Duloxetine: A Dual Serotonin‐Norepinephrine Reuptake Inhibitor for Treatment of Major Depressive Disorder
Abstract
The burden of mental illness has been underestimated worldwide. Depression was the fourth leading cause of disease burden in the world in 1990 and is projected to be the second leading cause of disability by 2020. It is a leading cause of morbidity and mortality in the United States, costing billions of dollars annually in direct and indirect medical costs and losses in productivity. Patients with major depressive disorder (MDD) may experience both psychological and medical complaints, including somatic sensations or pain. Some antidepressants have been shown to treat chronic pain syndromes, but despite the variety of antidepressants available in the United States, only 65–70% of patients respond to initial antidepressant treatment. Treatments are limited by delayed onset of antidepressant effects, side effects, partial response, and treatment resistance. Duloxetine, approved by the U.S. Food and Drug Administration for the treatment of MDD, is a reuptake inhibitor at serotonergic and noradrenergic neurons and appears to have low affinity for other neurotransmitter systems. In clinical trials, duloxetine was effective for the treatment of MDD and was well tolerated. Further study is needed to compare its efficacy with that of other antidepressants, to clarify effects on somatic symptoms, and to assess potential adverse cardiovascular and sexual side effects. Duloxetine is also approved for the management of diabetic peripheral neuropathic pain and is under investigation for the treatment of stress urinary incontinence in women.
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Side effects more specific to serotonin or norepinephrine have become a concern.
“In addition, side effects which are more specific to serotonin or norepinephrine also have become a concern.56”
From Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review (2018) · cites this paper as [6]
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- Authors
- Kirwin, J. L., & Gören, J. L.
- Affiliations
- Northeastern University (US)
- McLean Hospital (US)
- Venue
- Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
- Publisher
- Wiley
- Published
- 2005-03
- Volume
- 25
- Issue
- 3
- Pages
- 396-410
- ISSN
- 0277-0008 (ISSN-L)
- 1875-9114
- OpenAlex
- W2080466203
- Cited by
- 42
- References
- 56
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 1 · 2018: 3 · 2017: 1 · 2015: 1 · 2014: 2 · 2012: 1
- FWCI
- 2.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- duloxetine, major depressive disorder, serotonin-norepinephrine reuptake inhibitors, antidepressants, treatment-resistant depression, antidepressant efficacy, antidepressant side effects, diabetic peripheral neuropathic pain, stress urinary incontinence, somatic symptoms of depression, cardiovascular side effects, sexual side effects
- MeSH terms
- Duloxetine Hydrochloride, Adolescent, Adult, Aged, Depressive Disorder, Major, Major Depressive Disorder, Drug Interactions, Humans, Middle Aged, Thiophenes, Randomized Controlled Trials as Topic, Selective Serotonin Reuptake Inhibitors
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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.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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