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GENERIC NAME: duloxetine
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DRUG CLASS AND MECHANISM: Duloxetine is known as a selective serotonin and norepinephrine reuptake inhibitor (SNRI) used in treating depression, panic and pain affiliated with diabetic peripheral neuropathy or fibromyalgia. Other drugs within this class include milnacipran (Savella), venlafaxine (Effexor), and desvenlafaxine (Pristiq). Duloxetine affects neurotransmitters, the substances that nerves inside the brain make and release in order to talk to the other person. Neurotransmitters either travel around the space between nerves and connect to receptors at first of nearby nerves or they follow receptors on top belonging to the nerves that produced them, to generally be taken up because of the nerve and released again (an operation referred to as re-uptake).

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Most professionals feel that an imbalance among neurotransmitters will be the cause of depression along with psychiatric disorders. Serotonin and norepinephrine are two neurotransmitters released by nerves whilst in the brain. Duloxetine functions preventing the reuptake of serotonin and epinephrine by nerves if they have been released. Since uptake can be a mechanism for removing released neurotransmitters and terminating their actions on adjacent nerves, reduced uptake because of duloxetine boosts the effect of serotonin and norepinephrine using the brain. The mechanism the reason for its effectiveness treating pain isn't known and also is thought to involve its effects on serotonin and norepinephrine inside brain. Duloxetine was licensed through the FDA in August 2004.

PREPARATIONS: Delayed-release capsules: 20, 30, and 60 mg

STORAGE: Capsules needs to be stored at room temperature, between 15 to 30 C (59 to 86 F).

PRESCRIBED FOR: Duloxetine is required for the treatment of depression, generalized panic, and pain related to diabetic peripheral neuropathy or fibromyalgia.

DOSING: The recommended dose for the treatment depression is 20 or 30 mg two times a day or 60 mg once daily. Patients might be began with 30 mg once daily first week before the dose is advanced to 60 mg daily. The recommended dose for panic attacks, pain related to diabetic neuropathy or fibromyalgia is 60 mg daily. There is absolutely no evidence that doses more than 60 mg/day provide additional benefits.

DRUG INTERACTIONS: Duloxetine should not be utilized in together with a monoamine oxidase inhibitor (MAOI) like phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and selegiline (Eldepryl), or within Fourteen days of discontinuing the MAOI. Not less than 5 days must be allowed after stopping duloxetine prior to starting an MAOI. Mixtures of SNRIs and MAOIs may result in serious, sometimes fatal, reactions including huge temperature, muscle rigidity, rapid fluctuations of pulse and high blood pressure, extreme agitation progressing to delirium, and coma. Similar reactions can happen if duloxetine is combined with antipsychotics, tricyclic antidepressants or another drugs which affect serotonin with the brain (by way of example, tryptophan, and sumatriptan (Imitrex).