Duloxetine is a drug aimed for people suffering from major depressive disorder(MDD) and generalized anxiety disorder (GAD). However, it has also been found as an effective treatment for pain experienced due to peripheral neuropathy. Moreover, certain countries have approved it as a viable treatment for stress uninary incontinence (SUI).
Manufactured and marketed by Eli Lilly and company, Duloxetine was discovered by David Wong and Frank Bymaster in 1988. In fact, this same duo created the popular drug, Prozac. Then referred to as LY227942, Duloxetine was found to have characteristics similar to antidepressants. Also, researches realized that it can alter the levels of serotonin and norepinephrine, substances relevant to a person’s mood and stress level. As such, it was termed as a a selective SNRI (serotonin-norepinephrine reuptake inhibitor)
Serotonin and norepinephrine levels play an important role in depression. Many believe that once these substances are released by the nerve cells in the brain, the person will have a generally more positive disposition. However, sometimes the nerve cells simply reabsorb these substances. When re-absorption occurs, the levels of serotonin and norepinephrine drop. This may alter the person’s overall mood which can largely contribute to feelings of depression.
Duloxetine works by making sure serotonin and norephinephrine do not get reabsorbed by the nerve cells. More specifically, Duloxetine acts on 5-HT and NE and D2 receptors respectively. Because the substances are not immediately absorbed by the cells, their effects can be prolonged. As such, these substances have increased activity in the brain and spinal cord which, according to researchers, produce mood lightening effects. These mood lightening effects come from serotonin and norepinephrine’s ability to mediate the symptoms of depression as well as alter perception of pain. The produced effect in the patient takes care of both the physical feelings of pain as well as the emotional symptoms of sadness and depression.
As a drug that can alter pain perception, Duloxetine is also effective in treating nerve pain in the feet, legs, or hands due to nerve damage as a result of poorly managed diabetes. However, it cannot treat the root of the nerve damage. It can only decrease the pain since Duloxetine only workd by increasing activity in the nerve signals.
Duloxetine comes in 20, 30, or 60 mg capsules. Patients must take it only under the advice of health care professionals.
Generally, people who are already taking other forms of anti-depressants should not take Duloxetine. Conversely, patients taking Duloxetine must consult their doctors before taking any other form of psychoactive drug.
Many patients report mild side effects while taking Duloxetine. Usually, people may experience nausea, dry mouth, dizziness, headache, and insomnia. Some patients may also experience sexual dysfunctions which can be alleviated once they stop taking Duloxetine. Moreover, some patients may develop hyponatraemia, which is drop in the sodium content of the blood. However, many psychologists say withdrawing from Duloxetine may cause more serious side effects. If one stops treatment abruptly, s/he may have dysphoric mood. She may also feel irritable, agitated and a little dizzy. There may also be experiences of sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures. These withdrawal symptoms may last for weeks, and even months.
Duloxetine has the following structural formula:
• Molecular formula of duloxetine is C18H19NOS
• Chemical IUPAC Name is N-methyl-3-naphthalen-1-yloxy-3-thiophen-2-yl-propan-1-amine
• Molecular weight is 297.416 g/mol
• Duloxetine available : 20mg capsule, 30mg capsule, 60mg capsule
Brand name(s): Cymbalta, Domperidone, Yentreve
Review published on: 26 April 2008
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