Current Opinions about the Use of Duloxetine: Results from a Survey Aimed at Psychiatrists

Abstract

Major depressive disorder (MDD) is a complex psychiatric disorder that, presented alone or with other comorbidities, requires different adjustments of antidepressant treatments. Some investigations have demonstrated that psychoactive drugs, such as serotonin and norepinephrine reuptake inhibitors (SNRIs), can exert more effective and faster antidepressant effects than other common medications used, such as serotonin selective reuptake inhibitors (SSRIs), although these differences are still controversial. During the last five years, the SNRI duloxetine has shown favorable results in clinical practice for the treatment of MDD, anxiety, and fibromyalgia. Through an online self-completed survey, in the present article, we collected information from 163 psychiatrists regarding the use of duloxetine and its comparison with other psychiatric drugs, concerning psychiatrists’ knowledge and experience, as well as patients’ preferences, symptoms, and well-being. We discussed and contrasted physicians’ reports and the scientific literature, finding satisfactory concordances, and finally concluded that there is agreement regarding the use of duloxetine, not only due to its tolerability and effectiveness but also due to the wide variety of situations in which it can be used (e.g., somatic symptoms in fibromyalgia, diabetes) as it relieves neuropathic pain as well.

Neurological and metabolic related pathophysiologies and treatment of comorbid diabetes with depression

“…Venlafaxine hydrochloride markedly elevated the consumption of glucose in the glucose consumption test in vitro 171 . Results from a survey aimed at psychiatrists illustrated that duloxetine was widely applied in fibromyalgia and DM due to its alleviation of neuropathic pain 172 . However, the administration of SNRIs, tricyclic antidepressants, SSRIs, and other antidepressants was associated with increased risk of diabetes 173 .…”

“… 171 Results from a survey aimed at psychiatrists illustrated that duloxetine was widely applied in fibromyalgia and DM due to its alleviation of neuropathic pain. 172 However, the administration of SNRIs, tricyclic antidepressants, SSRIs, and other antidepressants was associated with increased risk of diabetes. 173 Furthermore, treatment with SSRIs or SNRIs correlated with a rise in the risk of T2DM, and this association intensified with increasing cumulative dose, duration of use and average daily dose.…”