Duloxetine: A Review of its Use in the Treatment of Major Depressive Disorder

Frampton, James E.; Plosker, Greg L.
May 2007
CNS Drugs;2007, Vol. 21 Issue 7, p581
Academic Journal
Duloxetine (Cymbalta) is an orally administered, selective serotonin and noradrenaline reuptake inhibitor (SNRI) that has been approved for the treatment of major depressive disorder (MDD).Based on a considerable body of evidence, duloxetine at dosages ranging from 40 to 120 mg/day was effective in the short- and long-term treatment of MDD. Significant improvements versus placebo in core emotional symptoms as well as painful physical symptoms associated with depression, were seen in most, but not all, appropriately designed studies; results of meta-analyses suggested that improvements in these efficacy measures were apparent after 1–2 weeksʼ treatment with the highest recommended dosage of 60mg once daily. Short-term (≤15 weeks) administration of duloxetine at fixed or flexible dosages between 60 and 120 mg/day was noninferior to paroxetine 20mg once daily, noninferior or inferior to escitalopram 10–20mg once daily, and had a similar global benefit-risk (GBR) profile to that of venlafaxine extended-release (XR) 150–225 mg/day in the treatment of MDD. Longer-term (6–8 months) treatment with duloxetine was similar in efficacy to paroxetine and escitalopram. Duloxetine is generally well tolerated, although it may be appropriate to avoid initiating treatment with the 60 mg/day dosage, as this has been associated with a higher discontinuation rate due to adverse events in some (but not all) comparative studies with escitalopram and venlafaxine XR.Definitive comparisons are awaited, although duloxetine seemingly provides a useful alternative to SSRIs and other SNRIs for the treatment of MDD. It also appears to be an attractive option for MDD patients presenting with painful physical symptoms.


Related Articles

  • Ditch the pills.  // New Scientist;7/23/2005, Vol. 187 Issue 2509, p4 

    The article presents a study, which examines the role of antidepressants in tackling mental depression in human beings. The study was conducted by Joanna Moncrieff and Irving Kirsch, and published in the "British Medical Journal." They opine that antidepressants are no better than placebos and...

  • Review: tricyclic related drugs, but not classical tricyclics, are a tolerable alternative to SSRIs in older people with depression. Wee, Roban // Evidence Based Mental Health;Feb2005, Vol. 8 Issue 1, p22 

    The article presents a study on the alternatives to selective serotonin reuptake inhibitors (SSRI) in older people with depression. Subgroup analyses by tricyclic antidepressants (TCA) class found that although classical TCAs significantly increased withdrawal compared with SSRIs, there was no...

  • Block of volume-regulated anion channels by selective serotonin reuptake inhibitors. Maertens, C.; Droogmans, G.; Verbesselt, R.; Nilius, B. // Naunyn-Schmiedeberg's Archives of Pharmacology;Aug2002, Vol. 366 Issue 2, p158 

    We have used the whole-cell patch clamp technique to study the effects of the commonly used antidepressants sertraline, paroxetine, citalopram and fluvoxamine on the volume-regulated anion channel (VRAC) in endothelial cells. It was the purpose of the present experiments to investigate whether...

  • Forensic database study suggests selective serotonin reuptake inhibitors do not increase the risk of suicide in people taking antidepressants. Cipriani, Andrea // Evidence Based Mental Health;Nov2005, Vol. 8 Issue 4, p113 

    This article presents a study which found that selective serotonin reuptake inhibitors (SSRI) do not increase the risk of suicide in people taking antidepressants. In people taking antidepressants, SSRI use was no more common among people who had committed suicide than among those who had died...

  • Fluoxetine, a Highly Selective Serotonin Reuptake Inhibitor: A Review of Preclinical Studies. Schmidt, Michael J.; Fuller, Ray W.; Wong, David T. // British Journal of Psychiatry;Sep88 Supplement, p40 

    The article reports on fluoxetine, a highly selective serotonin reuptake inhibitor. It is noted that the chemical structure of fluoxetine lacks the three-fused ring system contained in tricyclic antidepressant drugs like imipramine and amitriptyline. Fluoxetine has been established to be a...

  • The Evidence for 20 mg a day of Fluoxetine as the Optimal Dose in the Treatment of Depression. Altamura, A.C.; Montgomery, S.A.; Wernicke, J.F. // British Journal of Psychiatry;Sep88 Supplement, p109 

    The article reports on the use of fluoxetine in the treatment of depression. Fluoxetine, a selective serotonin-uptake inhibitor, has been established to be effective in the treatment of depression. Various studies have posited that this compound is more effective than placebo. This drug has also...

  • Serotonin receptors: role in depression. Artigas, F. // Actas Espanolas de Psiquiatria;ene 2008 Supplement 1, Vol. 36, p28 

    The article focuses on the efficacy of selective serotonin reuptake inhibitors (SSRIs) in treating mental depression. It states that serotonergic neurons are comprised of two autoreceptors which includes the raphé nuclei and 5-HT axons. According to studies, the administration of SSRIs...

  • Drug Treatments for Patients with Dysthymia. Kripke, Clarissa // American Family Physician;10/1/2004, Vol. 70 Issue 7, p1269 

    Presents information on drug treatments that are effective for dysthymia. Comparison between the efficacy of anti-depressants and placebo; Information on the side effects of tricyclic antidepressants and selective serotonin reuptake inhibitors.

  • Induction of mania with selective serotonin re-uptake inhibitors and tricyclic antidepressants. Peet, Malcolm; Peet, M // British Journal of Psychiatry;Apr94, Vol. 164, p549 

    The rate of treatment-emergent switch into mania has been calculated from all available clinical trial data on the selective serotonin re-uptake inhibitors (SSRIs) fluoxetine, fluvoxamine, paroxetine, and sertraline, relative to comparative groups treated with tricyclic antidepressants (TCAs) or...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics