A randomized controlled trial of duloxetine in diabetic peripheral neuropathic pain

Wernicke, Joachim; Pritchett, Yili; D’Souza, Deborah N.; Waninger, A.; Trân, Pierre V.; Iyengar, Smriti; Raskin, Joel

doi:10.1212/01.wnl.0000240225.04000.1a

Cited by 445 publications

(329 citation statements)

References 34 publications

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“…Doses of 60 and 120 mg/day showed efficacy in the treatment of pain associated with DSPN in multicenter randomized trials, although some of these had a rather high drop-out rate (15, 86,94,96,[98][99][100][101]. Duloxetine was also suggested to induce improvement in neuropathy-related quality of life (100).…”

Section: Approved Medicationsmentioning

confidence: 99%

“…Both venlafaxine and duloxetine (see above) inhibit the reuptake of serotonin and norepinephrine without the muscarinic, histaminic, and adrenergic side effects that accompany the use of the tricyclic agents (98)(99)(100)102). However, the level of evidence for pain reduction associated with DSPN is higher with duloxetine (see above).…”

Section: Monoamine Reuptake Inhibitorsmentioning

confidence: 99%

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Diabetic Neuropathy: A Position Statement by the American Diabetes Association

et al. 2016

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Section: Approved Medicationsmentioning

confidence: 99%

Section: Monoamine Reuptake Inhibitorsmentioning

confidence: 99%

Diabetic Neuropathy: A Position Statement by the American Diabetes Association

et al. 2016

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“…The literature regarding SNRI use for the prevention of chronic post-surgical pain is limited; however, given that the SNRI medication (duloxetine) is a firstline medication for the treatment of chronic neuropathic pain [67], its role in the prevention of chronic post-surgical pain should be further investigated. Duloxetine has been shown to be efficacious for the treatment of diabetic peripheral neuropathy and fibromyalgia [68][69][70][71]. Appropriately powered trials are necessary to examine the efficacy of the SNRIs in CPSP prevention, including dose-response studies and head-to-head comparisons with other drugs, such as pregabalin.…”

Section: Selective Norepinephrine and Serotonin Re-uptake Inhibitors mentioning

confidence: 99%

Preventive Analgesia and Novel Strategies for the Prevention of Chronic Post-Surgical Pain

Clarke

Poon

Weinrib

et al. 2015

Drugs

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Chronic post-surgical pain (CPSP) is a serious complication of major surgery that can impair a patient's quality of life. The development of CPSP is a complex process which involves biologic, psychosocial, and environmental mechanisms that have yet to be fully understood. Currently perioperative pharmacologic interventions aim to suppress and prevent sensitization with the aim of reducing pain and analgesic requirement in acute as well as long-term pain . Despite the detrimental effects of CPSP on patients, the body of literature focused on treatment strategies to reduce CPSP remains limited and continues to be understudied. This article reviews the main pharmacologic candidates for the treatment of CPSP, discusses the future of preventive analgesia, and considers novel strategies to help treat acute postoperative pain and lessen the risk that it becomes chronic. In addition, this article highlights important areas of focus for clinical practice including: multimodal management of CPSP patients, psychological modifiers of the pain experience, and the development of a Transitional Pain Service specifically designed to manage patients at high risk of developing chronic post-surgical pain. Key PointsThe development of chronic post-surgical pain (CPSP) is a complex process which involves biologic, psychosocial, and environmental mechanisms.Ketamine (an NMDA antagonist) appears to be the pharmacologic agent with the most consistent positive preventive analgesic results.The variation in patient response to pharmacologic agents can be explained, in part, by genetic polymorphisms.Understanding the heritability of CPSP will be useful when developing predictive algorithms to determine the preoperative risk for developing CPSP.Psychological treatments delivered before and after surgery have the potential to influence the trajectory of CPSP from the earliest days, in combination with multimodal, preventive analgesia.

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“…Duloxetine has been approved for the pain associated with diabetic peripheral neuropathy (DPN), based on the positive results of clinical trials [12][13][14]. However two recent studies Yang et al 2013), used duloxetine in CIPN and they found significant reduction in pain scores in duloxetine group than the placebo [15,16].…”

Section: Discussionmentioning

confidence: 99%

Role of Duloxetine as Adjuvant in Chemotherapy Induced Peripheral Neuropathic Pain-An Update

Garg¹

2016

J Addict Med Ther Sci

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A randomized controlled trial of duloxetine in diabetic peripheral neuropathic pain

Abstract: This study confirms previous findings that duloxetine at 60 mg QD and 60 mg BID is effective and safe in the management of diabetic peripheral neuropathic pain.

Cited by 445 publications

References 34 publications

Diabetic Neuropathy: A Position Statement by the American Diabetes Association

Diabetic Neuropathy: A Position Statement by the American Diabetes Association

Preventive Analgesia and Novel Strategies for the Prevention of Chronic Post-Surgical Pain

Role of Duloxetine as Adjuvant in Chemotherapy Induced Peripheral Neuropathic Pain-An Update

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