Duloxetine pharmacology

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    Duloxetine pharmacology


    Paroxetine, sold under the brand names Paxil and Seroxat among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is used to treat major depressive disorder, obsessive-compulsive disorder, social anxiety disorder, panic disorder, posttraumatic stress disorder, generalized anxiety disorder and premenstrual dysphoric disorder. It has also been used in the treatment of hot flashes and night sweats associated with menopause. The United States Department of Justice fined Glaxo Smith Kline $3 billion in 2012, including a sum for withholding data on paroxetine, unlawfully promoting it for under-18s and preparing an article, following one of its clinical trials, study 329, that misleadingly reported the drug was effective in treating adolescent depression. Paroxetine is primarily used to treat major depressive disorder, obsessive-compulsive disorder, post-traumatic stress disorder, social anxiety disorder, panic disorder, generalized anxiety disorder, premenstrual dysphoric disorder and menopausal hot flashes. A variety of meta analyses have been conducted to evaluate the efficacy of paroxetine in depression. Food and Drug Administration approved low-dose paroxetine for the treatment of moderate-to-severe vasomotor symptoms such as hot flashes and night sweats associated with menopause. They have variously concluded that paroxetine is superior or equivalent to placebo and that it is equivalent or inferior to other antidepressants. Paroxetine shares many of the common adverse effects of SSRIs, including (with the corresponding rates seen in people treated with placebo in parentheses): nausea 26% (9%), diarrhea 12% (8%), constipation 14% (9%), dry mouth 18% (12%), somnolence 23% (9%), insomnia 13% (6%), headache 18% (17%), hypomania 1% (0.3%), blurred vision 4%(1%), loss of appetite 6% (2%), nervousness 5% (3%), paraesthesia 4% (2%), dizziness 13% (6%), asthenia (weakness; 15% (6%)), tremor 8% (2%), sweating 11% (2%), and sexual dysfunction (≥10% incidence). After consolidation of the antidepressive response, it is recommended to continue treatment for several months, in order to avoid relapse. Therapeutic response is usually seen after 2-4 weeks of treatment. However, there is no clinical evidence suggesting that patients not responding to the initial recommended dose may benefit from dose up-titrations. Dosages above 60 mg once daily, up to a maximum dose of 120 mg per day have been evaluated from a safety perspective in clinical trials. Major Depressive Disorder: The starting and recommended maintenance dose is 60 mg once daily with or without food. In patients responding to duloxetine, and with a history of repeated episodes of major depression, further long-term treatment at a dose of 60 to 120 mg/day could be considered. Generalised Anxiety Disorder: The recommended starting dose in patients with generalised anxiety disorder is 30 mg once daily with or without food.

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    Mechanism of action, side effects, contraindications and dosage of urological drugs, from the online textbook of urology by D. Manski Duloxetine is a dual antidepressant that binds selectively with high affinity to both NA and 5-HT transporters Karpa et al. 2002 and equipotently inhibits the reuptake of 3 H 5-HT and 3 H. Duloxetine is a potent dual inhibitor of serotonin and norepinephrine reuptake and is currently approved in the United States for the treatment of major depressive disorder, generalized anxiety disorder, diabetic peripheral neuropathic pain, and fibromyalgia.

    ; Eli Lilly and Co.) is classified as a selective serotonin and norepinephrine reuptake inhibitor (SSNRI). It was approved by the Food and Drug Administration (FDA) in August 2004 for the treatment of major depressive disorder (MDD) and one month later received an indication for the treatment of peripheral neuropathic pain associated with diabetic neuropathy (DN). MDD is characterized by a depressed mood or loss of interest in activities for a minimum of 2 weeks. At least four other symptoms must be experienced by the patient and may include fatigue, change in sleep patterns or appetite, impaired concentration, feelings of guilt, or periodic thoughts of death or suicide. MDD may manifest as unipolar depression, referring only to the periodic occurrence of depressive symptoms, or as bipolar depression, where depressive symptoms alternate with manic episodes consisting of a combination of increased psychomotor activity, decreased need for sleep, and delusional, grandiose, paranoid, or psychotic behavior. A possible cause of depression is a medical illness, either through psychological stress, the disease itself, or the pharmacological treatment. Neuroendocrine hormonal variations can also contribute to the etiology of MDD, especially when combined with environmental stressors (e.g., death of a relative, assault, or severe relationship issues). Unfortunately, many sections of the German textbook are not translated yet. As a workaround, you can use the Google Translator function for this website (original German link: Medikamente).

    Duloxetine pharmacology

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    Duloxetine Cymbalta, Yentreve a serotonin-norepinephrine reuptake inhibitor for major depression. Australian prescriber review. The onset of efficacy was defined as a 20% sustained reduction in the patient’s score on the Hamilton Rating Scale for Depression Maier subscale, by the second week of treatment. Among Duloxetine-Treated Patients in Placebo-Controlled. 17.1 Information on Medication Guide Trials. 17.2 Clinical Worsening and Suicide Risk F = FormularyAWP = Average Wholesale Price. Formulary Status. Cymbalta ® was added to The Cleveland Clinic Foundation Formulary of Accepted Drugs in October 2004. Conclusion. Duloxetine is a new member of the SSNRI class of antidepressants. It is FDA-approved for the treatment of MDD and DN and is currently being evaluated for women with SUI.

     
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