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FORMULARY FORUM

Duloxetine: A Dual Reuptake Inhibitor

Psychiatry Pharmacy Resident, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Brecksville, OH; Assistant Professor of Pharmacy Practice, Albany College of Pharmacy, Albany, NY

Matthew A Fuller, PharmD BCPS BCPP FASHP

Clinical Pharmacy Specialist, Psychiatry, Louis Stokes Cleveland Department of Veterans Affairs Medical Center; Associate Clinical Professor of Psychiatry, Clinical Instructor of Psychology, School of Medicine, Case Western Reserve University, Cleveland, OH; Adjunct Associate Professor of Clinical Pharmacy, College of Pharmacy, University of Toledo, Toledo, OH

Reprints: Matthew A Fuller PharmD BCPS BCPP FASHP, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Pharmacy 119B, 10000 Brecksville Rd., Brecksville, OH 44141-3204, fax 440/546-2706

OBJECTIVE: To review the pharmacology, pharmacokinetics, clinical efficacy, and safety profile of duloxetine for the treatment of major depressive disorder (MDD).

DATA SOURCES: Searches using MEDLINE and PsycINFO were conducted (1966 to November 2003).

STUDY SELECTION AND DATA EXTRACTION: All duloxetine MDD information gathered was considered. Articles containing comprehensive information regarding duloxetine use for MDD were evaluated.

DATA SYNTHESIS: Duloxetine is a serotonin–norepinephrine reuptake inhibitor being considered for treatment of MDD and stress urinary incontinence. While approved dosing ranges have not yet been determined, studies support the efficacy and safety of 40–60 mg twice daily for the treatment of acute MDD. Adverse effects have been of mild to moderate severity and are considered to be transient. Cardiovascular effects (increased heart rate or blood pressure), while present, do not appear to be clinically significant. Overall, duloxetine appears to be well tolerated.

CONCLUSIONS: Duloxetine is a safe and effective antidepressant. Approval of this agent provides another treatment option for the management of MDD.

Key Words: duloxetine, major depressive disorder, serotonin–norepinephrine reuptake inhibitor

Published Online, November 2, 2004. www.theannals.com, DOI 10.1345/aph.1E084

THIS ARTICLE IS APPROVED FOR CONTINUING EDUCATION CREDIT
ACPE UNIVERSAL PROGRAM NUMBER: 407-000-04-036-H01

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