MedWorm: Cymbalta

  Pregabalin in fibromyalgia: meta-analysis of efficacy and safety from company clinical trial reports

Conclusions. Pregabalin is effective in treating FM and is relatively safe. The size of therapeutic effect is similar to that with other recent interventions such as duloxetine and the combination of tramadol and paracetamol. Enriched enrolment randomized withdrawal design gives similar results to classical trial designs in FM. (Source: Rheumatology)

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  Efficacy and tolerability of duloxetine in the treatment of patients with borderline personality disorder: a pilot study

This study investigates duloxetine in the treatment of patients with BPD. Eighteen outpatients with a DSM-IV-TR diagnosis of BPD were treated with open-label duloxetine, 60 mg/day, for 12 weeks. Patients were assessed at baseline, week 4 and 12 with the CGI Severity item, the BPRS, the HAM-D, the HAM-A, the SOFAS, the BPD Severity Index (BPDSI) and the HSCL-90-Somatization Subscale (HSCL-90 SOM). Adverse effects were evaluated using the Dosage Record Treatment Emergent Symptom Scale. Statistics were performed with the analysis of variance. Significant P values were ≤0.05. Fourteen patients completed the study. Four patients (22.2%) discontinued treatment in the first 4 weeks because of non-compliance. A significant change was found for: BPRS, HAM-D, SOFAS, BPDSI total score and items &l...

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  Duloxetine: First report of binge eating: case report

(Source: Reactions)

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  Spinal mechanism of standard analgesics: Evaluation using mouse models of allodynia.

In conclusion, present findings provide implication that the spinal anti-nociceptive mechanistic site of pregabalin is different from that of ziconotide, mexiletine, and duloxetine, and pregabalin could have a broader anti-nociceptive mechanism other than N-type calcium channel blockade. PMID: 20188724 [PubMed - as supplied by publisher] (Source: European Journal of Pharmacology)

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  Antidepressant Drugs for Chronic Urological Pelvic Pain: An Evidence-Based Review

This study aimed to evaluate the available evidence for the efficacy and acceptability of antidepressant drugs in the management of urological chronic pelvic pain. Studies were selected through a comprehensive literature search. We included all types of study designs due to the limited evidence. Studies were classified into levels of evidence according to their design. Ten studies were included with a total of 360 patients. Amitriptyline, sertraline, duloxetine, nortriptyline, and citalopram are the antidepressants that have been reported in the literature. Only four randomized controlled trials (RCTs) were identified (two for amitriptyline and two for sertraline) with mixed results. We conclude that the use of antidepressants for the management of chronic urological pelvic pain is not ade...

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  Paxil May Raise Death Risk for Those Taking Tamoxefin

Breast cancer patients who are taking Tamoxefin to prevent a recurrence of the disease should not take the antidepressant Paxil (paroxetine), a new study suggests. Women in the study who took both drugs together had a greater than average risk of dying from breast cancer. The study looked at medical records for 2,430 breast cancer patients who had been taking tamoxefin. About 1 out 4 of these women had also taken Paxil; and, on average, about 41% of the time that the women were taking tamoxefin they were also taking Paxil. The researchers found that there was about one extra death from breast cancer for every 20 women who had taken the two drugs together. The researchers believe that the risk of death from breast cancer was increased because Paxil interferes with the cancer-preventing a...

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  Health News of the Day

is a daily summary made from the selected links I post on Twitter. It is in bullet-point format with links to the original sources which include 350 RSS feeds that produce about 2,500 items per day: Procalcitonin-guided strategy to treat suspected bacterial infections reduced antibiotic exposure in ICU by 2.7 days http://goo.gl/mws0 Both low and high HbA1c associated with increased mortality in diabetes. Guidelines for minimum HbA1c value may be needed. Survival as a function of HbA1c in type 2 diabetes: U-shaped association, with the lowest hazard ratio at HbA1c of 7·5% http://goo.gl/Lywx No sedation vs. interrupted sedation in mechanical ventilation was associated with fewer days on the ventilator. Lancet http://goo.gl/OYoe One Bowl = 2 Servings. Puzzled? F.D.A. Weighs Update to St...

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  AAPM: Help for Pain and Mood in Fibromyalgia (CME/CE)

SAN ANTONIO (MedPage Today) -- Patients with fibromyalgia and comorbid depression had significant improvement in both conditions when treated with duloxetine (Cymbalta), according to pooled data from four clinical trials. (Source: MedPage Today Pain Management)

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  Cymbalta Significantly Reduced Chronic Low Back Pain in New Study

INDIANAPOLIS, Feb. 3 /PRNewswire-FirstCall/ -- In a new study, 60 mg of Cymbalta® (duloxetine HCl) taken once daily significantly reduced chronic low back pain, as measured by the Brief Pain Inventory (BPI) average pain rating, compared... (Source: Drugs.com - Clinical Trials)

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  Antidepressant Cymbalta Eases Back Pain

Cymbalta, a drug used to treat depression, fibromyalgia, and diabetic nerve pain, may also provide relief from hard-to-treat chronic low back pain. (Source: WebMD Health)

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  Cymbalta(R) Significantly Reduced Chronic Low Back Pain In New Study

In a new study, 60 mg of Cymbalta(R) (duloxetine HCl) taken once daily significantly reduced chronic low back pain, as measured by the Brief Pain Inventory (BPI) average pain rating, compared with placebo.(1) The data were presented at the annual meeting of the American Academy of Pain Medicine (AAPM) in San Antonio, Texas. A total of 401 patients participated in the 12-week, double-blind, placebo-controlled study, designed to assess the efficacy of duloxetine 60 mg once daily on the reduction of pain severity in patients with chronic low back pain... (Source: Health News from Medical News Today)

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  Cymbalta(R) Significantly Reduced Chronic Low Back Pain In New Study

In a new study, 60 mg of Cymbalta(R) (duloxetine HCl) taken once daily significantly reduced chronic low back pain, as measured by the Brief Pain Inventory (BPI) average pain rating, compared with placebo.(1) The data were presented at the annual meeting of the American Academy of Pain Medicine (AAPM) in San Antonio, Texas... (Source: Pharma Industry News From Medical News Today)

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  Cymbalta(R) Significantly Reduced Chronic Low Back Pain in New Study

INDIANAPOLIS, Feb. 3 (HSMN NewsFeed) -- In a new study, 60 mg of Cymbalta® (duloxetine HCl) taken once daily significantly reduced chronic low back pain, as measured by the Brief Pain Inventory (BPI) average pain rating, compared with placebo.(1) The... BiopharmaceuticalsEli Lilly, Cymbalta, duloxetine, back pain (Source: HSMN NewsFeed)

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  Cymbalta® Significantly Reduced Chronic Low Back Pain In New Study

In a new study, 60 mg of Cymbalta® (duloxetine HCl) taken once daily significantly reduced chronic low back pain, as measured by the Brief Pain Inventory (BPI) average pain rating, compared with placebo. (Source: Pharmaceutical Online News)

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  What evidence is available for the use of antidepressants for the management of menopausal hot flushes?

Source: Wessex Drug and Medicines Information Centre Area: Evidence > Medicines Q & A . To help reduce hot flushes, women should be encouraged to take regular exercise, reduce stress and wear lighter clothing. Any trigger factors should be avoided.   . Antidepressants are unlicensed for the management of hot flushes but may be considered for women who have contra-indications to or concerns about HRT. Limited evidence from a recent meta-analysis suggests that venlafaxine, paroxetine, citalopram or fluoxetine are effective in reducing the frequency and severity of menopausal hot flushes.     . The Royal College of Obstetricians and Gynaecologists suggests that the most convincing data available are for venlafaxine at a dose of 37.5mg twice daily. Furthe...

