-
International Journal of Molecular... Dec 2017Oxaliplatin is a widely used chemotherapy agent, but induces serious peripheral neuropathy. Duloxetine is a dual reuptake inhibitor of serotonin and norepinephrine, and...
Oxaliplatin is a widely used chemotherapy agent, but induces serious peripheral neuropathy. Duloxetine is a dual reuptake inhibitor of serotonin and norepinephrine, and is shown to be effective against pain. However, whether and how duloxetine can attenuate oxaliplatin-induced allodynia in rodents is not clearly understood. A single injection of oxaliplatin (6 mg/kg, intraperitoneal; i.p.) induced a cold and mechanical allodynia, which was assessed by acetone and von Frey filament tests, respectively. When significant allodynic signs were observed, three different doses of duloxetine (10, 30, and 60 mg/kg, i.p.) were injected. Administration of 30 and 60 mg/kg of duloxetine significantly reduced the allodynia, whereas 10 mg/kg did not. By using an in vivo extracellular recording method, we further confirmed that 30 mg/kg of duloxetine could significantly inhibit the hyperexcitability of spinal wide dynamic range (WDR) cells. The anti-allodynic effect of duloxetine was completely blocked by an intrathecal injection of phentolamine (non-selective α-adrenergic receptor antagonist, 20 μg), or prazosin (α₁-adrenergic receptor antagonists, 10 μg); however, idazoxan (α₂-adrenergic receptor antagonist, 10 μg) did not block it. In conclusion, we suggest that duloxetine may have an effective protective action against oxaliplatin-induced neuropathic pain and spinal hyperexcitability, which is mediated by spinal α₁-adrenergic receptors.
Topics: Adrenergic alpha-2 Receptor Antagonists; Animals; Duloxetine Hydrochloride; Male; Mice; Mice, Inbred C57BL; Neuralgia; Neurons; Organoplatinum Compounds; Oxaliplatin; Rats; Rats, Sprague-Dawley; Spinal Cord
PubMed: 29206213
DOI: 10.3390/ijms18122626 -
Journal of Clinical Psychopharmacology
Topics: Adolescent; Antipsychotic Agents; Aripiprazole; Dopamine Agents; Drug Therapy, Combination; Duloxetine Hydrochloride; Humans; Male; Schizophrenia; Treatment Outcome
PubMed: 33347030
DOI: 10.1097/JCP.0000000000001313 -
BMJ Clinical Evidence Apr 2009Stress incontinence, involving involuntary leaking of urine on effort, exertion, sneezing, or coughing, affects 17-45% of adult women. Risk factors include pregnancy... (Review)
Review
INTRODUCTION
Stress incontinence, involving involuntary leaking of urine on effort, exertion, sneezing, or coughing, affects 17-45% of adult women. Risk factors include pregnancy (especially with vaginal delivery), smoking, and obesity.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-surgical treatments and surgical treatments for women with stress incontinence? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 97 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: adrenoceptor agonists, anterior vaginal repair, laparoscopic colposuspension, needle suspension, oestrogen supplements, pelvic floor electrical stimulation, pelvic floor muscle exercises, retropubic colposuspension, selective serotonin reuptake inhibitors (duloxetine), suburethral slings, tension-free vaginal tape, transobturator foramen procedures, and vaginal cones.
Topics: Duloxetine Hydrochloride; Humans; Pelvic Floor; Selective Serotonin Reuptake Inhibitors; Suburethral Slings; Urinary Incontinence, Stress; Urologic Surgical Procedures; Vagina
PubMed: 19445750
DOI: No ID Found -
The Korean Journal of Internal Medicine Sep 2019About 21% of adults with osteoarthritis (OA) are diagnosed with concomitant depression in addition to chronic pain. Duloxetine, an anti-depressant medication, has been... (Meta-Analysis)
Meta-Analysis
About 21% of adults with osteoarthritis (OA) are diagnosed with concomitant depression in addition to chronic pain. Duloxetine, an anti-depressant medication, has been recently approved for managing Knee OA. We performed a systematic review to ascertain the efficacy and safety of duloxetine for OA. We searched MEDLINE, EMBASE, Web of Science, Google Scholar, and the Cochrane Database from inception to December 2018. Randomized clinical trials (RCTs) assessing the efficacy and/or safety of duloxetine versus placebo in OA patients were included. Data extraction and quality assessment were undertaken by two independent reviewers. Seven RCTs (n = 2,102 participants) met our inclusion criteria, and five RCTs (n = 1,713) were eligible for meta-analysis. The results of our analyses indicate that duloxetine has statistically significant, moderate benefits on pain, function, and quality of life in knee OA patients for up to 13 weeks. Reported incidences of gastrointestinal adverse events were three to four times higher in participants who received duloxetine versus placebo. Duloxetine may be an effective treatment option for individuals with knee OA, but use of the drug is associated with a significantly higher risk of adverse events. Patient preferences and clinicians' judgment must be considered before the initiation of duloxetine.
