-
Patient Preference and Adherence
- About Dovepress
Open access peer-reviewed scientific and medical journals.
- Open Access
Dove Medical Press is now a member of the Open Access Initiative
- An Author's Guide
A guide to help authors get their paper published.
- Advocacy
Support Open Access and Dove Press
- Reprints
Promotional Article Monitoring - further details
- Favored Author Program
Real benefits for authors, including fast-track processing of papers.
Duloxetine in the management of diabetic peripheral neuropathic pain
Review
(9616) Total Article Views
Authors: Ormseth MJ, Scholz BA, Boomershine CS
Published Date July 2011 Volume 2011:5 Pages 343 - 356
DOI: http://dx.doi.org/10.2147/PPA.S16358
Michelle J Ormseth, Beth A Sholz, Chad S BoomershineDivision of Rheumatology and Immunology, Vanderbilt University, Nashville, TN, USA
Abstract: Diabetic neuropathy affects up to 70% of diabetics, and diabetic peripheral neuropathic pain (DPNP) is the most common and debilitating of the diabetic neuropathies. DPNP significantly reduces quality of life and increases management costs in affected patients. Despite the impact of DPNP, management is poor with one-quarter of patients receiving no treatment and many treated with medications having little or no efficacy in managing DPNP. Duloxetine is one of two drugs approved by the United States Food and Drug Administration for DPNP management. Duloxetine is a serotonin and norepinephrine reuptake inhibitor (SNRI) proven safe, effective, and cost-saving in reducing DPNP symptoms at a dose of 60 mg/day. Duloxetine doses greater than 60 mg/day for DPNP management are not recommended since they are no more efficacious and associated with more side effects; addition of pregabalin or gabapentin for these patients may be beneficial. Side effects of duloxetine are generally mild and typical for the SNRI class including nausea, dizziness, somnolence, fatigue, sweating, dry mouth, constipation, and diarrhea. Given its other indications, duloxetine is a particularly good choice for DPNP treatment in patients with coexisting depression, anxiety, fibromyalgia, or chronic musculoskeletal pain. Duloxetine treatment had no clinically significant effect on glycemic control and did not increase the risk of cardiovascular events in diabetes patients. However, duloxetine use should be avoided in patients with hepatic disease or severe renal impairment. Given its safety, efficacy, and tolerability, duloxetine is an excellent choice for DPNP treatment in many patients.
Keywords: duloxetine, diabetic peripheral neuropathic pain, review, treatment
Post to:
Cannotea Citeulike Del.icio.us Facebook LinkedIn Twitter
Other articles by Dr Chad Boomershine
Readers of this article also read:
- Testimonials
"I was impressed at the rapidity of publication from submission to final acceptance." Dr Edwin Thrower, PhD, Yale University.
- Health literacy and health seeking behavior among older men in a middle-income nation
- Prolonged rupture of membranes in term infants: should all babies be screened?
- Increasing access to quality health care for the poor: Community perceptions on quality care in Uganda
- Narcissistic rage: The Achilles’ heel of the patient with chronic physical illness