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  CYMBALTA (Duloxetine Hydrochloride) Capsule, Delayed Release [Eli Lilly And Company]

Updated Date: Jan 25, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Effects of Duloxetine in Treatment-Refractory Men with Posttraumatic Stress Disorder

This study aimed to evaluate the effectiveness and tolerability of the dual reuptake inhibitor duloxetine in the treatment of PTSD and co-morbid MDD.[...]© Georg Thieme Verlag KG Stuttgart · New YorkGet connected:Table of contents  |  Abstract  |  Full text (Source: Pharmacopsychiatry)

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  Duloxetine/escitalopram: Hyponatraemia and SIADH in an elderly patient: case report

(Source: Reactions)

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  Duloxetine/fluoxetine interaction: Serotonin syndrome in an elderly patient: case report

(Source: Reactions)

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  Duloxetine in the Treatment of Osteoarthritis Knee Pain

Content Type Journal ArticleCategory Clinical Trial ReportDOI 10.1007/s11920-009-0088-8Authors Thomas N. Wise, Inova Fairfax Hospital Johns Hopkins University School of Medicine 3300 Gallows Road Falls Church VA 22042 USA Journal Current Psychiatry ReportsOnline ISSN 1535-1645Print ISSN 1523-3812 (Source: Current Psychiatry Reports)

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  FDA Cancels Meeting To Review Lilly's Cymbalta

From Associated Press (January 5, 2010) WASHINGTON--The Food and Drug Administration has canceled a meeting to review Eli Lilly & Co.’s antidepressant Cymbalta for a new use against chronic pain. The agency said in a statement Tuesday... (Source: Drugs.com - Pharma News)

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  Duloxetine eases stress urinary incontinence

A study has shown that Duloxetine seems to be an effective treatment for women with stress urinary incontinence. (Source: Nursing Times Breaking News)

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  New drug treatments for urinary incontinence

Abstract: Urinary incontinence remains a common and distressing condition affecting many women and is known to have a significant effect on quality of life (QoL). Whilst conservative and behavioural therapy are important in the management of women with both stress incontinence and overactive bladder (OAB) ultimately many may benefit from pharmacological therapy. Antimuscarinic drugs are the commonly used agents in the treatment of OAB although often compliance and persistence are affected by adverse effects. Consequently many newer agents remain under investigation. In addition duloxetine has recently been introduced for the management of women with stress incontinence and may offer an alternative to surgery in selected cases.The aim of this review is to provide an overview of the current ...

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  Doubling Duloxetine Does Not Up Response Rate in Depression

ISTANBUL, TURKEY — Doubling the standard 60-mg/day dose of duloxetine does not boost the response rate in patients hospitalized for severe depression. Underscoring the drug's broad safety margin, however, the tolerability and safety of duloxetine (Cymbalta) at 120 mg/day were essentially the same as at 60 mg/day in this population, Dr. Stephan Brecht reported at the annual congress of the European College of Neuropsychopharmacology. (Source: Clinical Psychiatry News)

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  Early Pain Reduction Flags Greater Duloxetine Efficacy

ISTANBUL, TURKEY — Early marked reduction in pain in response to duloxetine proved to be the strongest predictor of significant long-term improvement in depressive symptoms in depressed subjects in the German PADRE study. (Source: Clinical Psychiatry News)

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  A Case Study of Salami Slicing: Pooled Analyses of Duloxetine for Depression

Psychother Psychosom 2010;79:97-106 (DOI:10.1159/000270917) (Source: Karger Publishers)

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  Mirtazapine and Bupropion Combined Treatment in Treatment-resistant Depression

We present a case of treatment-resistant depression with fu ...more (Source: Tzu Chi Medical Journal)

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  Cochrane review: Duloxetine for treating painful neuropathy or chronic pain

Source: Cochrane Library Area: Evidence > Drug Specific Reviews Background Duloxetine is a balanced serotonin and noradrenaline reuptake inhibitor licensed for the treatment of major depressive disorders, urinary stress incontinence and the management of neuropathic pain associated with diabetic peripheral neuropathy. A number of trials have been conducted to investigate the use of duloxetine in neuropathic and nociceptive painful conditions.   Objectives To assess the benefits and harms of duloxetine for treating painful neuropathy and different types of chronic pain.     Search strategy We searched The Cochrane Neuromuscular Group Specialized Register (10 March 2009), The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2009), MEDL...

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  Study on enantiomeric separation of basic drugs by NACE in methanol-based medium using erythromycin lactobionate as a chiral selector

In this study, an approach to the enantioseparation of basic drugs by means of NACE with erythromycin lactobionate (EL) belonging to the group of macrolide antibiotics has been investigated. Especially different from the above four classes of antibiotics, there are no reports concerned with the use of macrolides which belong to macrocyclic antibiotics as chiral selectors in CE. In this work EL is first used as a chiral selector in NACE for the enantiomeric separations of two racemic basic drugs that possess high separability consisting of propranolol and duloxetine. Furthermore, EL possesses advantages such as high solubility and low viscosity in the solvent and very weak UV absorption. The chiral separations were achieved using Tris-boric acid as the BGE and methanol as the organic medium...

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  Economic evaluation of duloxetine versus serotonin selective reuptake inhibitors and venlafaxine XR in treating major depressive disorder in Scotland

Conclusions: Duloxetine represents an important option in the treatment of MDD in the UK that can be recommended on economic grounds. With similar efficacy and different side-effect profile to venlafaxine XR it represents a valuable choice to MDD patients. (Source: Journal of Affective Disorders)

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  MTRAC verdict and summary: Duloxetine for GAD

Source: MTRAC Area: Evidence > Drug Specific Reviews The Midlands Therapeutics Review and Advisory Committee (MTRAC) has reviewed the evidence on duloxetine (Cymbalta®) for the treatment of generalised anxiety disorder (GAD).   The Committee concluded that duloxetine is suitable for prescribing in primary care for the treatment of GAD. However, it is considered to have a low place in therapy. (Source: NeLM - Mental Health)

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  Cymbalta 30mg, 60mg gastro-resistant capsules (duloxetine) - Revised SPC

Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Revised SPC includes changes to: Section 4.2 (Posology and method of administration) - In patients responding to duloxetine, and with a history of repeated episodes of major depression, further long-term treatment at a dose of 60 to 120 mg /day could be considered. Section 5 (Pharmacological Properties) - During 52 weeks of placebo-controlled double blind treatment, duloxetine-treated patients with recurrent MDD had a significantly longer symptom free period (p<.001) compared with patients randomised to placebo. All patients had previously responded to duloxetine during open-label duloxetine treatment (28 to 34 weeks) at a dose of 60 to 120 mg/day. During the 52-week placebo-controlled double-...

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  Anxiety does not predict response to duloxetine in major depression: results of a pooled analysis of individual patient data from 11 placebo-controlled trials

The objective of this study is to determine whether specific antidepressant effects, estimated by drug-placebo differences, are reduced in anxious depression during treatment of MDD with duloxetine. Methods: This is a retrospective secondary pooled analysis of all placebo-controlled trials of duloxetine at therapeutic doses conducted by the sponsor in outpatients with nonpsychotic unipolar MDD, using the Hamilton Depression Rating Scale (HAMD). Anxious depression was defined by [ge]7 on the anxiety/somatization factor of the HAMD. Response was defined as [ge]50% improvement from baseline to endpoint on the HAMD. Remission was defined as an endpoint HAMD[le]7. Analyses were performed in the intent-to-treat sample with at least one post-treatment rating. Results: Eleven trials included 2,841...

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  CYMBALTA (Duloxetine Hydrochloride) Capsule, Delayed Release [Eli Lilly And Company]

Updated Date: Dec 9, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Duloxetine in Treating Medically Unexplained Pain and Raynaud's Phenomenon [LETTERS TO THE EDITOR]

(Source: J Neuropsychiatry Clin Neurosci)

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  Efficacy of duloxetine in patients with fibromyalgia: pooled analysis of 4 placebo-controlled clinical trials.

