ISSUE 1363
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Previously approved by the FDA for treatment of depression, general anxiety disorder, diabetic peripheral neuropathic pain and fibromyalgia,1,2 duloxetine (Cymbalta – Lilly) has now also been approved for treatment of chronic musculoskeletal pain.
MECHANISM OF ACTION — Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor (SNRI). Its mechanism of action in reducing pain is unknown.
CLINICAL STUDIES — Chronic Low Back Pain – Three double-blind, randomized, 3-month trials of duloxetine in a total of >1000 patients with chronic (≥6 months) low back pain have been published and are summarized in the package insert.3-5 All were conducted by employees of the manufacturer. Two of the three trials found duloxetine more effective than placebo in reducing pain, as measured by Brief Pain
... more1. Duloxetine (Cymbalta) for diabetic neuropathic pain. Med Lett Drugs Ther 2005; 47:67.
2. Duloxetine (Cymbalta) for fibromyalgia. Med Lett Drugs Ther 2008; 50:57.
8. GG Briggs et al. Use of duloxetine in pregnancy and lactation. Ann Pharmacother 2009; 43:1898.
9. Retail cost at drugstore.com. Accessed April 21, 2011.
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