Topics: Aged; Antirheumatic Agents; Duloxetine Hydrochloride; Female; Humans; Male; Middle Aged; Osteoarthritis, Knee; Quality of Life; Remission Induction; Risk Factors; Treatment Outcome
PubMed: 30871298
DOI: 10.3904/kjim.2018.460 -
Journal of Gastrointestinal Cancer Jun 2023Peripheral neuropathy is a dose-limiting adverse effect of oxaliplatin. The aim of this study was to evaluate the efficacy and safety of duloxetine in the prevention of... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
Peripheral neuropathy is a dose-limiting adverse effect of oxaliplatin. The aim of this study was to evaluate the efficacy and safety of duloxetine in the prevention of oxaliplatin-induced peripheral neuropathy (OIPN).
METHOD
Cancer patients receiving oxaliplatin based chemotherapy were randomized into two arms. Duloxetine 60 mg capsule was given in the first 14 days of each chemotherapy cycle to one arm and placebo was similarly given to another. We compared the two arms based on the incidence of neuropathy and the results of the nerve conduction study (NCS). Grade of complained neuropathy was recorded according to Common Terminology Criteria for Adverse Events (CTCAE).
RESULTS
Thirty-two patients mostly rectal cancer (90.6%) were randomized to duloxetine and placebo arms. Highest grade of neuropathy in each cycle was not significantly different between the two groups. Six weeks after treatment incidence of neuropathy of any grade was 52.9 in duloxetine arm compared to 76.9% in placebo arm (P: 0.26). Patients in the duloxetine arm had a lower percentage of chemotherapy cycles (mean) in which they reported distal paresthesia (51% vs. 84%, P = 0.01) and throat discomfort (37% vs. 69%, P = 0.01). Results of NCS were mostly comparable between the two arms except for the velocity in two of the examined nerve which was significantly higher in duloxetine group. Duloxetine was safe and well-tolerated.
CONCLUSION
Although a definite conclusion might be difficult to draw but administering duloxetine for 14 days in each chemotherapy cycle could not decrease the incidence of acute OIPN based on CTCAE grading system.
Topics: Humans; Oxaliplatin; Duloxetine Hydrochloride; Peripheral Nervous System Diseases; Double-Blind Method
PubMed: 35426033
DOI: 10.1007/s12029-022-00824-0 -
Lancet (London, England) Aug 2022
Topics: Duloxetine Hydrochloride; Humans; Treatment Outcome
PubMed: 36007533
DOI: 10.1016/S0140-6736(22)01526-4 -
Human Psychopharmacology Mar 2022The aim of this study was evaluation of the association between severity of pain and expression of total or ubiquitinated serotonin transporter (SERT) protein in...
OBJECTIVE
The aim of this study was evaluation of the association between severity of pain and expression of total or ubiquitinated serotonin transporter (SERT) protein in patients with burning mouth syndrome and atypical odontalgia (BMS/AO), who were treated by duloxetine.
METHODS
Patients with BMS/AO were assessed for severity of pain using the visual analog scale (VAS), and expression of total and ubiquitinated SERT protein in platelets before (baseline) and 12 weeks after duloxetine-treatment.
RESULTS
The expression of total and ubiquitinated SERT protein at baseline in all patients (n = 33) were higher and lower, respectively, compared to those in healthy controls. 12 weeks after duloxetine-treatment, there was no difference in the total SERT protein levels between patients (n = 21) and healthy controls. In the 16 patients who could be measured, mean VAS scores and total SERT protein levels were significantly decreased after the treatment, compared to those at baseline. There was tendency for a positive correlation between total SERT protein levels and VAS scores in these patients.
