Duloxetine Hydrochloride CAS# 136434-34-9, is also known as the brand name Cymbalta marketed by Lilly. This effective antidepressant will be going off patent in June of 2013. Duloxetine hydrochloride is currently approved to treat the following: clinical depression; peripheral diabetic neuropathy pain, or nerve pain in the hands, feet, arms, and legs from diabetes; generalized anxiety disorder (also known as GAD); fibromyalgia and several types of chronic musculoskeletal pain such as arthritis.
Duloxetine is in a class of medications deemed SNRI’s, or selective serotonin and norepinephrine reuptake inhibitors. By increasing the amounts of serotonin and norepinephrine, duloxetine is efficacious in aiding and maintaining a mental balance of these naturally occurring substances. Patients who experience chronic pain also experience the powerful ability of duloxetine to halt much of the movement of pain signals in the brain. The delayed release capsules are offered in 30 and 60 milligram doses, with most patients finding the 60 milligram dose adequate. While there are some patients taking up to 120 milligrams a day, physicians have not found the benefit to be greatly significant with an increase over the standard 60 milligram dose. Side effects include constipation, decreased sexual desire, diarrhea, drowsiness, dizziness, nausea and trouble sleeping. Adolescents and children are not approved for treatment with duloxetine. Teenagers and young adults may experience suicidal thoughts and actions when first starting treatment with duloxetine. This patient population must be monitored for any of these potential devastating adverse effects.
Osteoarthritis sufferers received promising news regarding treatment with duloxetine in March of 2012. A study published by The International Journal of Clinical Practice offered data from two FDA approved studies regarding duloxetine, on its own, or in combination with non-steroidal anti-inflammatory drugs, such as ibuprofen for the treatment of osteoarthritis. These double blind and controlled studies gleaned positive information, which indicated duloxetine to be an effectual treatment for arthritis pain, as monotherapy and in conjunction with adjunct NSAIDs. One of the studies evaluated 524 patients with osteoarthritis of the knee for ten weeks. Those patients who were dosed a combination of duloxetine and NSAIDs reported greater pain reductions versus the control group, who were given an NSAID with a placebo. Recommendations released from these studies indicated a clear benefit of prescribing NSAIDs and adjunctive antidepressants to formidably impact the central pain pathways in osteoarthritis patients.
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