Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia
Open accessAbstract
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. This is the first update of a review first published in 2010. OBJECTIVES: To assess the benefits and harms of duloxetine for treating painful neuropathy and different types of chronic pain. SEARCH METHODS: On 19th November 2013, we searched The Cochrane Neuromuscular Group Specialized Register, CENTRAL, DARE, HTA, NHSEED, MEDLINE, and EMBASE. We searched ClinicalTrials.gov for ongoing trials in April 2013. We also searched the reference lists of identified publications for trials of duloxetine for the treatment of painful peripheral neuropathy or chronic pain. SELECTION CRITERIA: We selected all randomised or quasi-randomised trials of any formulation of duloxetine, used for the treatment of painful peripheral neuropathy or chronic pain in adults. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS: We identified 18 trials, which included 6407 participants. We found 12 of these studies in the literature search for this update. Eight studies included a total of 2728 participants with painful diabetic neuropathy and six studies involved 2249 participants with fibromyalgia. Three studies included participants with depression and painful physical symptoms and one included participants with central neuropathic pain. Studies were mostly at low risk of bias, although significant drop outs, imputation methods and almost every study being performed or sponsored by the drug manufacturer add to the risk of bias in some domains. Duloxetine at 60 mg daily is effective in treating painful diabetic peripheral neuropathy in the short term, with a risk ratio (RR) for ≥ 50% pain reduction at 12 weeks of 1.73 (95% CI 1.44 to 2.08). The related NNTB is 5 (95% CI 4 to 7). Duloxetine at 60 mg daily is also effective for fibromyalgia over 12 weeks (RR for ≥ 50% reduction in pain 1.57, 95% CI 1.20 to 2.06; NNTB 8, 95% CI 4 to 21) and over 28 weeks (RR 1.58, 95% CI 1.10 to 2.27) as well as for painful physical symptoms in depression (RR 1.37, 95% CI 1.19 to 1.59; NNTB 8, 95% CI 5 to 14). There was no effect on central neuropathic pain in a single, small, high quality trial. In all conditions, adverse events were common in both treatment and placebo arms but more common in the treatment arm, with a dose-dependent effect. Most adverse effects were minor, but 16% of participants stopped the drug due to adverse effects. Serious adverse events were rare. AUTHORS' CONCLUSIONS: There is adequate amounts of moderate quality evidence from eight studies performed by the manufacturers of duloxetine that doses of 60 mg and 120 mg daily are efficacious for treating pain in diabetic peripheral neuropathy but lower daily doses are not. Further trials are not required. In fibromyalgia, there is lower quality evidence that duloxetine is effective at similar doses to those used in diabetic peripheral neuropathy and with a similar magnitude of effect. The effect in fibromyalgia may be achieved through a greater improvement in mental symptoms than in somatic physical pain. There is low to moderate quality evidence that pain relief is also achieved in pain associated with depressive symptoms, but the NNTB of 8 in fibromyalgia and depression is not an indication of substantial efficacy. More trials (preferably independent investigator led studies) in these indications are required to reach an optimal information size to make convincing determinations of efficacy.Minor side effects are common and more common with duloxetine 60 mg and particularly with 120 mg daily, than 20 mg daily, but serious side effects are rare.Improved direct comparisons of duloxetine with other antidepressants and with other drugs, such as pregabalin, that have already been shown to be efficacious in neuropathic pain would be appropriate. Unbiased economic comparisons would further help decision making, but no high quality study includes economic data.
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Duloxetine is an antidepressant belonging to the serotonin and noradrenalin reuptake inhibitors (SNRIs).
“Duloxetine is an antidepressant which belongs to the category of the serotonin and noradrenalin reuptake inhibitors (SNRIs) [22].”
