Duloxetine in the treatment of diabetic peripheral neuropathic pain

Diabetic peripheral neuropathic pain is a common complication of diabetes mellitus that adversely affects the quality of life of these patients. Many antidepressants and anticonvulsants are effective in relieving diabetic peripheral neuropathic pain. Duloxetine, a dual serotonin and norepinephrine reuptake inhibitor, was very effective in reducing diabetic peripheral neuropathic pain and improving quality of life and was the first antidepressant approved by regulatory authorities for the treatment of diabetic peripheral neuropathic pain. Safety was evaluated in 1074 diabetic peripheral neuropathic pain patients representing 472 patient-years exposure. More duloxetine-treated (79/568, 13.9%) than placebo-treated (16/223, 7.2%; p = 0.008) patients discontinued owing to adverse events. Duloxetine should be used with similar cautions to the newer antidepressants. In addition, rare duloxetine-induced hepatic enzyme elevations should result in discontinuation of duloxetine therapy. Duloxetine should prove effec...