Duloxetine improves depression-related pain

NEW YORK (Reuters Health) - Treatment with duloxetinerelieves pain in patients with major depressive disorder,according to a report in the Journal of Clinical Psychiatry.
Duloxetine is used to treat depression and generalizedanxiety disorder. It is also used to treat pain and tinglingcaused by diabetic neuropathy.
The drug belongs to a class of medications called selectiveserotonin and norepinephrine reuptake inhibitors and works byincreasing brain levels of serotonin and norepinephrine,natural substances that help maintain mental balance and blockpain signals.
Painful physical symptoms in depression receive inadequateattention, note Dr. Stephan Brecht from Boehringer Ingelheim,Germany and colleagues. The investigators therefore evaluatedthe effectiveness of duloxetine compared with placebo fortreating pain in 327 patients with moderate-to-severe painassociated with depression.
After 8 weeks of treatment, the pain improved significantlymore in patients treated with duloxetine than in those whoreceived placebo, the authors report. Patients receivingduloxetine also experienced greater improvements in thecategories of "worst pain," "least pain," and "pain-right-now."
The effects of duloxetine treatment were significant asearly as week 1, and duloxetine patients achieved sustainedresponses faster than did placebo patients.
The response rates for the reduction of average pain levelsat week 8 were higher for duloxetine patients (60.3 percent)than for placebo patients (44.0 percent), the researchers note,and improvements in daily functioning were significantly betterfor duloxetine patients.
Depression severity was also significantly reduced by 8weeks of treatment with duloxetine, compared with placebo, theinvestigators add.
Duloxetine patients reported more adverse events than didplacebo patients, with nausea, excessive perspiration, and drymouth being the most commonly reported treatment-related sideeffects.
The investigators conclude that these results support theeffectiveness and tolerability of duloxetine in the treatmentof both pain and depression in patients who havemoderate-to-severe pain associated with depression.
SOURCE: Journal of Clinical Psychiatry, November 2007.