title: [Duloxetine for chronic pain management: pharmacology and clinical use].
abstract: The purpose of this article is to provide an overview of some of the important information related to safety and tolerability of duloxetine. Duloxetine, a potent reuptake inhibitor of serotonin and noradrenaline, is effective for the treatment of major depressive disorder, anxiety disorder, and painful diabetic neuropathy (PDN). Duloxetine is safe and well-tolerated across indications, with few reported serious side effects. Common adverse events are consistent with the pharmacology of the molecule and are mainly referable to the gastrointestinal and the nervous systems. Duloxetine should not be used in combination with CYP 1A2 inhibitors or nonselective, irreversible monoamine oxidase inhibitors. Duloxetine has a generally favorable side effect profile and dosing is simple. Nausea is the most common side effect, but it occurs less frequently if treatment is initiated at 30 mg . day-1 and titrated after one week to 60 mg . day-1, an efficacious dosage at which pain relief can occur within one week. Clinical trials have demonstrated the analgesic efficacy of duloxetine for PDN and fibromyalgia in addition to improvements in quality-of-life measurements. Furthermore trials for osteoarthritis, headache, and the pain associated with Parkinson disease may provide insight into alternative uses for duloxetine.
authors.affiliation: Department ofAnesthesiology, Tokai University School of Medicine, Isehara 259-1193.
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Masuda
authors.forename: Miho
authors.initials: M
authors.lastname: Itoh
authors.forename: Toshiyasu
authors.initials: T
authors.lastname: Suzuki
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy*; D003863:Depression / Q000150:complications; D003866:Depressive Disorder / Q000150:complications; D003929:Diabetic Neuropathies / Q000150:complications; D000068736:Duloxetine Hydrochloride; D006801:Humans; D013876:Thiophenes / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D018759:Adrenergic Uptake Inhibitors; D013876:Thiophenes; D000068736:Duloxetine Hydrochloride