Duloxetine is an antidepressant and increases the level of norepinephrine and serotonin and increases the mood and mood. Duloxetine is therefore used mainly in the treatment of depression. Another major application is stress urinary incontinence in women, as the active ingredient strengthens the bladder and pelvic floor muscles. Learn more about the effects, side effects and dosage of Duloxetine.
Other uses of Duloxetine
Duloxetine is also used in diabetic polyneuropathy. Due to its analgesic effect it helps with the diabetes-induced nerve pain (neuropathy).
In the US, duloxetine is also approved for the treatment of fibromyalgia, a muscle pain syndrome. In Germany, use in this indication was rejected by the European Medicines Agency (EMA) in 2008.
Dose and deposit duloxetine
How many capsules of duloxetine should be taken daily should be decided by the attending physician. As a rule, this will be a psychiatric specialist. The amount of the dose depends on the age, sex, height, weight and smoking status.
A typical starting dose is 60 mg once daily followed by a continuous increase to a maintenance dose of 120 mg.
It is important not to abruptly discontinue the drug, but to sneak out, otherwise serious side effects threaten.
Side effects of Duloxetine
The most common side effects with Duloxetine include:
- Diarrhea and constipation
- a headache
- a dry mouth
- loss of appetite
In addition, visual disturbances, tremors and sleep disorders can occur. Increased levels of norepinephrine can cause sweating and hot flashes, increased blood pressure, urinary retention and erectile dysfunction.
A particularly critical side effect arises from the initial drive increase of the drug. Since this effect begins before the mood-enhancing effect, there is a risk of suicide attempts in the first two weeks after the start of therapy, which is why one should be closely supervised by a specialist during this time.
Interactions with Duloxetine
Duloxetine should not be combined with certain other antidepressants, which also increase serotonin levels. Otherwise it threatens the life-threatening serotonin syndrome, which is manifested by palpitations, fever and nausea.
It is also important to avoid concomitant intake of centrally attenuating substances such as benzodiazepines, opiates and alcohol.
Contraindications of the active substance
The following contraindications should be noted when taking Duloxetine:
- MAO inhibitors such as selegelin or tranylcypromine
- Serotonergic drugs, for example, venlafaxine, fluoxetine, citalopram
- Certain antibiotics such as ciprofloxacin or enoxacin
- St. John's Wort
- Liver and kidney dysfunction
- An allergy to the active ingredient duloxetine
- Children younger than 18 years
- Uncontrolled high blood pressure
There is no absolute contraindication in pregnancy and lactation, but no recommendation for use as there are no studies for duloxetine in these circumstances.
Instructions for taking Duloxetine
The intake of duloxetine capsules should be independent of the meals. With regard to the duration of use, it should be noted that duloxetine should be taken for at least six months in order to observe an effect.
Duloxetine is a so-called "serotonin norepinephrine reuptake inhibitor" (SNRI). The drug group of SNRI, which also includes venlafaxine, is effective in the central nervous system. Here, a complex interaction of different hormones and messenger substances (neurotransmitters) takes place. The neurotransmitters serotonin and norepinephrine play an important role.
Serotonin is found throughout the body and has several functions. Among other things, it is responsible for the feeling of happiness in the brain. Norepinephrine is a stress hormone that affects blood pressure and heart rate. It has a drive-enhancing and activating effect on the nerve cells.
Mechanism of action of duloxetine
In the nerve cells, serotonin and norepinephrine are released into the so-called "synaptic cleft", which is located between two communicating nerve cells. By docking to the receptors of the subsequent nerve cell, the neurotransmitters unfold their effect.
Duloxetine prevents the reuptake of the two messengers back into the cell of origin and thus ensures a consistently high concentration and a widespread effect. By increasing the concentration of norepinephrine, analgesic nerve tracts in the spinal cord are stimulated, so that the body's own pain relief is activated.