly and Company researchers.
Lilly is currently the largest manufacturer of psychiatric medications and produces Prozac (fluoxetine), Dolophine (methadone), Cymbalta (duloxetine), and Zyprexa (olanzapine).

Selective serotonin reuptake inhibitor

SSRIselective serotonin reuptake inhibitorsSSRIs
During marketing of other SSRIs and SNRIs, there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as brain zap electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures.
Although described as SNRIs, duloxetine (Cymbalta), venlafaxine (Effexor), and desvenlafaxine (Pristiq) are in fact relatively selective as serotonin reuptake inhibitors (SRIs).

Suicide

suicidalcommitted suicidesuicides
Severe side effects include an increased risk of suicide, serotonin syndrome, mania, and liver problems.

Serotonin syndrome

hyperserotonemiaserotonin toxicitycentral toxic serotonin reaction
Severe side effects include an increased risk of suicide, serotonin syndrome, mania, and liver problems.

Mania

manicmanic episodemanic episodes
Severe side effects include an increased risk of suicide, serotonin syndrome, mania, and liver problems.

Liver disease

liver problemsliver dysfunctionliver
Severe side effects include an increased risk of suicide, serotonin syndrome, mania, and liver problems.

Pregnancy

pregnantfirst trimesterpregnant women
There are concerns that use during the later part of pregnancy can harm the baby.

Generic drug

generic medicationgenericgeneric drugs
It is available as a generic medication.

Musculoskeletal disorder

musculoskeletal disordersmusculoskeletalmusculoskeletal diseases
The main uses of duloxetine are in major depressive disorder, generalized anxiety disorder, neuropathic pain, chronic musculoskeletal pain, and fibromyalgia.

American Society of Clinical Oncology

American Society for Clinical OncologyASCOAmerican Society of Clinical Oncology (ASCO)
Duloxetine is recommended as a first-line agent for the treatment of chemotherapy-induced neuropathy by the American Society of Clinical Oncology, as a first-line therapy for fibromyalgia in the presence of mood disorders by the German Interdisciplinary Association for Pain Therapy, as a Grade B recommendation for the treatment of diabetic neuropathy by the American Association for Neurology and as a level A recommendation in certain neuropathic states by the European Federation of Neurological Societies.

European Federation of Neurological Societies

Duloxetine is recommended as a first-line agent for the treatment of chemotherapy-induced neuropathy by the American Society of Clinical Oncology, as a first-line therapy for fibromyalgia in the presence of mood disorders by the German Interdisciplinary Association for Pain Therapy, as a Grade B recommendation for the treatment of diabetic neuropathy by the American Association for Neurology and as a level A recommendation in certain neuropathic states by the European Federation of Neurological Societies.

Cochrane (organisation)

Cochrane reviewCochrane CollaborationCochrane
A 2014 Cochrane review concluded that duloxetine is beneficial in the treatment of diabetic neuropathy and fibromyalgia but that more comparative studies with other medicines are needed.

Prescrire

La revue Prescrire
The French medical journal Prescrire concluded that duloxetine is no better than other available agents and has a greater risk of side effects.

Placebo

placebo effectplacebosplacebo studies
While duloxetine has demonstrated improvement in depression-related symptoms compared to placebo, comparisons of duloxetine to other antidepressant medications have been less successful.

Maudsley Prescribing Guidelines

Major guidelines such as Maudsley Prescribing Guidelines, and Canadian Psychiatric Association Guidelines do not list duloxetine among the recommended treatment options.

Annals of Internal Medicine

Ann. Intern. Med.
A review from the Annals of Internal Medicine lists duloxetine among the first line drug treatments, however, along with citalopram, escitalopram, sertraline, paroxetine, and venlafaxine.