CONCLUSIONS: This pooled analysis provides evidence that 12 weeks of treatment with duloxetine 60-120 mg/d effectively improves fibromyalgia symptoms and may offer benefits beyond pain relief. PMID: 19956462 [PubMed - in process] (Source: Primary Care Companion to the Journal of Clinical Psychiatry)

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  Cymbalta (Duloxetine Hcl) - updated on RxList

Cymbalta (Duloxetine Hcl) drug description - FDA approved labeling for prescription drugs and medications at RxList (Source: RxList - New and Updated Drug Monographs)

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  FDA Approves Cymbalta(R) For Maintenance Treatment Of Generalized Anxiety Disorder

The U.S. Food and Drug Administration (FDA) has approved Cymbalta® (duloxetine HCl) for the maintenance treatment of generalized anxiety disorder (GAD) in adults, Eli Lilly and Company (NYSE: LLY) announced. "Since generalized anxiety disorder can be a chronic illness, it is important that doctors and their patients find a treatment option that is effective in both the acute and maintenance phase of treatment," said James M. Martinez, MD, U.S. Medical Director for Cymbalta... (Source: Health News from Medical News Today)

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  FDA Approves Cymbalta(R) For Maintenance Treatment Of Generalized Anxiety Disorder

The U.S. Food and Drug Administration (FDA) has approved Cymbalta® (duloxetine HCl) for the maintenance treatment of generalized anxiety disorder (GAD) in adults, Eli Lilly and Company (NYSE: LLY) announced... (Source: Pharma Industry News From Medical News Today)

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  FDA Approves Cymbalta(R) For Maintenance Treatment Of Generalized Anxiety Disorder

The U.S. Food and Drug Administration (FDA) has approved Cymbalta® (duloxetine HCl) for the maintenance treatment of generalized anxiety disorder (GAD) in adults, Eli Lilly and Company (NYSE: LLY) announced... (Source: Anxiety News From Medical News Today)

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  FDA Approves Duloxetine for Maintenance Treatment of Generalized Anxiety Disorder

A clinical study shows that continued duloxetine therapy delays time to relapse in patients with generalized anxiety disorder. Medscape Medical News (Source: Medscape Today Headlines)

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  FDA Approves Cymbalta for Maintenance Treatment of Generalized Anxiety Disorder

INDIANAPOLIS, Nov 30, 2009 /PRNewswire-FirstCall via COMTEX News Network/ -- The U.S. Food and Drug Administration (FDA) has approved Cymbalta (duloxetine HCl) for the maintenance treatment of generalized anxiety disorder (GAD) in adults, Eli... (Source: Drugs.com - New Drug Approvals)

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  FDA Approves Cymbalta(R) for Maintenance Treatment of Generalized Anxiety Disorder

INDIANAPOLIS, Nov. 30 (HSMN NewsFeed) -- The U.S. Food and Drug Administration (FDA) has approved Cymbalta® (duloxetine HCl) for the maintenance treatment of generalized anxiety disorder (GAD) in adults, Eli Lilly and Company (NYSE: LLY ) announced t... Biopharmaceuticals, FDAEli Lilly, Cymbalta, duloxetine, generalized anxiety disorder (Source: HSMN NewsFeed)

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  The General and Comparative Efficacy and Safety of Duloxetine in Major Depressive Disorder: A Systematic Review and Meta-Analysis

(Source: Drug Safety)

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  Duloxetine/methylthioninium chloride interaction: First report of an interaction, leading to encephalopathy and serotonin syndrome in an elderly patient: case report

(Source: Reactions)

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  [Serotonin-noradrenalin reuptake inhibitors in the treatment of non-malignant pain syndromes; a systematic review.]

CONCLUSION: The results revealed that snris are effective in reducing pain particularly in the treatment of diabetic neuropathy. Results with regard to the other medical conditions are less clear. More research is needed to find out in which medical conditions snris have a significant pain reducing effect and why this effect does not hold in the case of other medical conditions. PMID: 19904708 [PubMed - in process] (Source: Tijdschrift voor Psychiatrie)

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  Differential inhibitory effects of drugs acting at the noradrenaline and 5-hydroxytrptamine transporters in rat and human neocortical synaptosomes

Conclusions and implications: This study provides the first compilation of drug potency at native human neocortical SERT and NET. The significant species differences (viz., human vs. rat) in drug potency suggest that the general use of rodent data should be limited to predict clinical efficacy or profile. (Source: British Journal of Pharmacology)

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  Duloxetine for major depressive episodes in the course of psychotic disorders: an observational clinical trial

Patients with psychotic disorders often suffer from intercurrent major depressive episodes (MDE). Case reports suggested successful antidepressive treatment with duloxetine, a selective dual reuptake inhibitor of serotonin and norepinephrine. We initiated this open prospective clinical trial to evaluate efficacy, safety and tolerability of this approach. Patients with a psychotic lifetime diagnosis suffering from mildly severe MDE were treated with duloxetine over a period of 6 weeks. We evaluated effects on mood, monitored the psychotic psychopathology and assessed side effects, basal clinical and pharmacological parameters. Twenty patients were included and experienced a significant improvement of their MDE during the observation period (Calgary Depression Scale for Schizophrenia and Ham...

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  MTRAC verdict: Duloxetine in pain due to diabetic peripheral neuropathy

Source: MTRAC Area: Evidence > Drug Specific Reviews The Midlands Therapeutics Review and Advisory Committee (MTRAC) has reviewed the evidence on duloxetine (Cymbalta®) for diabetic peripheral neuropathic pain in adults.   The Committee concluded that duloxetine  is suitable for primary care prescribing in this situation. It noted that the evidence for benefit was relatively strong, and that a draft NICE guideline recommends it for first-line use.   Duloxetine had been assessed in this indication in three placebo-controlled trials, reducing 24-hour pain scores to a significantly greater degree than placebo in all three. There were also benefits in a number of secondary outcomes. Adverse effects including somnolence, dizziness, fatigue, and gastro-intestinal disturb...

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  Evaluation of anti-obesity activity of duloxetine in comparison with sibutramine along with its anti-depressant activity: an experimental study in obese rats.

The objective of the present study was to compare the anti-obesity effect of duloxetine with sibutramine along with its effect on blood pressure and depression in obese rats. The secondary objective of the study was to determine if a relationship exists between obesity and depression. Obesity was induced by high-fat diet (HFD) in healthy male Sprague-Dawley rats. After 5 weeks of feeding HFD, animals were overweight (17.57%) with high food intake (57.15%) in comparison with normal animals. These obese animals were treated with duloxetine (30 mg.kg-1, p.o.) and sibutramine (5 mg.kg-1, p.o.) for 4 weeks. Control animals were treated with duloxetine alone (30 mg.kg-1, p.o.). Our results depict that duloxetine was as effective as sibutramine in reducing food intake, body mass, and relative adi...

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  Clinical aspects and management of fibromyalgia syndrome.

Authors: Chong YY, Ng BY Fibromyalgia syndrome (FMS) is a chronic and debilitating musculoskeletal pain disorder of unknown aetiology with usual accompanying features of fatigue, sleep disturbances and stiffness. Its place in medical textbooks was controversial with rheumatologists holding the helm of its management for many years. Over the last decade, abnormalities have been identifi ed at multiple levels in the peripheral, central, and sympathetic nervous systems as well as the hypothalomo-pitutary-adrenal axis stress response system. With the elucidation of these pathways of pain, FMS is known more as a central sensitivity syndrome. This led to tremendous increment in interest in both pharmacological and non-pharmacological treatment of FMS. The United States Food and Drug Administ...

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  Fibromyalgia: The diagnosis and pharmacologic treatment

Abstract: Fibromyalgia (FM) is a chronic condition characterized by widespread pain and diffuse tenderness along with a constellation of ancillary symptoms. The 1990 ACR criteria for classification of FM are important in enhancing much the research of FM. FM is part of a spectrum of functional somatic syndromes. FM is not a homogenous condition and several subtypes of FM had been determined. The best strategy for management of FM is to use a multidisciplinary approach to treatment using both pharmacological and non-pharmacological interventions.Tramadol, tricyclic drugs, mixed reuptake inhibitors and anticonvulsants show efficacy in this condition. Recently, three drugs: pregabalin, duloxetine and milnacipran have been approved by the FDA for treatment of FM. (Source: European Journal of P...

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  CYMBALTA (Duloxetine Hydrochloride) Capsule, Delayed Release [Eli Lilly And Company]

Updated Date: Oct 27, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Update On Duloxetine For The Management Of Stress Urinary Incontinence

UroToday.com - The role of duloxetine in the treatment of women with stress urinary incontinence (SUI) remains somewhat unclear. The randomised trial evidence does seem to indicate that it is an effective treatment. (Source: Health News from Medical News Today)

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  Use of Antidepressants for Management of Hot Flashes

Pharmacotherapy 29(11): 1357-1374 Abstract A growing body of evidence suggests that antidepressant therapies, particularly selective serotonin reuptake inhibitors and venlafaxine, are effective in the management of hot flash symptoms. Several of these agents have the support of the American College of Obstetricians and Gynecologists and the North American Menopause Society. To review the literature on antidepressants for the treatment of hot flashes in women, we searched the PubMed, International Pharmaceutical Abstracts, and MEDLINE databases from inception through May 2009. All publication types that included human participants and that were published in English were eligible for review. These articles, relevant abstracts, and additional references were used to collect pertinent data. Al...