From Duloxetine for fibromyalgia syndrome: a systematic review and meta-analysis (2023) · cites this paper as [22]
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CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016
Dowell, D., Haegerich, T. M., & Chou, R. (2016) · JAMA · doi:10.1001/jama.2016.1464 · Cited by 5,161 · see citing works
Industry sponsorship and research outcome
Lundh, A., Lexchin, J., Mintzes, B., Schroll, J. B., & Bero, L. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.mr000033.pub3 · Cited by 1,697 · see citing works
EULAR revised recommendations for the management of fibromyalgia
Macfarlane, G. J., Kronisch, C., Dean, L. E., Atzeni, F., Häuser, W., Fluß, E., Choy, E., Kosek, E., Amris, K., Branco, J., et al. (2017) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2016-209724 · Cited by 1,566 · see citing works
Kennedy, S. H., Lam, R. W., McIntyre, R. S., Tourjman, S. V., Bhat, V., Blier, P., Hasnain, M., Jollant, F., Levitt, A. J., MacQueen, G. M., et al. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716659417 · Cited by 1,150 · see citing works
Brahmer, J. R., Abu-Sbeih, H., Ascierto, P. A., Brufsky, J., Cappelli, L. C., Cortazar, F. B., Gerber, D. E., Hamad, L., Hansen, E., Johnson, D. B., et al. (2021) · Journal for ImmunoTherapy of Cancer · doi:10.1136/jitc-2021-002435 · Cited by 917 · see citing works
Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment
Sarzi‐Puttini, P., Giorgi, V., Marotto, D., & Atzeni, F. (2020) · Nature Reviews Rheumatology · doi:10.1038/s41584-020-00506-w · Cited by 837 · see citing works
Assessment and manifestation of central sensitisation across different chronic pain conditions
Arendt‐Nielsen, L., Morlion, B., Perrot, S., Dahan, A., Dickenson, A., Kress, H. G., Wells, C., Bouhassira, D., & Drewes, A. M. (2018) · European Journal of Pain · doi:10.1002/ejp.1140 · Cited by 695 · see citing works
Cannabis-based medicines for chronic neuropathic pain in adults
Mücke, M., Phillips, T., Radbruch, L., Petzke, F. W., & Häuser, W. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012182.pub2 · Cited by 606 · see citing works
Topical capsaicin (high concentration) for chronic neuropathic pain in adults
Derry, S., Rice, A. S. C., Cole, P., Tan, T., & Moore, A. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007393.pub4 · Cited by 569 · see citing works
Diabetic Peripheral Neuropathy: Epidemiology, Diagnosis, and Pharmacotherapy
Iqbal, Z., Azmi, S., Yadav, R., Ferdousi, M., Kumar, M., Cuthbertson, D. J., Lim, J., Malik, R. A., & Alam, U. (2018) · Clinical Therapeutics · doi:10.1016/j.clinthera.2018.04.001 · Cited by 487 · see citing works
Pathogenesis, diagnosis and clinical management of diabetic sensorimotor peripheral neuropathy
Sloan, G., Selvarajah, D., & Tesfaye, S. (2021) · Nature Reviews Endocrinology · doi:10.1038/s41574-021-00496-z · Cited by 534 · see citing works
Drossman, D. A., Tack, J., Ford, A. C., Szigethy, E., Törnblom, H., & Van Oudenhove, L. (2018) · Gastroenterology · doi:10.1053/j.gastro.2017.11.279 · Cited by 470 · see citing works
