A Systematic Review of Efficacy, Safety, and Tolerability of Duloxetine

Daniela Rodrigues-Amorim, José Manuel Olivares, Carlos Spuch, Tania Rivera-Baltanás, Daniela Rodrigues-Amorim, José Manuel Olivares, Carlos Spuch, Tania Rivera-Baltanás

Abstract

Duloxetine is a serotonin-norepinephrine reuptake inhibitor approved for the treatment of patients affected by major depressive disorder (MDD), generalized anxiety disorder (GAD), neuropathic pain (NP), fibromyalgia (FMS), and stress incontinence urinary (SUI). These conditions share parallel pathophysiological pathways, and duloxetine treatment might be an effective and safe alternative. Thus, a systematic review was conducted following the 2009 Preferred Reporting Items (PRISMA) recommendations and Joanna Briggs Institute Critical (JBI) Appraisals guidelines. Eighty-five studies focused on efficacy, safety, and tolerability of duloxetine were included in our systematic review. Studies were subdivided by clinical condition and evaluated individually. Thus, 32 studies of MDD, 11 studies of GAD, 19 studies of NP, 9 studies of FMS, and 14 studies of SUI demonstrated that the measured outcomes indicate the suitability of duloxetine in the treatment of these clinical conditions. This systematic review confirms that the dual mechanism of duloxetine benefits the treatment of comorbid clinical conditions, and supports the efficacy, safety, and tolerability of duloxetine in short- and long-term treatments.

Keywords: clinical conditions; duloxetine; efficacy; safety; tolerability.

Copyright © 2020 Rodrigues-Amorim, Olivares, Spuch and Rivera-Baltanás.

Figures

Figure 1
Figure 1
PRISMA 2009 flow diagram of search process. MDD, major depressive disorder; GAD, generalized anxiety disorder; NP, neuropathic pain; SUI, stress urinary incontinence.
Figure 2
Figure 2
Adverse events of duloxetine-treated patients and placebo patients. Bar graph of the most common adverse effects vs. the number (N) of participants who developed them (Ntotal duloxetine-treated patients = 4,848 and Ntotal placebo patients = 3,536). The table shows the corresponding percentage.

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