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  European CHMP supports change to depression indication for duloxetine (Cymbalta®)

Source: EMEA Area: News The European Medicines Agency's Committee for Medicinal Products for Human Use (CHMP) has adopted a positive opinion on a change to the depression indication for duloxetine (Cymbalta®) from major depressive episodes to major depressive disorder. (Source: NeLM - Mental Health)

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  Tinnitus in postherpetic neuralgia

We describe a woman who developed postherpetic neuralgia (PHN) located on the skin areas of the left ophthalmic division of the fifth cranial nerve without ocular involvement. PHN was associated with tinnitus, which was located ipsilaterally to the painful side and increased in proportion to the intensity of pain. Tinnitus was responsive to treatment with duloxetine, 60 mg daily, and subsided when the PHN resolved. This is the first description of tinnitus in PHN. Content Type Journal ArticleCategory Brief ReportDOI 10.1007/s10194-009-0167-6Authors Milena De Marinis, Sapienza University of Rome Department of Neurological Sciences Viale dell’ Università 30 00185 Rome ItalyValter Santilli, “Sapienza” University Department of Locomotor Apparatus Sciences Rome Italy ...

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  Pain Response To Duloxetine Predicts Efficacy

ISTANBUL, TURKEY — Early marked reduction in pain in response to duloxetine proved to be the strongest predictor of significant long-term improvement in depressive symptoms in depressed subjects in the German PADRE study. (Source: Family Practice News)

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  What Makes Patients with Fibromyalgia Feel Better? Correlations Between Patient Global Impression of Improvement and Changes in Clinical Symptoms and Function: A Pooled Analysis of 4 Randomized Placebo-controlled Trials of Duloxetine.

CONCLUSION: In addition to pain reduction, what makes patients with FM feel better may include improvement in fatigue, physical functioning, mood, and impact on daily living. An assessment of these domains may be important in clinical trials of FM and in the management of patients with FM. PMID: 19833743 [PubMed - as supplied by publisher] (Source: J Rheumatol)

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  Developments in the scientific and clinical understanding of fibromyalgia

Our understanding of FM has made significant advances over the past decade. The current concept views FM as the result of central nervous system malfunction resulting in amplification of pain transmission and interpretation. Research done over the past years has demonstrated a role for polymorphisms of genes in the serotoninergic, dopaminergic and catecholaminergic systems in the etiopathogenesis of FM. various external stimuli such as infection, trauma and stress may contribute to the development of the syndrome. The management of FM requires an integrated approach combining pharmacological and non - pharmacological modalities. The recent FDA approval of pregabalin, duloxetine and milnacipran as medications for FM may herald a new era for the development of medications with higher specifi...

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  CLINICAL CROSSROADS: A 52-Year-Old Woman With Disabling Peripheral Neuropathy: Review of Diabetic Polyneuropathy

Ms Q is a 52-year-old woman who has had progressive polyneuropathy in the setting of diabetes for the past 8 years. Ms Q's major disability is that of increasingly severe neuropathic pain and cramps that have been poorly responsive to a variety of therapies, including gabapentin and topiramate. The diagnosis of and differential diagnosis for diabetic polyneuropathy are reviewed herein. In general, treatment options for diabetic polyneuropathy remain primarily symptomatic. Improving the metabolic profile through weight loss, exercise, and if necessary, medications may help slow neuropathy progression. Many medications are effective in reducing pain, and newly developed ones, such as pregabalin and duloxetine, while specifically marketed for diabetic neuropathy, are likely to be no better an...

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  Use of Duloxetine in Pregnancy and Lactation (November).

CONCLUSIONS: No developmental toxicity or other signs of toxicity were observed in an infant exposed to duloxetine during the second half of gestation and during breast-feeding in the first 32 days after birth. However, the possibility of functional/ neurobehavioral deficits appearing later in life cannot be excluded. PMID: 19809008 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

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  First preliminary results of a single case report: Duloxetine might improve some symptoms of attention-deficit hyperactivity disorder.

Authors: Niederhofer H PMID: 19800768 [PubMed - as supplied by publisher] (Source: European Psychiatry)

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  Beyond the Abstract - Update on duloxetine for the management of stress urinary incontinence, ...

BERKELEY, CA (UroToday.com) - The role of duloxetine in the treatment of women with stress urinary incontinence (SUI) remains somewhat... (Source: UroToday)

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  CYMBALTA (Duloxetine Hydrochloride) Capsule, Delayed Release [Eli Lilly And Company]

Updated Date: Sep 22, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Duloxetine can significantly improve energy and vitality in patients with major depressive disorder

(Source: PharmacoEconomics and Outcomes News)

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  Highly Enantioselective Friedel−Crafts Reaction of Thiophenes with Glyoxylates: Formal Synthesis of Duloxetine

Organic Letters, Volume 0, Issue 0, Articles ASAP (As Soon As Publishable). (Source: Organic Letters)

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  New data show patients with chronic low back pain maintained pain reduction on duloxetine

New data show patients with chronic low back pain on duloxetine hydrochloride (Cymbalta®) maintained reductions in pain for 41 weeks.(1) In patients who initially responded to duloxetine, this maintenance of pain reduction was accompanied by further reduction in pain that was statistically significant as measured by the Brief Pain Inventory (BPI) average pain rating.(1) (Source: World Pharma News)

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  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

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.Twelve week open-label study using duloxetine up to 120 mg/day + DPCM.Outpatient late-life depression research clinic.Thirty community-dwelling adults >60 years old.Montgomery Asberg Depression Rating Scale (MADRS) and McGill Pain Questionnaire-Short Form (MPQ-SF).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....

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  New Data Show Patients With Chronic Low Back Pain Maintained Pain Reduction On Duloxetine

New data show patients with chronic low back pain on duloxetine hydrochloride (Cymbalta®) maintained reductions in pain for 41 weeks.[i] In patients who initially responded to duloxetine, this maintenance of pain reduction was accompanied by further reduction in pain that was statistically significant as measured by the Brief Pain Inventory (BPI) average pain rating. (Source: Health News from Medical News Today)

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  New Data Show Patients With Chronic Low Back Pain Maintained Pain Reduction On Cymbalta(R)

New data show patients with chronic low back pain on Cymbalta(R) (duloxetine HCl) maintained reductions in pain for 41 weeks.(1) In patients who initially responded to duloxetine, this maintenance of pain reduction was accompanied by further reduction in pain that was statistically significant as measured by the Brief Pain Inventory (BPI) average pain rating. (Source: Health News from Medical News Today)

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  New Data Show Patients With Chronic Low Back Pain Maintained Pain Reduction on Cymbalta

Further Pain Reduction on Cymbalta Shown During Study's Extension Phase INDIANAPOLIS, Sept. 11 /PRNewswire-FirstCall/ -- New data show patients with chronic low back pain on Cymbalta (duloxetine HCl) maintained reductions in pain for 41 weeks.(1) In... (Source: Drugs.com - Clinical Trials)

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  New Data Show Patients With Chronic Low Back Pain Maintained Pain Reduction on Cymbalta(R)

Further Pain Reduction on Cymbalta Shown During Study's Extension Phase INDIANAPOLIS, Sept. 11 (HSMN NewsFeed) -- New data show patients with chronic low back pain on Cymbalta® (duloxetine HCl) maintained reductions in pain for 41 weeks.(1) In pat... BiopharmaceuticalsEli Lilly, Cymbalta, duloxetine, chronic low back pain (Source: HSMN NewsFeed)

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  New data show patients with chronic low back pain maintained pain reduction on duloxetine

Indianapolis/U.S.A.and Ingelheim/Germany - New data show patients with chronic low back pain on duloxetine hydrochloride (Cymbalta®) maintained reductions in pain for 41 weeks.1 In patients who initially responded to duloxetine, this maintenance of pain reduction was accompanied by further reduction in pain that was statistically significant as measured by the Brief Pain Inventory (BPI) average pain rating.1 The data will be presented today at the sixth triennial congress of the European Federation of International Association for the Study of Pain Chapters (EFIC®). A total of 181 patients enrolled in the open-label 41-week extension phase of the study, designed to evaluate long-term maintenance of effect in patients with chronic low back pain taking duloxetine 60 mg or 120 mg once da...