Ford, A. C., Lacy, B. E., Harris, L. A., Quigley, E. M. M., & Moayyedi, P. (2019) · American Journal of Gastroenterology · doi:10.1038/s41395-018-0222-5 · Cited by 467 · see citing works
American College of Gastroenterology Monograph on Management of Irritable Bowel Syndrome
Ford, A. C., Moayyedi, P., Chey, W. D., Harris, L. A., Lacy, B. E., Saito, Y. A., & Quigley, E. M. M. (2018) · American Journal of Gastroenterology · doi:10.1038/s41395-018-0084-x · Cited by 388 · see citing works
Pregabalin for neuropathic pain in adults
Derry, S., Bell, R. F., Straube, S., Wiffen, P. J., Aldington, D. J., & Moore, A. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007076.pub3 · Cited by 386 · see citing works
Self-citationManagement of functional somatic syndromes and bodily distress
Henningsen, P., Zipfel, S., Sattel, H., & Creed, F. (2018) · Psychotherapy and Psychosomatics · doi:10.1159/000484413 · Cited by 335 · see citing works
Challenges of neuropathic pain: focus on diabetic neuropathy
Rosenberger, D. C., Blechschmidt, V., Timmerman, H., Wolff, A. P., & Treede, R. (2020) · Journal of Neural Transmission · doi:10.1007/s00702-020-02145-7 · Cited by 343 · see citing works
Amitriptyline for neuropathic pain in adults
Moore, A., Derry, S., Aldington, D. J., Cole, P., & Wiffen, P. J. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008242.pub3 · Cited by 309 · see citing works
Self-citationBair, M. J., & Krebs, E. E. (2020) · Annals of Internal Medicine · doi:10.7326/aitc202003030 · Cited by 320 · see citing works
Neuroplasticity Underlying the Comorbidity of Pain and Depression
Doan, L., Manders, T. R., & Wang, J. (2015) · Neural Plasticity · doi:10.1155/2015/504691 · Cited by 284 · see citing works
Bäckryd, E., Tanum, L., Lind, A., Larsson, A. O., & Gordh, T. (2017) · Journal of Pain Research · doi:10.2147/jpr.s128508 · Cited by 250 · see citing works
Treatment of painful diabetic neuropathy
Javed, S., Petropoulos, I. N., Alam, U., & Malik, R. A. (2014) · Therapeutic Advances in Chronic Disease · doi:10.1177/2040622314552071 · Cited by 245 · see citing works
(2020) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000003716 · Cited by 230 · see citing works
Therapeutic Approaches for Peripheral and Central Neuropathic Pain
Szok, D., Tajti, J., Nyári, A., Vécsei, L., & Trojano, L. (2019) · Behavioural Neurology · doi:10.1155/2019/8685954 · Cited by 220 · see citing works
Gabapentin for chronic neuropathic pain in adults
Wiffen, P. J., Derry, S., Bell, R. F., Rice, A. S., Tölle, T. R., Phillips, T., & Moore, R. A. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007938.pub4 · Cited by 561 · see citing works
Self-citationTramadol for neuropathic pain in adults
Duehmke, R. M., Derry, S., Wiffen, P. J., Bell, R. F., Aldington, D. J., & Moore, A. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003726.pub4 · Cited by 203 · see citing works
Self-citationZiegler, D., Tesfaye, S. H., Spallone, V., Владимировна, Г. И., Kaabi, J. A., Mankovsky, B., Martinka, E., Radulian, G., Nguyen, K. T., Stirban, A. O., et al. (2021) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2021.109063 · Cited by 207 · see citing works
Treatment of central sensitization in patients with ‘unexplained’chronic pain: An update