CONCLUSIONS
Our findings indicate that duloxetine relieves pain in association with downregulation of platelet SERT expression in patients with BMS/AO.
Topics: Burning Mouth Syndrome; Down-Regulation; Duloxetine Hydrochloride; Humans; Serotonin Plasma Membrane Transport Proteins; Toothache
PubMed: 34541697
DOI: 10.1002/hup.2818 -
Schmerz (Berlin, Germany) Aug 2017The perception of the media is that chemotherapy is mainly associated with nausea, vomiting and hair loss. In the longer term the development of peripheral neuropathy,... (Review)
Review
The perception of the media is that chemotherapy is mainly associated with nausea, vomiting and hair loss. In the longer term the development of peripheral neuropathy, i.e. chemotherapy-induced peripheral neuropathy (CIPN) is often more important for patients. The CIPN represents a side effect of many antineoplastic substances with severe functional impairment and its prevention and treatment is an important task. In addition to many interventions, which have been shown to be ineffective, physiotherapeutic measures and possibly the prophylactic application of cold are helpful for prevention. Randomized studies on the treatment of painful CIPN provided positive data for duloxetine and to a lesser extent for venlafaxine.
Topics: Antineoplastic Agents; Cryotherapy; Duloxetine Hydrochloride; Humans; Neuralgia; Peripheral Nervous System Diseases; Physical Therapy Modalities; Randomized Controlled Trials as Topic; Venlafaxine Hydrochloride
PubMed: 28293734
DOI: 10.1007/s00482-017-0198-x -
Journal of Chromatographic Science Jul 2012A high-performance liquid chromatographic (HPLC) method is described for the determination of duloxetine hydrochloride in capsules. The method was based on pre-column...
A high-performance liquid chromatographic (HPLC) method is described for the determination of duloxetine hydrochloride in capsules. The method was based on pre-column derivatization with 4-chloro-7-nitrobenzo-2-oxa-1,3-diazole using the fluorimetric detection technique. Duloxetine hydrochloride was analyzed by HPLC using an Inertsil C18 column (5 μm, 150 × 4.6 mm) and mobile phase consisted of methanol and water (65:35, v/v). The fluorescence detector was adjusted at excitation and emission wavelengths of 461 and 521 nm, respectively. The linearity of the method was in the range of 10-600 ng/mL. Limits of detection and quantification were 0.51 and 1.53 ng/mL, respectively. The proposed method was successfully applied for determination of duloxetine hydrochloride in its pharmaceutical preparation. The results were in good agreement with those obtained using a reference method.
Topics: Antidepressive Agents; Capsules; Chromatography, High Pressure Liquid; Duloxetine Hydrochloride; Spectrometry, Fluorescence; Thiophenes
PubMed: 22511287
DOI: 10.1093/chromsci/bms034 -
Archives of Pharmacal Research Dec 2015In this study, the enteric-coated delayed-release pellets of duloxetine hydrochloride (DLX) were formulated using a fluidized bed coater. Three separate layers, the drug...
In this study, the enteric-coated delayed-release pellets of duloxetine hydrochloride (DLX) were formulated using a fluidized bed coater. Three separate layers, the drug layer, the barrier layer, and the enteric layer, were coated onto inert core pellets. Among the three formulations (F1-F3), the dissolution profiles of formulation F2 were most similar to those of the marketed product, with similarity and difference factors of 83.99 and 3.77, respectively. In addition, pharmacokinetic parameters of AUC, C(max), T(max), t(1/2), K(el), and MRT of DLX for the developed formulation (F2) did not differ significantly from those for the marketed product in beagle dogs, suggesting that they were bioequivalent. Our results demonstrated that the in vitro dissolution data resembled the in vivo performance of the drug. Therefore, this study has a positive scope for further scale up and development of the formulation for achievement of the generic product.
Topics: Animals; Chemistry, Pharmaceutical; Delayed-Action Preparations; Dogs; Drug Evaluation, Preclinical; Drug Implants; Duloxetine Hydrochloride; Tablets, Enteric-Coated
PubMed: 26183280
DOI: 10.1007/s12272-015-0590-y