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  duloxetine, Cymbalta

Title: duloxetine, CymbaltaCategory: MedicationsCreated: 7/11/2007Last Editorial Review: 9/10/2009 (Source: MedicineNet Chronic Pain General)

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  duloxetine, Cymbalta

Title: duloxetine, CymbaltaCategory: MedicationsCreated: 7/11/2007Last Editorial Review: 9/10/2009 (Source: MedicineNet Medications General)

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  duloxetine, Cymbalta

Title: duloxetine, CymbaltaCategory: MedicationsCreated: 7/11/2007Last Editorial Review: 9/10/2009 (Source: MedicineNet Senior Health General)

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  duloxetine, Cymbalta

Title: duloxetine, CymbaltaCategory: MedicationsCreated: 7/11/2007Last Editorial Review: 9/10/2009 (Source: MedicineNet HIV General)

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  duloxetine, Cymbalta

Title: duloxetine, CymbaltaCategory: MedicationsCreated: 7/11/2007Last Editorial Review: 9/10/2009 (Source: MedicineNet Arthritis General)

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  duloxetine, Cymbalta

Title: duloxetine, CymbaltaCategory: MedicationsCreated: 7/11/2007Last Editorial Review: 9/10/2009 (Source: MedicineNet Depression General)

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  Patient Characteristics Impacting Health State Index Scores, Measured by the EQ-5D of Females with Stress Urinary Incontinence Symptoms

Conclusion: This article describes the characteristics of patients at the SUIT enrollment visit, and demonstrates that the number of incontinence episodes has a significant impact on the EQ-5D index score. (Source: Value in Health)

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  Duloxetine: Serotonin syndrome in an elderly patient: case report

(Source: Reactions)

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  Duloxetine Serum Concentrations and Clinical Effects. Data from a Therapeutic Drug Monitoring (TDM) Survey

Pharmacopsychiatry 2009; 42: 189-193DOI: 10.1055/s-0029-1220890Abstract The aim of this study was to relate drug concentrations in serum and clinical effects in patients treated with the new antidepressant duloxetine.[...]© Georg Thieme Verlag KG Stuttgart · New YorkGet connected:Table of contents  |  Abstract  |  Full text (Source: Pharmacopsychiatry)

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  Duloxetine hydrochloride

The title compound [systematic name: N-methyl-3-(1-naphthyloxy)-3-(2-thienyl)propan-1-aminium chloride], C18H20NOS+·Cl−, was crystallized from 1,4-dioxane. Twofold rotational disorder exhibited by the thiophene ring in a 0.580 (5):0.420 (5) ratio represents two different conformations of the molecule that exist in the same crystal form. The crystal structure contains strong N—H...Cl hydrogen bonds. (Source: Acta Crystallographica Section E)

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  Antidepressants: Selective Serotonin And Norepinephrine Reuptake Inhibitor Drugs Show Benefits In German Study

Patients with depression benefit from taking venlafaxine and duloxetine, two drugs belonging to the selective serotonin and norepinephrine reuptake inhibitor drug class. This is the conclusion of a report published by German researchers. Clinical comparisons with a sham drug (placebo) show that patients respond better to the therapy, suffering less from the symptoms of depression. (Source: ScienceDaily Headlines)

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  The Mothers Act Disease Mongering Campaign - Part IV

This article says Courtenay publishes a website about "postpartum depression among dads" called "www.saddaddy.com." However, when clicking on the saddaddy link, PostpartumMen comes up today.And surely by coincidence, Courtenay will soon have a new book for sale titled, "Sad Dads," which he is currently writing, according to his bio on the consulting firm's website."If you'd like to arrange an individual consultation with Dr. Courtenay, please call 415-346-6719," the PostpartumMen website states.And apparently postpartum depression in dads is catchy. "If you're experiencing PPND, it increases the likelihood that your partner is also depressed," Courtenay informs men on his website."It's important that she get help for herself as well," he kindly advises.He then provides a link to a page wit...

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  Antidepressants: Benefit Of SNRI Is Proven

Venlafaxine and duloxetine alleviate symptoms better than sham drug: The Institute for Quality and Efficiency in Health Care (IQWiG) was commissioned by the Federal Joint Committee (G-BA) to investigate whether patients with depression benefit from taking drugs belonging to the selective serotonin and norepinephrine reuptake inhibitor (SNRI) drug class. (Source: Health News from Medical News Today)

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  Antidepressants: Benefit of SNRI is proven

(Institute for Quality and Efficiency in Health Care) Patients with depression benefit from taking venlafaxine and duloxetine, 2 drugs belonging to the selective serotonin and norepinephrine reuptake inhibitor drug class. This is the conclusion of a report published by the German Institute for Quality and Efficiency in Health Care. Clinical comparisons with a sham drug (placebo) show that patients respond better to the therapy, suffering less from the symptoms of depression. (Source: EurekAlert! - Medicine and Health)

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  Comparison of mechanical allodynia and the affective component of inflammatory pain in rats.

Authors: Boyce-Rustay JM, Zhong C, Kohnken R, Mikusa JP, Baker SJ, Simler GH, Wensink EJ, Decker MW, Honore P Most animal models of pain cannot separate the sensory and affective components of pain. One model that has been used to assess affective pain is the place escape avoidance procedure (PEAP). The aim of the current study is two fold. First, validate PEAP with Complete Freund's Adjuvant (CFA)-induced inflammation for the assessment of the affective component of pain using the reference analgesics celecoxib, diclofenac and duloxetine; fluoxetine and scopolamine were tested as negative controls. Secondly, determine if there is a difference in efficacy in PEAP in comparison to the effects of the same compounds on von Frey-evoked mechanical allodynia in CFA animals. All compounds wer...

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  Duloxetine for the Treatment of Recurrent Major Depressive Disorder in Elderly Patients: Treatment Outcomes in Patients With Comorbid Arthritis [ORIGINAL RESEARCH REPORTS]

DISCUSSION: The magnitude and time-course of depressive symptom improvement did not differ significantly between patients with and without arthritis. Some studies have suggested that the severity of pain in arthritis patients may be linked to depression severity. (Source: Psychosomatics)

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  Sexual side-effects of contemporary antidepressants: review.

Authors: Schweitzer I, Maguire K, Ng C The aim of the present study was to review the sexual side-effects of contemporary antidepressants in Australia, comparing the selective serotonin re-uptake inhibitors (SSRIs) with venlafaxine, reboxetine, mirtazepine, duloxetine, bupropion, desvenlafaxine and agomelatine. Double-blind, randomized comparative studies of these antidepressants that included assessment of sexual dysfunction with validated rating scales in patients with major depressive disorder were identified from the literature using MEDLINE, EMBASE and PsychINFO databases. Bupropion and duloxetine caused significantly less sexual dysfunction than the SSRIs in short-term studies and reboxetine significantly less in both short- and longer term studies. Bupropion and agomelatine caus...

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  Up to May 2009, ADRAC has received 108 reports of suspected adverse drug reactions with duloxetine.

(Source: Reactions)

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  Duloxetine: Hypomania: case report

(Source: Reactions)

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  Duloxetine: Serotonin syndrome: case report

(Source: Reactions)

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  The Clinical Importance of Changes in the 0 to 10 Numeric Rating Scale for Worst, Least, and Average Pain Intensity: Analyses of Data from Clinical Trials of Duloxetine in Pain Disorders

Abstract: Data on 1,700 patients pooled from 5 randomized, placebo-controlled duloxetine studies (3 in diabetic peripheral neuropathic pain and 2 in fibromyalgia) were analyzed to determine clinically important differences (CIDs) in the 0 to 10 Numeric Rating Scale-Pain Intensity (NRS-PI) for patient-reported “worst” and “least” pain intensity while validating the previously published level for “average” pain. The correspondence between the baseline-to-endpoint raw and percentage change in the NRS-PI for the worst, least, and average pain were compared to patients' perceived improvements at endpoint as measured by the 7-point Patient Global Impression of Improvement (PGI-I) scales. Stratification by baseline pain separated the raw but not the percent change scores. The PGI-I ca...