Nijs, J., Malfliet, A., Ickmans, K., Baert, I., & Meeus, M. (2014) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2014.925446 · Cited by 195 · see citing works
British Society of Gastroenterology guidelines on the management of functional dyspepsia
Black, C. J., Paine, P., Agrawal, A., Aziz, I., Eugenicos, M. P., Houghton, L. A., Hungin, P., Overshott, R., Vasant, D. H., Rudd, S., et al. (2022) · Gut · doi:10.1136/gutjnl-2022-327737 · Cited by 216 · see citing works
Antidepressant Medications and Weight Change: A Narrative Review
Gill, H., Gill, B., El‐Halabi, S., Chen-Li, D. C. J., Lipsitz, O., Rosenblat, J. D., Rheenen, T. E. V., Rodrigues, N. B., Mansur, R. B., Majeed, A., et al. (2020) · Obesity · doi:10.1002/oby.22969 · Cited by 197 · see citing works
Efficacy of α-lipoic acid in diabetic neuropathy
Παπάνας, Ν., & Ziegler, D. (2014) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2014.972935 · Cited by 197 · see citing works
Osteen, J. D., Immani, S., Tapley, T. L., Indersmitten, T., Hurst, N. W., Healey, T. A., Aertgeerts, K., Negulescu, P. A., & Lechner, S. M. (2025) · Pain and Therapy · doi:10.1007/s40122-024-00697-0 · Cited by 193 · see citing works
Serotonin and Norepinephrine Reuptake Inhibitors
Shelton, R. C. (2018) · Handbook of experimental pharmacology · doi:10.1007/164_2018_164 · Cited by 182 · see citing works
RSSDI-ESI clinical practice recommendations for the management of type 2 diabetes mellitus 2020
Madhu, S., Chawla, R., Makkar, B. M., Ghosh, S. K., Saboo, B., & Kalra, S. (2020) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/ijem.ijem_225_20 · Cited by 175 · see citing works
An Association of Serotonin with Pain Disorders and Its Modulation by Estrogens
Paredes, S., Cantillo, S., Candido, K. D., & Knežević, N. N. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20225729 · Cited by 164 · see citing works
Depression and Pain: Use of Antidepressants
Bonilla-Jaime, H., Sánchez-Salcedo, J. A., Estevez-Cabrera, M. M., Molina‐Jiménez, T., Cortes-Altamirano, J. L., & Alfaro-Rodríguez, A. (2021) · Current Neuropharmacology · doi:10.2174/1570159x19666210609161447 · Cited by 159 · see citing works
Yang, H., SLOAN, G. P., Ye, Y., Wang, S., Duan, B., Tesfaye, S. H., & Gao, L. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00929 · Cited by 158 · see citing works
Update on Treatment Guideline in Fibromyalgia Syndrome with Focus on Pharmacology
Kia, S., & Choy, E. (2017) · Biomedicines · doi:10.3390/biomedicines5020020 · Cited by 152 · see citing works
Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia
Welsch, P., Üçeyler, N., Klose, P., Walitt, B. T., & Häuser, W. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010292.pub2 · Cited by 152 · see citing works
Antidepressants for pain management in adults with chronic pain: a network meta-analysis
Birkinshaw, H., Friedrich, C., Cole, P., Eccleston, C., Serfaty, M. A., Stewart, G. B., White, S. P., Moore, A., Phillippo, D., & Pincus, T. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd014682.pub2 · Cited by 153 · see citing works
Must we reduce pain intensity to treat chronic pain?
