Duloksetin

Duloksetin, also spelled duloksetin in Turkish, is a prescription antidepressant in the serotonin-norepinephrine reuptake inhibitor (SNRI) class. It increases the levels of the neurotransmitters serotonin and norepinephrine in the central nervous system by blocking their reuptake, with some activity on dopamine reuptake. This mechanism is associated with relief of depressive and certain chronic pain symptoms.

Duloksetin is approved for multiple conditions, most notably major depressive disorder and generalized anxiety disorder. It is also used for painful diabetic neuropathy, fibromyalgia, and chronic musculoskeletal pain such as osteoarthritis or low back pain. The choice of use depends on the clinical presentation and prior treatment response.

The drug is taken orally. Duloksetin is largely metabolized in the liver via the cytochrome P450 systems, principally CYP1A2 and CYP2D6, producing inactive metabolites that are excreted in urine and feces. The elimination half-life is approximately 12 hours, which informs dosing frequency and gradual withdrawal after discontinuation. Dose adjustments may be needed in liver impairment or older patients, and it should be used with caution in hepatic disease.

Common adverse effects include nausea, dry mouth, fatigue, dizziness, insomnia or sleep disturbance, constipation or decreased appetite, sweating, and sexual dysfunction. Discontinuation symptoms can occur with abrupt stopping. Serious but less frequent risks include hyponatremia, elevated blood pressure in some patients, liver injury, and serotonin syndrome when combined with other serotonergic drugs or monoamine oxidase inhibitors. Careful monitoring is advised when used with NSAIDs or anticoagulants, and alcohol intake should be limited.

Duloksetin is a widely used antidepressant with a broad range of approved indications and a safety profile that requires monitoring for metabolic and cardiovascular effects.