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  Cymbalta for Fibromyalgia Treatment

Title: Cymbalta for Fibromyalgia TreatmentCategory: Health FactsCreated: 8/7/2009Last Editorial Review: 8/7/2009 (Source: MedicineNet Senior Health General)

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  Cymbalta for Fibromyalgia Treatment

Title: Cymbalta for Fibromyalgia TreatmentCategory: Health FactsCreated: 8/7/2009Last Editorial Review: 8/7/2009 (Source: MedicineNet HIV General)

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  Cymbalta for Fibromyalgia Treatment

Title: Cymbalta for Fibromyalgia TreatmentCategory: Health FactsCreated: 8/7/2009Last Editorial Review: 8/7/2009 (Source: MedicineNet Rheumatoid Arthritis General)

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  Cymbalta for Fibromyalgia Treatment

Title: Cymbalta for Fibromyalgia TreatmentCategory: Health FactsCreated: 8/7/2009Last Editorial Review: 8/7/2009 (Source: MedicineNet Depression General)

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  Abnormal gait, due to inflammation but not nerve injury, reflects enhanced nociception in preclinical pain models.

Authors: Piesla MJ, Leventhal L, Strassle BW, Harrison JE, Cummons TA, Lu P, Whiteside GT Validation of gait analysis has the potential to bridge the gap between data from animal pain models and clinical observations. The goal of these studies was to compare alterations in gait due to inflammation or nerve injury to traditional pain measurements in animals. Pharmacological experiments determined whether gait alterations were related to enhanced nociception, edema or motor nerve dysfunction. Gait was analyzed using an automated system (DigiGait) after injection of an inflammatory agent (carrageenan; CARR, or FCA; Freund's complete adjuvant) or nerve injury (axotomy; AXO, partial sciatic nerve ligation; PSNL, spinal nerve ligation; SNL or chronic constriction injury; CCI). All models cau...

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  Biogenic amine depletion causes chronic muscular pain and tactile allodynia accompanied by depression: A putative animal model of fibromyalgia

Abstract: Fibromyalgia is a prevalent and burdensome disorder characterized by chronic widespread pain and complex comorbid symptoms. To develop better treatments for pain-centered fibromyalgia symptoms, there is still a need for animal models which mimic the features of fibromyalgia patients. In the present study, we have established a fibromyalgia animal model by utilizing a never-before-published pharmacological effect of reserpine. Repeated administration of reserpine (1mg/kg s.c., once daily, for three consecutive days) causes a significant decrease in the muscle pressure threshold and tactile allodynia, which are sustained for 1week or more in both male and female rats. This treatment regimen decreases the amount of biogenic amines (dopamine, norepinephrine, and 5-hydroxytryptamine) ...

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  I need some advice

Author: shelwoy Posted: Tue Jul 28, 2009 10:25 pm I can tell you that I have been on many different AD's, have been misdiagnosed as bipolar, and hated the fact that I needed medication to function mentally.I would get fed up with the way most of the AD's made me feel, and stop taking them only to self medicate and wind up in a huge mess. Today I take Cymbalta and Suboxone, the combination of the two works really well together for me.Honestly, this is the best I have felt mentally in many years. I still struggle with "needing" meds, but I just try to be happy with the present because life is what you make of it. So what if I have a anxiety disorder? Atleast I am treated for it! (Source: Suboxone Forum)

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  The Mothers Act Disease Mongering Campaign - Part II

(NaturalNews) The Mothers Act legislation specifically defines the term "postpartum conditions" as "postpartum depression" or "postpartum psychosis." Use of the Act as an 8-year disease mongering campaign to further promote the new cottage industry of "reproductive psychiatry," or "reproductive mental health," comes from websites often run by people who will financially benefit from passage of the Act.In 1992, the late journalist Lynn Payer wrote a book titled, "Disease Mongering," and defined disease mongering as, "trying to convince essentially well people that they are sick, or slightly sick people that they are very ill."Tactics identified in the book currently used in the Mothers Act campaign include: (1) Framing the issues in a particular way, (2) Taking a normal function and implyin...

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  Evaluating the maintenance of effect of duloxetine in patients with diabetic peripheral neuropathic pain

To evaluate the maintenance of effect of duloxetine 60 mg QD over 26 weeks in patients with diabetic peripheral neuropathic pain (DPNP).Adult patients with DPNP and Brief Pain Inventory (BPI) 24-h average pain [ge]4 were treated in this open-label study with duloxetine 60 mg QD for 8 weeks. Responders ([ge]30% pain reduction) continued on duloxetine 60 mg QD (maintenance arm) for 26 weeks while non-responders had duloxetine increased to 120 mg QD (rescue arm). The primary outcome measure was the mean change from baseline (Week 8) to endpoint (Week 34) in BPI average pain in the maintenance arm. A number of secondary efficacy measures, as well as safety and tolerability, were assessed.Two hundred and sixteen patients entered the study and their baseline BPI average pain was 5.9. Thirty-two ...

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  From lexapro to subutex, vyvanse and xanax

Author: mj Posted: Wed Jul 22, 2009 2:49 am Wow, I can't imagine how that must feel to go without sleep for so long. With your addiction history it sounds like you probably would not need vyvanse since it is a stimulant. This will probably only increase your daily anxiety even more. I took Cymbalta at one time and it made me anxious so I switched to lexapro-which helped for quite a while then started making me too tired. I am weaning off of Wellbutrin now that I am on Suboxone for opiate addiction. I feel better when not taking the Wellbutrin, the suboxone alone is enough to relax me thru the day. I also got energy from opiates to help me get thru the day, but it also caused sleep disturbances. My problem was that I felt tired all t...

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  Duloxetine, a centrally acting analgesic, in the treatment of patients with osteoarthritis knee pain: A 13-week, randomized, placebo-controlled trial

Abstract: Pain is a common cause of disability in osteoarthritis. Duloxetine, a serotonin and norepinephrine reuptake inhibitor (SNRI), has demonstrated analgesic effects in diabetic peripheral neuropathy and fibromyalgia. Considering its central mechanism of action, duloxetine may be effective in other pain states with evidence of central sensitization. Herein, we report the results of a 13-week, randomized, double-blind, placebo-controlled trial of duloxetine (60–120mg/day) versus placebo in the treatment of knee pain in 231 patients meeting clinical and radiographic criteria for osteoarthritis of the knee. Duloxetine was superior to placebo on the primary efficacy measure (weekly mean 24-h pain scores) beginning at Week 1 and continuing through the treatment period (P⩽.05). There wa...

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  From lexapro to subutex, vyvanse and xanax

Author: suboxdoc Posted: Sun Jul 19, 2009 9:26 pm I have a few thoughts, and I'm not sure where to start. The insomnia is likely because of the combination of cymbalta and vyvanse. Vyvanse is a long-acting stimulant; it is by far my favorite ADD medication to prescribe, as it has a very low risk of addiction compared to other stimulants. At the same time, your psychiatrist made some very aggressive medication changes in a very short period of time. I'm not going to pass judgment on a person I don't know, but in general you might want to change only one medication at a time, giving your extreme response to the Yyvanse. Cymbalta blocks reuptake of norepinephrine, which is very activating transmitter in the brain, and amphetamine (the ...

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  The Mothers Act Disease Mongering Campaign - Part I

(NaturalNews) The Mothers Act represents the ultimate example of disease mongering at its worst because the eight-year attempt to pass this federal legislation has evolved into profiteering never before exhibited so conspicuously.Disease mongering "is the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments," according to Ray Moyniahan and David Henry in the April 11, 2006 paper in PLoS Med, titled, "The Fight against Disease Mongering." "It is exemplified most explicitly by many pharmaceutical industry -- funded disease-awareness campaigns -- more often designed to sell drugs than to illuminate or to inform or educate about the prevention of illness or the maintenance of health," the authors explain. "Drug companies are ...

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  Successful Pain Relief of Cutaneous Leiomyomata Due to Reed Syndrome with the Combination Treatment of Pregabalin and Duloxetine

Cutaneous leiomyoma is a rare benign tumor that is derived from the arrector pili muscle. Females with multiple cutaneous leiomyomas may also have uterine leiomyomas. This autosomal dominant genetic disorder is called Reed syndrome or familial leiomyomatosis cutis et uteri and is caused by a gene mutation located on chromosome 1q42.3-Q43. (Source: Journal of Pain and Symptom Management)

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  An Investigation on Key Parameters that Influence the Synthesis of (S)-(+)-N,N-Dimethyl-3-(1-naphthalenyloxy)-3-(2-thienyl)propylamine: A Key Intermediate for Duloxetine

Organic Process Research & Development, Volume 0, Issue 0, Articles ASAP (As Soon As Publishable). (Source: Organic Process Research)

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  Cymbalta Drug Profile

Cymbalta is an antidepressant in the SNRI class - a serotonin norepinephrine reuptake inhibitor. Cymbalta - generic duloxetine hydrochloride - is prescribed for the treatment of major depression and the pain associated with diabetic neuropathy. Cymbalta also has some significant off-label uses including bipolar disorder and fibromyalgia. (Source: About.com Bipolar Disorder)

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  CYMBALTA (Duloxetine Hydrochloride) Capsule, Delayed Release [Eli Lilly And Company]

Updated Date: Jun 29, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Duloxetine: In Patients with Fibromyalgia.