Sullivan, M. D., & Ballantyne, J. C. (2016) · Pain · doi:10.1097/j.pain.0000000000000336 · Cited by 164 · see citing works
Treatment of diabetic peripheral neuropathy: a review
Khdour, M. R. (2020) · Journal of Pharmacy and Pharmacology · doi:10.1111/jphp.13241 · Cited by 143 · see citing works
Pregabalin for pain in fibromyalgia in adults
Derry, S., Cording, M., Wiffen, P. J., Law, S., Phillips, T., & Moore, A. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011790.pub2 · Cited by 145 · see citing works
Self-citationWalitt, B. T., Klose, P., Fitzcharles, M., Phillips, T., & Häuser, W. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011694.pub2 · Cited by 143 · see citing works
Oral nonsteroidal anti-inflammatory drugs for neuropathic pain
Moore, A., Chi, C., Wiffen, P. J., Derry, S., & Rice, A. S. C. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010902.pub2 · Cited by 135 · see citing works
Self-citationAcupuncture for neuropathic pain in adults
Ju, Z., Wang, K., Cui, H. S., Yao, Y., Liu, S., Zhou, J. J., Chen, T. Y., & Xia, J. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012057.pub2 · Cited by 130 · see citing works
Safety and Efficacy of Medical Cannabis in Fibromyalgia
Sagy, I., Schleider, L. B., Abu‐Shakra, M., & Novack, V. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8060807 · Cited by 133 · see citing works
Oxycodone for neuropathic pain in adults
Gaskell, H., Derry, S., Stannard, C., & Moore, R. A. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010692.pub3 · Cited by 129 · see citing works
Morphine for chronic neuropathic pain in adults
Cooper, T. E., Chen, J., Wiffen, P. J., Derry, S., Carr, D. B., Aldington, D. J., Cole, P., & Moore, R. A. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011669.pub2 · Cited by 128 · see citing works
Self-citationRSSDI clinical practice recommendations for the management of type 2 diabetes mellitus 2017
Bajaj, S. (2018) · International Journal of Diabetes in Developing Countries · doi:10.1007/s13410-018-0604-7 · Cited by 129 · see citing works
Nortriptyline for neuropathic pain in adults
Derry, S., Wiffen, P. J., Aldington, D. J., & Moore, R. A. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011209.pub2 · Cited by 116 · see citing works
Self-citationTranscutaneous electrical nerve stimulation (TENS) for fibromyalgia in adults
Johnson, M. I., Claydon, L. S., Herbison, P., Jones, G., & Paley, C. A. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012172.pub2 · Cited by 118 · see citing works
Serotonin syndrome: Preventing, recognizing, and treating it
Wang, R. Z., Vashistha, V., Kaur, S., & Houchens, N. W. (2016) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.83a.15129 · Cited by 115 · see citing works
Ziegler, D., & Fonseca, V. A. (2014) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2014.08.008 · Cited by 111 · see citing works
Reduced Pro-Inflammatory Cytokines after Eight Weeks of Low-Dose Naltrexone for Fibromyalgia
Parkitny, L., & Younger, J. (2017) · Biomedicines · doi:10.3390/biomedicines5020016 · Cited by 112 · see citing works
Management of fibromyalgia: practical guides from recent evidence-based guidelines
Häuser, W., Ablin, J. N., Perrot, S., & Fitzcharles, M. (2017) · Polskie Archiwum Medycyny Wewnętrznej · doi:10.20452/pamw.3877 · Cited by 109 · see citing works
Treating pain in diabetic neuropathy: current and developmental drugs
Alam, U., Sloan, G., & Tesfaye, S. (2020) · Drugs · doi:10.1007/s40265-020-01259-2 · Cited by 104 · see citing works
Guy, S. D., Mehta, S., Casalino, A., Côté, I., Kras‐Dupuis, A., Moulin, D. E., Parrent, A. G., Potter, P. J., Short, C., Teasell, R. W., et al. (2016) · Spinal Cord · doi:10.1038/sc.2016.90 · Cited by 103 · see citing works
Management of diabetic neuropathy
Cernea, S., & Raz, I. (2021) · Metabolism · doi:10.1016/j.metabol.2021.154867 · Cited by 107 · see citing works
Does central sensitization help explain idiopathic overactive bladder?
