Duloxetine in the treatment of generalized anxiety disorder.
AuthorNorman, TR; Olver, JS
Source TitleNeuropsychiatric Disease and Treatment
PublisherInforma UK Limited
Document TypeJournal Article
CitationsNorman, T. R. & Olver, J. S. (2008). Duloxetine in the treatment of generalized anxiety disorder.. Neuropsychiatr Dis Treat, 4 (6), pp.1169-1180. https://doi.org/10.2147/ndt.s2820.
Access StatusAccess this item via the Open Access location
Open Access URLPublished version
Open Access at PMChttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2646646
C1 - Journal Articles Refereed
Duloxetine, a medication with effects on both serotonin and noradrenaline transporter molecules, has recently been approved for the treatment of generalized anxiety disorder. The evidence for its efficacy lies in a limited number of double blind, placebo controlled comparisons. Statistically significant improvements in the Hamilton Anxiety Rating Scale from baseline were demonstrated in all studies at doses of 60 to 120 mg per day. The significance of such changes in terms of clinical improvements compared to placebo is less certain, particularly when the effect size of the change is calculated. In comparative trials with venlafaxine, duloxetine was as effective in providing relief of anxiety symptoms. In addition to improvements in clinical symptoms duloxetine has also been associated with restitution of role function as measured by disability scales. Duloxetine use is associated with nausea, dizziness, dry mouth, constipation, insomnia, somnolence, hyperhidrosis, decreased libido and vomiting. These treatment emergent side effects were generally of mild to moderate severity and were tolerated over time. Using a tapered withdrawal schedule over two weeks in the clinical trials, duloxetine was associated with only a mild withdrawal syndrome in up to about 30% of patients compared to about 17% in placebo treated patients. Duloxetine in doses of up to 200 mg twice daily did not prolong the QTc interval in healthy volunteers. Like other agents with dual neurotransmitter actions duloxetine reduces the symptoms of generalized anxiety disorder in short term treatments. Further evidence for its efficacy and safety in long term treatment is required.
KeywordsClinical Pharmacology and Therapeutics; Nervous System and Disorders
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