Page: 1217DOI: 10.2165/00003495-200969090-00006Authors: Curran, Monique P. (Source: Drugs)

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  Duloxetine: Hyponatraemia in an elderly patient: case report.

Page: 19 (Source: Reactions Weekly)

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  Duloxetine: Hyponatraemia in an elderly patient: case report

(Source: Reactions)

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  Duloxetine: In Patients with Fibromyalgia

(Source: Drugs)

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  Digest

Safety of ramelteonThere is great interest in the role of melatonin agonists as treatments for insomnia. Ramelteon is already available in the USA, where it is used to reduce sleep latency associated with primary insomnia. Licensing in Europe has been delayed after the European Medicines Agency questioned its efficacy. Two studies now report on the safety of ramelteon over one year.The first study enrolled 1213 adults taking ramelteon 16mg (18-64 year age group) or 8mg (over-65 years) and were considered compliant if they took it at least three nights per week (J Clin Psychiatry 2009; pii:ej07m03834). In the younger group taking 16mg, 51 per cent discontinued treatment within six months and 62 per cent within 48 weeks; in the older group taking 8mg, the figures were 49 per cent and 58 per ...

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  Duloxetine in the treatment of irritable bowel syndrome: an open-label pilot study

To assess the efficacy of duloxetine for irritable bowel syndrome (IBS).We conducted an open-label 12-week trial of duloxetine 60 mg daily in 15 patients with IBS without concurrent major depressive disorder. The primary outcome measure was average abdominal pain. Secondary measures included IBS symptoms, Clinical Global Impression-Severity, Hamilton Anxiety Rating Scale, IBS Quality-of-Life Scale, and Sheehan Disability Scale. We analyzed changes using random regression and one-sample t-tests.Fourteen patients completed at least one post-baseline evaluation; eight completed the study. Duloxetine was associated with significant improvement (p < 0.05) in pain, severity of illness, quality of life, loose stool, work and family disability, and anxiety. However, duloxetine did not improve hard...

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  Duloxetine in obese binge eater outpatients: preliminary results from a 12-week open trial

Attempts have been made to find appropriate drug regimens to treat binge eating disorder (BED). Several reports have examined the use of selective serotonin reuptake inhibitors (SSRIs) or mood stabilizers; both serotonin and noradrenalin reuptake inhibitors (SNRIs) have been reported to be useful for binge eating, but the available data are limited. We evaluated the efficacy of duloxetine, an SNRI, in 45 obese patients who reported binge eating.Forty-five patients with BED or binge eating with sub-threshold symptoms (s-BED) with high eating impulsivity, received duloxetine 60-120 mg/day for 12 weeks.A significant reduction in number of binges/week was observed in BED patients; statistical analyses performed on the whole sample revealed significant reductions in scores on the binge eating s...

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  Safety and tolerability of duloxetine in the treatment of patients with fibromyalgia: pooled analysis of data from five clinical trials

Abstract  The purpose of this report is to describe the overall safety profile of both short- and longer-term duloxetine treatment of fibromyalgia. Data from four double-blind, randomized, placebo-controlled studies (two with 6-month open-label extension phases) and a 1-year, open-label safety study were included. Safety measures included treatment-emergent adverse events (TEAEs), adverse events leading to discontinuation, serious adverse events (SAEs), clinical laboratory tests, vital signs, and electrocardiograms. The most common TEAEs for short-term treatment with duloxetine were nausea (29.3%), headache (20.0%), dry mouth (18.2%), insomnia (14.5%), fatigue (13.5%), constipation (14.5%), diarrhea (11.6%), and dizziness (11.0%; all p < 0.05 vs. placebo). Most TEAEs ...

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  Duloxetine-induced hypomania: case report and brief review of the literature on SNRIs-induced mood switching

AbstractManic switching during antidepressant treatment has been reported with every class of antidepressant drugs. Serotonin-noradrenaline reuptake inhibitors (SNRIs) have been increasingly used for the treatment of unipolar and bipolar depression and are well tolerated and sufficiently effective because of their dual mechanism of action. A case of duloxetine-induced hypomania in a non-bipolar patient is presented, and a brief review of all cases of SNRIs’ induced mania and hypomania has been carried out. The available data suggest that SNRIs, especially venlafaxine, can induce mood switching in patients with bipolar depression and in certain patients with unipolar depression, but the potential of duloxetine and milnacipran to induce manic or hypomanic symptoms cannot be disregarded...

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  Improvement with Duloxetine in an Adult ADHD Patient

Conclusion: Duloxetine could be an option for patients who either do not tolerate or show resistance to more common pharmacological choices. Randomized controlled trials are needed to assess the efficacy of duloxetine in treating ADHD symptoms. (Source: Journal of Attention Disorders)

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  Duloxetine: A Review of its Use in the Treatment of Generalized Anxiety Disorder.

Page: 523DOI: 10.2165/00023210-200923060-00006Authors: Carter, Natalie J.; McCormack, Paul L. (Source: CNS Drugs)

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  Table of Contents

ConclusionsVariation in COMT Associated With Duloxetine ResponseQuetiapine XR Patients With MDDAtomoxetine for Cognitive Impairment in SchizophreniaChest Pain With Prazosin for PTSDNew ApprovalsFDA and SAMHSA Launch Safety Initiative for Methadone (Source: The Brown University Psychopharmacology Update)

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  Lilly Resubmits Cymbalta(R) Supplemental New Drug Application For Chronic Pain To U.S. Food And Drug Administration

As projected, Eli Lilly and Company (NYSE: LLY) has resubmitted its supplemental New Drug Application (sNDA) for Cymbalta(R) (duloxetine HCl) for the management of chronic pain to the U.S. Food and Drug Administration (FDA). (Source: Health News from Medical News Today)

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  Does Pain Cause the Perception of Fatigue in Patients with Chronic Pain? Findings from Studies for Management of Diabetic Peripheral Neuropathic Pain with Duloxetine

A major issue in pain literature is whether an etiological association between pain, sleep, and vitality exists. We utilized data from clinical trials of duloxetine for management of diabetic peripheral neuropathic pain (DPNP) to investigate these associations. Data were pooled from 3 double-blind, randomized, placebo-controlled, 12-week trials of patients without mood disorder (N = 1,139). After excluding 442 patients who reported maximum vitality at baseline, experienced treatment-emergent somnolence, asthenia or fatigue, or were taking sedating concomitant medications or duloxetine 20 mg/day, 697 were included in the analysis. Efficacy measures included weekly mean scores for average daily and night pain, pain interference with sleep, and vitality. Baseline to end point mean improvement...

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  Lilly Resubmits Cymbalta® Supplemental New Drug Application For Chronic Pain To U.S. Food And Drug Administration

As projected, Eli Lilly and Company (NYSE: LLY) has resubmitted its supplemental New Drug Application (sNDA) for Cymbalta® (duloxetine HCl) for the management of chronic pain to the U.S. Food and Drug Administration (FDA). Lilly's resubmission is based on a recently completed study in chronic pain due to osteoarthritis, the extension phase of a chronic low back pain study and previously completed studies in pain due to osteoarthritis and chronic low back pain. (Source: Pharmaceutical Online News)

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  Duloxetine: A Review of its Use in the Treatment of Generalized Anxiety Disorder

(Source: CNS Drugs)

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  Duloxetine/paroxetine: Exacerbation of epilepsy: case report

(Source: Reactions)

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  Therapy for Urinary Incontinence in General Practice.

In conclusion, this survey gives a realistic view on the incontinence management in primary care in Germany. The majority of general practitioners are engaged in incontinence, perform basic diagnostic features and prescribe drugs or absorbent products. The course of (university medical school) studies as a source of skills to diagnose or to treat inconti-nence should be improved. PMID: 19492276 [PubMed - as supplied by publisher] (Source: Aktuelle Urologie)

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  Serotonin syndrome induced by duloxetine.

