Duloxetine Treatment of Major Depressive Episodes in the Course of Psychotic Disorders

Abstract

During the course of psychotic disorders, patients often suffer from intercurrent major depressive episodes (MDEs), and suicides frequently occur. This constellation challenges further improvements in psychopharmacological therapy. The antidepressant duloxetine was recently introduced as a novel reuptake inhibitor of serotonin and noradrenaline. We provide the first reports on duloxetine treatment of MDEs in the course of psychotic disorders. In two cases this substance was successfully involved as an add-on to antipsychotic treatment consisting of clozapine or amisulpride. We achieved a response of the MDEs, as reflected by psychopathological rating scales. A significant rise in the clozapine serum level was detected, most likely because of pharmacokinetic interactions. Overall, the application of duloxetine was well tolerated; therefore, further investigations in prospective studies seem to be recommendable.

Dyskinesia during Treatment with Duloxetine

“…Accordingly, treatment guidelines recommend treatment of depressive episodes during the course of schizophrenia with antidepressants [3]. Based on these reports, clinicians may consider the use of selective serotonin and norepinephrine reuptake inhibitors such as duloxetine in the treatment of schizophrenic patients suffering a depressive episode [10].…”

9thInternational Forum on Mood and Anxiety Disorders

“…As far as depression itself is concerned the data are much more limited since only a very low percentage of clinical studies are using an adequate rating scale such as the Calgary Depression Scale (CDS). Positive data have been published for sertraline in post psychotic depression (Kirly, 1998) and for duloxetine on case reports (Zink, 2006). The situation is worse for comorbid anxiety where the interaction of specifi c anxiety subtypes and psychosis has been quite insuffi ciently studied (Huppert, 2005).…”

The Influence of Smoking on the Serum Level of Duloxetine

“…Moreover, duloxetine has an analgetic potency which also could be demonstrated in randomised controlled trials [1,16,23] . Zink et al reported on successful duloxetine treatment of major depressive episodes in the course of psychotic disorders [32] . Therefore duloxetine is especially useful in depressive episodes with somatic symptoms [8,13] .…”