Duloxetine in the management of diabetic peripheral neuropathic pain
Michelle J Ormseth, Beth A Sholz, Chad S BoomershineDivision of Rheumatology and Immunology, Vanderbilt University, Nashville, TN, USAAbstract: Diabetic neuropathy affects up to 70% of diabetics, and diabetic peripheral neuropathic pain (DPNP) is the most common and debilitating of the diabetic neur...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2011-07-01
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| Series: | Patient Preference and Adherence |
| Online Access: | http://www.dovepress.com/duloxetine-in-the-management-of-diabetic-peripheral-neuropathic-pain-a7900 |
| _version_ | 1818112192435716096 |
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| author | Boomershine CS Scholz BA Ormseth MJ |
| author_facet | Boomershine CS Scholz BA Ormseth MJ |
| author_sort | Boomershine CS |
| collection | DOAJ |
| description | Michelle J Ormseth, Beth A Sholz, Chad S BoomershineDivision of Rheumatology and Immunology, Vanderbilt University, Nashville, TN, USAAbstract: 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 |
| first_indexed | 2024-12-11T03:15:02Z |
| format | Article |
| id | doaj.art-30ea2ea919784c219ea3bc1f3f5460bd |
| institution | Directory Open Access Journal |
| issn | 1177-889X |
| language | English |
| last_indexed | 2024-12-11T03:15:02Z |
| publishDate | 2011-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Patient Preference and Adherence |
| spelling | doaj.art-30ea2ea919784c219ea3bc1f3f5460bd2022-12-22T01:22:47ZengDove Medical PressPatient Preference and Adherence1177-889X2011-07-012011default343356Duloxetine in the management of diabetic peripheral neuropathic painBoomershine CSScholz BAOrmseth MJMichelle J Ormseth, Beth A Sholz, Chad S BoomershineDivision of Rheumatology and Immunology, Vanderbilt University, Nashville, TN, USAAbstract: 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, treatmenthttp://www.dovepress.com/duloxetine-in-the-management-of-diabetic-peripheral-neuropathic-pain-a7900 |
| spellingShingle | Boomershine CS Scholz BA Ormseth MJ Duloxetine in the management of diabetic peripheral neuropathic pain Patient Preference and Adherence |
| title | Duloxetine in the management of diabetic peripheral neuropathic pain |
| title_full | Duloxetine in the management of diabetic peripheral neuropathic pain |
| title_fullStr | Duloxetine in the management of diabetic peripheral neuropathic pain |
| title_full_unstemmed | Duloxetine in the management of diabetic peripheral neuropathic pain |
| title_short | Duloxetine in the management of diabetic peripheral neuropathic pain |
| title_sort | duloxetine in the management of diabetic peripheral neuropathic pain |
| url | http://www.dovepress.com/duloxetine-in-the-management-of-diabetic-peripheral-neuropathic-pain-a7900 |
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