Reynolds, W. M., Dmochowski, R. R., Wein, A. J., & Bruehl, S. P. (2016) · Nature Reviews Urology · doi:10.1038/nrurol.2016.95 · Cited by 99 · see citing works
Duloxetine and Subacute Pain after Knee Arthroplasty when Added to a Multimodal Analgesic Regimen
YaDeau, J. T., Brummett, C. M., Mayman, D. J., Lin, Y., Goytizolo, E. A., Padgett, D. E., Alexiades, M. M., Kahn, R. L., Jules-Elysee, K. M., Fields, K. G., et al. (2016) · Anesthesiology · doi:10.1097/aln.0000000000001228 · Cited by 98 · see citing works
Medications for alcohol use disorders: An overview
Akbar, M. D., Egli, M., Cho, Y., Song, B., & Noronha, A. (2017) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2017.11.007 · Cited by 97 · see citing works
Havelin, J., Imbert, I., Cormier, J., Allen, J., Porreca, F., & King, T. E. (2015) · Journal of Pain · doi:10.1016/j.jpain.2015.12.001 · Cited by 95 · see citing works
Combination of morphine with nortriptyline for neuropathic pain
Gilron, I., Tu, D., Holden, R. R., Jackson, A. C., & Dumerton-Shore, D. (2015) · Pain · doi:10.1097/j.pain.0000000000000149 · Cited by 94 · see citing works
Antidepressants in inflammatory bowel disease
Mikocka-Walus, A., Ford, A. C., & Drossman, D. A. (2020) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-019-0259-y · Cited by 93 · see citing works
Bruce, R. D., Merlin, J. S., Lum, P. J., Ahmed, E., Alexander, C. S., Corbett, A., Foley, K. M., Leonard, K., Treisman, G. J., & Selwyn, P. A. (2017) · Clinical Infectious Diseases · doi:10.1093/cid/cix636 · Cited by 93 · see citing works
Treating Diabetic Neuropathy: Present Strategies and Emerging Solutions
Javed, S., Alam, U., & Malik, R. A. (2015) · The Review of Diabetic Studies · doi:10.1900/rds.2015.12.63 · Cited by 92 · see citing works
Gabapentin for fibromyalgia pain in adults
Cooper, T. E., Derry, S., Wiffen, P. J., & Moore, R. A. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012188.pub2 · Cited by 92 · see citing works
Self-citationHu, S., Huang, K. M., Adams, E., Loprinzi, C. L., & Lustberg, M. B. (2019) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-18-2152 · Cited by 89 · see citing works
Fibromyalgia Syndrome in Need of Effective Treatments
Theoharides, T. C., Tsilioni, I., Arbetman, L., Panagiotidou, S., Stewart, J. M., Gleason, R. M., & Russell, I. J. (2015) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1124/jpet.115.227298 · Cited by 86 · see citing works
Buprenorphine for neuropathic pain in adults
Moore, R. A., Derry, S., Wiffen, P. J., Stannard, C., Aldington, D. J., Cole, P., & Knaggs, R. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011603 · Cited by 86 · see citing works
Self-citationNanotechnology for pain management: Current and future therapeutic interventions
Bhansali, D., Teng, S. L., Lee, C. S., Schmidt, B. L., Bunnett, N. W., & Leong, K. W. (2021) · Nano Today · doi:10.1016/j.nantod.2021.101223 · Cited by 85 · see citing works
Milnacipran for pain in fibromyalgia in adults
Cording, M., Derry, S., Phillips, T., Moore, A., & Wiffen, P. J. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008244.pub3 · Cited by 84 · see citing works
Self-citationOral nonsteroidal anti-inflammatory drugs for fibromyalgia in adults
Derry, S., Wiffen, P. J., Häuser, W., Mücke, M., Tölle, T. R., Bell, R. F., & Moore, A. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012332.pub2 · Cited by 82 · see citing works
Self-citationPain management in hidradenitis suppurativa and a proposed treatment algorithm
