This page describes pharmacological agents that may have legal restrictions, side effects, and drug interactions in your jurisdiction. Information is for educational research only — consult a clinician before considering any compound.
Duloxetine
SNRI with FDA approval for MDD, GAD, diabetic peripheral neuropathy, fibromyalgia, chronic musculoskeletal pain.
Aliases (2)
Overview
What is Duloxetine?
Duloxetine (Cymbalta) is a serotonin-norepinephrine reuptake inhibitor (SNRI) FDA-approved for major depression, generalized anxiety disorder, fibromyalgia, diabetic peripheral neuropathy, and chronic musculoskeletal pain.
Key Benefits
Treats depression and anxiety, reduces chronic neuropathic and musculoskeletal pain, improves stress urinary incontinence (Europe). Dual NE/5-HT effect addresses both mood and pain modulation.
Mechanism of Action
Inhibits the serotonin transporter (SERT) and norepinephrine transporter (NET) with relatively balanced affinity, increasing synaptic 5-HT and NE in cortical, limbic, and descending pain-modulatory circuits.
Pharmacokinetics
What to Expect
- Week 1Tolerability and dose-response.
- Week 2-4Early effect window.
- Week 4-8Peak benefit assessment.
- Week 8+Cycle decision point.
Side Effects & Safety
- Common (>10%): Nausea (often improves), dry mouth, fatigue, sexual dysfunction, sweating, constipation.
- Less common (1-10%): Insomnia, ↑ BP (less than venlafaxine), tremor, dizziness.
- Rare-serious (<1%): Hepatotoxicity (avoid in heavy drinkers, hepatic disease), serotonin syndrome, hyponatremia, suicidal ideation <25 yo, Stevens-Johnson syndrome (very rare).
- Specific watch periods: LFTs at baseline + as indicated; hepatotoxicity risk amplified by alcohol use.
References
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