Authors: Hadikusumo B, Ng B PMID: 19452666 [PubMed - in process] (Source: The Australian and New Zealand Journal of Psychiatry)

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  Escitalopram Versus SNRI Antidepressants in the Acute Treatment of Major Depressive Disorder: Integrative Analysis of Four Double-Blind, Randomized Clinical Trials.

Conclusion: This pooled analysis indicates that escitalopram is at least as effective as the SNRIs (venlafaxine XR and duloxetine), even in severe depression, and escitalopram treatment was better tolerated. PMID: 19668123 [PubMed - in process] (Source: CNS Spectrums)

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  Duloxetine/paroxetine: Exacerbation of epilepsy: case report.

Page: 21 (Source: Reactions Weekly)

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  Fibromyalgia: a complex syndrome requiring a multidisciplinary approach

Fibromyalgia is a pain syndrome which is not due to tissue damage or inflammation and is thus fundamentally different from rheumatic disorders and many other pain conditions. In addition to widespread pain it is associated with a range of other symptoms such as sleep disturbance, fatigue, cognitive disturbance, stiffness and depressive symptoms. A number of multidisciplinary therapeutic programmes involving education, exercise and cognitive therapy have been shown to be effective in bringing relief. The various medications that are currently being developed for the treatment of fibromyalgia are based on different mechanistic approaches. In particular, serotonin noradrenaline reuptake inhibitors (SNRI) such as duloxetine and milnacipran and [alpha]2-[delta] receptor ligands such as pregabal...

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  The psychiatrist confronted with a fibromyalgia patient

Fibromyalgia is usually treated by rheumatologists but since co-morbid depression and anxiety are frequent, psychiatrists are likely to be confronted with patients suffering from the syndrome. The symptoms associated with fibromyalgia vary from patient to patient but there is one common symptom - they ache all over. In addition to pain, patients report headaches, poor sleep, fatigue, depressed mood and irregular bowel habits, which are also all symptoms of depression. For a formal diagnosis of fibromyalgia, the American College of Rheumatology (ACR) criteria require the patient to have widespread pain for at least 3 months together with tenderness at 11 or more of 18 specific tender points.Treatment of fibromyalgia requires a comprehensive approach involving education, aerobic exercise and...

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  Chronic oral nicotine increases brain [3H]epibatidine binding and responsiveness to antidepressant drugs, but not nicotine, in the mouse forced swim test

Discussion  It is suggested that the increased sensitivity to antidepressants after chronic nicotine exposure involves increased high-affinity nAChR-mediated neurotransmission. Content Type Journal ArticleCategory Original InvestigationDOI 10.1007/s00213-009-1560-1Authors Jesper T. Andreasen, NeuroSearch A/S Department of Affective Disorders 93 Pederstrupvej 2750 Ballerup DenmarkElsebet Ø. Nielsen, NeuroSearch A/S Department of Pharmacodynamics 93 Pederstrupvej 2750 Ballerup DenmarkJohn P. Redrobe, NeuroSearch A/S Department of Affective Disorders 93 Pederstrupvej 2750 Ballerup Denmark Journal PsychopharmacologyOnline ISSN 1432-2072Print ISSN 0033-3158 (Source: Psychopharmacology)

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  CYMBALTA (Duloxetine Hydrochloride) Capsule, Delayed Release [Eli Lilly And Company]

Updated Date: May 18, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Antidepressants: Brand Name or Generic?

For many antidepressants, the issue of brand-name versus generic has no practical significance. Elavil was first marketed almost a half century ago, and its patent has long expired. It lives on, however, but as generic amitriptyline. Today, only a few antidepressants are still fully protected by patents, namely, Cymbalta (2010), Lexapro (2012), and Pristiq (2022) for major depressive disorder (MDD); and Seroquel (2011) and Symbyax (2017) for bipolar depression. (Source: Psychiatric Times)

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  A double-blind, randomized trial of duloxetine versus placebo in the management of chronic low back pain

Conclusions: Duloxetine was superior to placebo on the primary objective from weeks 3[ndash]11, but superiority was not maintained at end-point. Duloxetine was superior to placebo on many secondary measures, and was well-tolerated. (Source: European Journal of Neurology)

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  Pharmacotherapy of chronic pain: a synthesis of recommendations from systematic reviews

Conclusions: A number of medications have proven effective in chronic pain disorders and their use individually or in combination should improve the management of chronic pain. (Source: General Hospital Psychiatry)

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  Pharmacokinetics of duloxetine hydrochloride enteric-coated tablets in healthy Chinese volunteers: A randomized, open-label, single- and multiple-dose study.

Conclusions: In these healthy Chinese subjects, AUC and Cmax increased proportionally with the dose, whereas t(1/2) was independent of the dose. Linear PK properties were found at doses of 30 to 90 mg. No statistically significant differences were observed between the PK parameters for the subjects in the multiple-dose phase (t(1/2), CL, V(d)) and those for subjects in the single-dose phase. The AUC and C(max) were greater after administration of multiple doses than after administration of a single dose, suggesting du-loxetine accumulation with multiple-dose administration of 30 mg. PMID: 19539103 [PubMed - in process] (Source: Clinical Therapeutics)

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  Treatment of depression in the elderly: A review of the recent literature on the efficacy of single- versus dual-action antidepressants.

Conclusion: The available data, although limited, suggest that the dual-action agents (TCAs and SNRIs) do not appear to confer any additional benefits in efficacy over single-action agents (SSRIs) in the treatment of depression in the elderly. PMID: 19539096 [PubMed - in process] (Source: Clinical Therapeutics)

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  Population Pharmacokinetics of Orally Administered Duloxetine in Patients: Implications for Dosing Recommendation

(Source: Clinical Pharmacokinetics)

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  Effect of antidepressants on melatonin metabolite in depressed patients

AbstractAntidepressants increase melatonin levels, but it is still unclear whether this effect is related to the improvement of depressive symptoms or to unrelated pharmacological action of antidepressants. To answer this question, the effect of antidepressants on 6-sulphatoxymelatonin (aMT6s), the main melatonin urinary metabolite, was examined in drug-free depressed patients – most of them antidepressant-naive. aMT6s was evaluated in 34 depressed patients, before and after 8 weeks of placebo (n = 12) or antidepressant (n = 22; fluoxetine, duloxetine or Hypericum perforatum). Both groups showed an improvement of depressive symptoms after treatment compared to baseline (Hamilton Depression scores): 17.0 ± 1.4 vs. 9.0 ± 2.8, P ...

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  Severe and symptomatic hyponatremia following duloxetine treatment

(Source: Journal of Psychopharmacology)

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  Effectiveness of the psychological and pharmacological treatment of catastrophization in patients with fibromyalgia: a randomized controlled trial

DiscussionIt is necessary to assess the effectiveness of pharmacological and psychological treatments for pain catastrophizing in fibromyalgia. This randomized clinical trial will determine whether both treatments are effective for this important prognostic variable in patients with fibromyalgia. Trial registration: Current Controlled Trials ISRCTN10804772. (Source: Trials)

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  Brain Functional Changes and Duloxetine Treatment Response in Fibromyalgia: A Pilot Study

Conclusions. This pilot study suggests that QEEG biomarkers may prove useful for predicting improvement in painful symptoms during SNRI treatment in FMS. Larger studies are needed to confirm this finding. (Source: Pain Medicine)

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  CYMBALTA (Duloxetine Hydrochloride) Capsule, Delayed Release [Eli Lilly And Company]

Updated Date: Apr 21, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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  Variation in Catechol-O-Methyltransferase Is Associated with Duloxetine Response in a Clinical Trial for Major Depressive Disorder

Conclusions: Single nucleotide polymorphisms in COMT were associated with symptom change in duloxetine-treated patients with MDD. If replicated, the magnitude of the COMT genotype effect is of clinical relevance. (Source: Biological Psychiatry)

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  Non-fatal overdose of duloxetine in combination with other antidepressants and benzodiazepines. - Menchetti M, Ferrari Gozzi B, Addolorata Saracino M, Mercolini L, Petio C, Augusta Raggi M.

The pharmaco-toxicological profile of duloxetine, a novel SNRI antidepressant, is still not completely known; in particular, intoxication cases have been scarcely studied. Here a duloxetine overdose case, in combination with other antidepressants and benzo... (Source: SafetyLit: All (Unduplicated))

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