Savage, K. T., Singh, V., Patel, Z. S., Yannuzzi, C. A., McKenzie-Brown, A. M., Lowes, M. A., & Orenstein, L. A. V. (2020) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2020.09.039 · Cited by 86 · see citing works
Management of the multiple symptoms of irritable bowel syndrome
Simrén, M., Törnblom, H., Palsson, O. S., & Whitehead, W. E. (2017) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(16)30116-9 · Cited by 82 · see citing works
Rana, I., Khan, N., Ansari, M. M., Shah, F. A., Din, F. U., Sarwar, S., Imran, M., Qureshi, O. S., Choi, H.-I., Lee, C., et al. (2020) · Colloids and Surfaces B Biointerfaces · doi:10.1016/j.colsurfb.2020.111209 · Cited by 81 · see citing works
Lorcaserin: A review of its preclinical and clinical pharmacology and therapeutic potential
Higgins, G. A., Fletcher, P. J., & Shanahan, W. R. (2019) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2019.107417 · Cited by 79 · see citing works
Suboptimal Treatment of Diabetic Peripheral Neuropathic Pain in the United States
Yang, M., Qian, C., & Liu, Y. (2015) · Pain Medicine · doi:10.1111/pme.12845 · Cited by 78 · see citing works
Kwiatek, R. (2017) · Australian Prescriber · doi:10.18773/austprescr.2017.056 · Cited by 81 · see citing works
Oxycodone for neuropathic pain and fibromyalgia in adults
Gaskell, H., Moore, R. A., Derry, S., & Stannard, C. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010692.pub2 · Cited by 76 · see citing works
Tao, Z.-Y., Wang, P.-X., Wei, S., Traub, R. J., Li, J., & Cao, D. (2019) · Neural Plasticity · doi:10.1155/2019/1389296 · Cited by 75 · see citing works
Opioids and Sleep-Disordered Breathing
Ryswyk, E. V., & Antic, N. A. (2016) · CHEST Journal · doi:10.1016/j.chest.2016.05.022 · Cited by 74 · see citing works
Multimodale Therapie des Fibromyalgiesyndroms
Schiltenwolf, M., Eidmann, U., Köllner, V., Kuhn, T. E., Offenbächer, M., Petzke, F. W., Sarholz, M., Weigl, M. B., Wolf, B., & Häuser, W. (2017) · Der Schmerz · doi:10.1007/s00482-017-0205-2 · Cited by 71 · see citing works
Zeng, L., Alongkronrusmee, D., & van Rijn, R. M. (2017) · Journal of Pain Research · doi:10.2147/jpr.s125987 · Cited by 72 · see citing works
The impact of anxiety on chronic musculoskeletal pain and the role of astrocyte activation
Burston, J. J., Valdes, A. M., Woodhams, S. G., Mapp, P. I., Stocks, J., Watson, D. J., Gowler, P. R. W., Xu, L., Sagar, D. R., Fernandes, G., et al. (2018) · Pain · doi:10.1097/j.pain.0000000000001445 · Cited by 72 · see citing works
Current standing of plant derived flavonoids as an antidepressant
Khan, H. Z., Perviz, S., Sureda, A., Nabavi, S. M., & Tejada, S. (2018) · Food and Chemical Toxicology · doi:10.1016/j.fct.2018.04.052 · Cited by 72 · see citing works
Schlereth, T. (2020) · Neurological Research and Practice · doi:10.1186/s42466-020-00063-3 · Cited by 70 · see citing works
Perioperative Duloxetine to Improve Postoperative Recovery After Abdominal Hysterectomy
Castro‐Alves, L. J., de Medeiros, A. C. P. O., Neves, S. P., de Albuquerque, C. L. C., Módolo, N. S. P., Azevedo, V. L. D., & Oliveira, G. S. D. (2015) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000000971 · Cited by 71 · see citing works
Cannabis and pain: a scoping review
Pantoja‐Ruiz, C., Restrepo-Jiménez, P., Castañeda‐Cardona, C., Ferreirós, A., & Rosselli, D. (2021) · Brazilian Journal of Anesthesiology (English Edition) · doi:10.1016/j.bjane.2021.06.018 · Cited by 76 · see citing works
Burning through the pain: treatments for diabetic neuropathy
Javed, S., Alam, U., & Malik, R. A. (2015) · Diabetes Obesity and Metabolism · doi:10.1111/dom.12535 · Cited by 70 · see citing works
Methadone for neuropathic pain in adults
