Duloxetine was approved for the treatment of major depression in 2004. While duloxetine has demonstrated improvement in depression-related symptoms compared to placebo, comparisons of duloxetine to other antidepressant medications have been less successful. A 2012 Cochrane Review did not find greater efficacy of duloxetine compared to SSRIs and newer antidepressants. Additionally, the review found evidence that duloxetine has increased side effects and reduced tolerability compared to other antidepressants. It thus did not recommend duloxetine as a first line treatment for major depressive disorder, given the (then) high cost of duloxetine compared to inexpensive off-patent antidepressants and lack of increased efficacy. do not list duloxetine among the recommended treatment options. 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. Restricted benefit Duloxetine (Cymbalta) 30 mg and 60 mg capsules can be prescribed on the Pharmaceutical Benefit Scheme (PBS) for people with a major depressive disorder.1 The 30 mg capsule is listed as a month's supply with no repeats. People with renal impairment who require this strength on an ongoing basis will need an authority for any repeats. The Pharmaceutical Benefits Advisory Committee (PBAC) considered duloxetine to be as effective as venlafaxine (Efexor-XR), but with more adverse effects in the first 6 weeks of therapy. In the following 6 weeks the incidence of adverse effects was similar for the two drugs.2 The PBAC had previously accepted as plausible the argument that the discontinuation rate with duloxetine could be reduced by slower dose titration. However, it remained concerned that in trials twice as many people stopped taking duloxetine because of adverse events as stopped taking venlafaxine. 3 Antidepressants are effective in moderate or severe major depressive disorder. There are many different antidepressants available in a number of classes, with similar efficacy but differences in adverse effects.
These highlights do not include all the information needed to use DULOXETINE DELAYED-RELEASE CAPSULES safely and effectively. These studies did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in patients over age 24; there was a reduction in risk with antidepressant use in patients aged 65 and older In patients of all ages who are started on antidepressant therapy, monitor closely for worsening, and for emergence of suicidal thoughts and behaviors. See full prescribing information for DULOXETINE DELAYED-RELEASE CAPSULES. Advise families and caregivers of the need for close observation and communication with the prescriber Swallow duloxetine delayed-release capsules whole. Do not open the capsule and sprinkle its contents on food or mix with liquids. Duloxetine delayed-release capsules can be given without regard to meals. Approval: 2004 Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term studies. If a dose of duloxetine delayed-release capsules is missed, take the missed dose as soon as it is remembered. If it is almost time for the next dose, skip the missed dose and take the next dose at the regular time. Do not take two doses of duloxetine delayed-release capsules at the same time. Administer duloxetine delayed-release capsules at a total dose of 40 mg/day (given as 20 mg twice daily) to 60 mg/day (given either once daily or as 30 mg twice daily). Adults Starting dose: 60 mg/day Target Dose: 60 mg/day once daily Maximum Dose: 120 mg/day Elderly Starting dose: 30 mg/day Target Dose: 60 mg/day once daily Maximum Dose: 120 mg/day Children (7-17 yrs) Starting dose: 30 mg/day Target Dose: 30–60 mg/day once daily Maximum Dose: 120 mg/day Lobo ED, Heathman M, Kuan HY, Reddy S, O’Brien L, Gonzales C, Skinner M, Knadler MP. It is not intended or recommended for patients or other laypersons or as a substitute for medical advice, diagnosis, or treatment. Effects of varying degrees of renal impairment on the pharmacokinetics of duloxetine: analysis of a single-dose phase I study and pooled steady-state data from phase II/III trials. Patients must always consult a qualified health care professional regarding their diagnosis and treatment. Disclaimer: The content on this website is provided as general education for medical professionals. Healthcare professionals should always check this website for the most recently updated information.
Cymbalta duloxetine, a drug prescribed for neuropathic pain associated with diabetic peripheral neuropathy, depression, and anxiety. Side effect, dosage, and drug. Information on use of duloxetine for major depressive disorder