Efficacy and safety of duloxetine 60 mg once-daily in patients with chronic low back pain

Skljarevski, Vladimir; Zhang, S.; Desaiah, Durisala; Palacios, S; Miazgowski, T.; Patrick, Kelly E.

doi:10.1016/j.jpain.2010.01.158

Cited by 4 publications

(2 citation statements)

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“…It is also the only antidepressant approved for the treatment of diabetic peripheral neuropathic pain (DPNP) and fibromyalgia, and has been observed to improve chronic back pain in mixed aged adults without depression (Skljarevski et al ., 2009). Tricyclic anti-depressants also have dual serotonin and norepinephrine reuptake inhibition, and have been observed to improve pain more quickly than depression (Max et al ., 1992).…”

Section: Introductionmentioning

confidence: 99%

Duloxetine and care management treatment of older adults with comorbid major depressive disorder and chronic low back pain: results of an open‐label pilot study

Karp

Weiner

Dew

et al. 2009

Int J Geriat Psychiatry

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Objective: In older adults, major depressive disorder (MDD) and chronic low back pain (CLBP) are common and mutually exacerbating. We predicted that duloxetine pharmacotherapy and Depression and Pain Care Management (DPCM) would result in (1) significant improvement in MDD and CLBP and (2) significant improvements in health-related quality of life, anxiety, disability, self-efficacy, and sleep quality. Design and Intervention:Twelve week open-label study using duloxetine up to 120 mg/day + DPCM.Setting: Outpatient late-life depression research clinic.Patients: Thirty community-dwelling adults >60 years old. Outcome Measures: Montgomery Asberg Depression Rating Scale (MADRS) and McGill Pain Questionnaire-Short Form (MPQ-SF).Results: 46.7% (n = 14) of the sample had a depression remission. All subjects who met criteria for the depression remission also had a pain response. 93.3% (n = 28) had a significant pain response. Of the subjects who met criteria for a low back pain response, 50% (n = 14) also met criteria for the NIH Public Access Author ManuscriptInt J Geriatr Psychiatry. Author manuscript; available in PMC 2010 June 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript depression remission. The mean time to depression remission was 7.6 (SE = 0.6) weeks. The mean time to pain response was 2.8 (SE = 0.5) weeks. There were significant improvements in mental health-related quality of life, anxiety, sleep quality, somatic complaints, and both self-efficacy for pain management and for coping with symptoms. Physical health-related quality of life, back painrelated disability, and self-efficacy for physical functioning did not improve. Conclusions:Serotonin and norepinephrine reuptake inhibitors like duloxetine delivered with DPCM may be a good choice to treat these linked conditions in older adults. Treatments that target low self-efficacy for physical function and improving disability may further increase response rates.

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Section: Introductionmentioning

confidence: 99%

Duloxetine and care management treatment of older adults with comorbid major depressive disorder and chronic low back pain: results of an open‐label pilot study

Karp

Weiner

Dew

et al. 2009

Int J Geriat Psychiatry

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“… 10 , 12 Duloxetine, 13 a potent SNRI has been shown to improve pain, which may further help to ameliorate the symptoms of depression. 14 , 15 However, a specific effect in pain symptoms has not been consistently shown for the SSRIs. 16 , 17 Additionally, most of these evidence come from western countries, and there is a large knowledge gap with respect to other parts of the world, such as Asian countries.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of patients with major depressive disorder treated with either duloxetine, escitalopram, fluoxetine, paroxetine, or sertraline

Huang

Wang

Zhang

et al. 2018

NDT

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PurposeTo compare treatment outcomes in patients with major depressive disorder treated with duloxetine, escitalopram, fluoxetine, paroxetine, or sertraline for up to 6 months.Patients and methodsData were taken from a 6-month prospective, observational study that included 1,549 major depressive disorder patients without sexual dysfunction in 12 countries. We report the overall results and those from Asian countries. Depression severity was measured using the Clinical Global Impression and the 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). Clinical and functional remissions were defined as having a QIDS-SR16 <6, and as having a rating of <3 on all three Sheehan Disability Scale items and no reduced productivity, respectively. Mixed effects modeling with repeated measures analysis and generalized estimating equation models were used. Propensity scores were included in the models.ResultsThe mixed effects modeling with repeated measures regression models showed that the Clinical Global Impression rating during follow-up was significantly lower in those patients treated with duloxetine compared with escitalopram (0.40, 95% CI 0.25 to 0.56); fluoxetine (0.22, 95% CI 0.05 to 0.38); paroxetine (0.38, 95% CI 0.23 to 0.54); and sertraline (0.32, 95% CI 0.16 to 0.49). The QIDS-SR16 of duloxetine-treated patients was significantly lower than those treated with escitalopram (1.58, 95% CI 1.03 to 2.12); fluoxetine (1.48, 95% CI 0.90 to 2.06); paroxetine (1.53, 95% CI 1.00 to 2.07); and sertraline (1.19, 95% CI 0.61 to 1.78). The probability of clinical remission of the patients treated with escitalopram, fluoxetine, paroxetine, and sertraline was lower than those treated with duloxetine (OR 0.46, 95% CI 0.33 to 0.64; OR 0.42, 95% CI 0.29 to 0.61; OR 0.40, 95% CI 0.29 to 0.56; OR 0.50, 95% CI 0.35 to 0.71; respectively). The regression analysis of functional remission also showed more favorable results for duloxetine, with OR ranging from 0.43, 95% CI 0.31 to 0.60 for paroxetine to 0.49, 95% CI 0.35 to 0.70 for sertraline. The results for the Asian countries were generally consistent.ConclusionDuloxetine-treated patients had better 6-month outcomes in terms of depression severity and clinical and functional remission, compared with selective serotonin reuptake inhibitor-treated patients.

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Dosing Patterns for Duloxetine and Predictors of High-Dose Prescriptions in Patients With Major Depressive Disorder: Analysis from a United States Third-Party Payer Perspective

Liu

Cui

Niu

et al. 2011

Clinical Therapeutics

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Efficacy and safety of duloxetine 60 mg once-daily in patients with chronic low back pain

Cited by 4 publications

References 0 publications

Duloxetine and care management treatment of older adults with comorbid major depressive disorder and chronic low back pain: results of an open‐label pilot study

Duloxetine and care management treatment of older adults with comorbid major depressive disorder and chronic low back pain: results of an open‐label pilot study

Clinical outcomes of patients with major depressive disorder treated with either duloxetine, escitalopram, fluoxetine, paroxetine, or sertraline

Dosing Patterns for Duloxetine and Predictors of High-Dose Prescriptions in Patients With Major Depressive Disorder: Analysis from a United States Third-Party Payer Perspective

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