McNicol, E. D., Ferguson, M. C., & Schumann, R. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012499.pub2 · Cited by 69 · see citing works
Advances About Immunoinflammatory Pathogenesis and Treatment in Diabetic Peripheral Neuropathy
Xue, T., Zhang, X., Xing, Y., Liu, S., Zhang, L., Wang, X., & Min, Y. (2021) · Frontiers in Pharmacology · doi:10.3389/fphar.2021.748193 · Cited by 68 · see citing works
Systematic Review of Pharmacologic Treatments of Pain After Spinal Cord Injury: An Update
Mehta, S., McIntyre, A., Janzen, S. E., Loh, E., & Teasell, R. W. (2016) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2015.12.023 · Cited by 68 · see citing works
Prevention and Management Strategies for Diabetic Neuropathy
Smith, S., Normahani, P., Lane, T. R. A., Hohenschurz‐Schmidt, D., Oliver, N. S., & Davies, A. H. (2022) · Life · doi:10.3390/life12081185 · Cited by 75 · see citing works
Acupuncture for Fibromyalgia in Primary Care: A Randomised Controlled Trial
Vas, J., Santos-Rey, K., Navarro-Pablo, R., Modesto, M., Aguilar, I., Campos, M. Á., Aguilar-Velasco, J. F., Romero, M., Párraga, P., Hervás, V., et al. (2016) · Acupuncture in Medicine · doi:10.1136/acupmed-2015-010950 · Cited by 69 · see citing works
Fiorillo, A., Dell’Osso, B. M., Albert, U., Atti, A. R., Carmassi, C., Carrà, G., Cosci, F., Vecchio, V. D., Nicola, M. D., Ferrari, S., et al. (2015) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s83130 · Cited by 67 · see citing works
Fibromyalgia syndrome: epidemiology, diagnosis and treatment
Koçyiğit, B. F., & Akyol, A. (2022) · Reumatologia/Rheumatology · doi:10.5114/reum.2022.123671 · Cited by 70 · see citing works
Fentanyl for neuropathic pain in adults
Derry, S., Knaggs, R., Wiffen, P. J., Stannard, C., Aldington, D. J., Cole, P., & Moore, A. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011605 · Cited by 65 · see citing works
Self-citationCommon Functional Gastroenterological Disorders Associated With Abdominal Pain
Bharucha, A. E., Chakraborty, S., & Sletten, C. D. (2016) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2016.06.003 · Cited by 66 · see citing works
- Authors
- Lunn, M. P., Hughes, R. A., & Wiffen, P. J.
- Affiliations
- National Hospital for Neurology and Neurosurgery; Department of Neurology and MRC Centre for Neuromuscular Diseases; Queen Square London UK WC1N 3BG
- National Hospital for Neurology and Neurosurgery (GB)
- Churchill Hospital (GB)
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2014-01-03
- Volume
- 2015
- Issue
- 10
- Pages
- CD007115-CD007115
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC10711341
- OpenAlex
- W1873305365
- Cited by
- 565
- References
- 87
- Citations by year
- 2026: 19 · 2025: 30 · 2024: 42 · 2023: 42 · 2022: 58 · 2021: 58 · 2020: 53 · 2019: 46 · 2018: 44 · 2017: 57 · 2016: 50 · 2015: 46 · 2014: 19
- FWCI
- 6.71
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research (13/89/29)
- Medical Research Council (MR/K000608/1)
- Topics
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- duloxetine, serotonin-norepinephrine reuptake inhibitors, peripheral neuropathic pain, diabetic peripheral neuropathy, fibromyalgia, chronic pain, central pain, depression, adverse effects, drug safety, risk of bias, analgesia, stress urinary incontinence, major depressive disorder
- MeSH terms
- Duloxetine Hydrochloride, Adult, Analgesics, Diabetic Neuropathies, Fibromyalgia, Humans, Neuralgia, Thiophenes, Randomized Controlled Trials as Topic, Chronic Pain
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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