Duloxetine is a medication that is licensed in the UK under the name of Cymbalta, to treat diabetic neuropathic pain. It is in fact an antidepressant, since it is a selective serotonin and noradrenaline re-uptake inhibitor, which acts as an antidepressant.
Diabetic neurpathic pain is developed by up to 40% of people with diabetes and it is often a difficult condition to live with. The neuropathy can feel like a stabbing sensation or as if the person is being burned or there can be tingling or even just numbness. The neuropathy can also increase with age and with the length of time that the patient has had diabetes.
Effects Of Diabetic Neuropathy
When someone has diabetic neuropathy, not only do they have to contend with the pain that is caused by the neuropathy, but they may also have real problems sleeping. In turn this can lead to anxiety, serious depression and general disability, so it has effects that are much greater than the pain itself, there are also associated secondary problems.
Efficacy
Clinical trials have shown that the efficacy of duloxetine is greater than placebo alone and that it can ensure that patients experience a significant reduction in pain, often by as much as 30%.
Contra-Indications
Some patients are nervous about taking duloxetine simply because they are worried about taking what is a relatively strong antidepressant, along with all their other medication. Sometimes there are fears that the duloxetine will result in them being dependent on the medication or unable to deal with potential side effects.
However, in a study undertaken of patients in clinical trials, it was found that only 14% of the patients (some 568 in total) stopped taking it because they felt that it was not agreeing with them. Now this figure of 14% may seem high, but of those patients taking the placebo in the clinical trial, 7% of patients decided that the medication was also presenting them with significant side effects, even though this was not actually possible. The main side effects reported were nausea, dizziness and a feeling of sleepiness or fatigue.
However, the other 86% of patients who took the medication in the trials found that there were no side effects that were unacceptable.
Specific Role For Diabetic Neuropathy
Diabetic neuropathy is remarkably hard to treat effectively, since it tends to present itself as being unresponsive to conventional painkillers or even other antidepressants. That is why duloxetine may be of particular benefit to people who have diabetic neuropathy and cannot elicit relief from any other medication.
Although it is a powerful antidepressant, there is no reason to be fearful of duloxetine. If you do find that it is causing side effects, then these can be discussed with your Pain Consultant, with a view to altering the dosage or even reviewing the prescription.
However, its use can greatly assist people who are suffering with diabetic neuropathic pain and as such we should regard it as a powerful weapon in the war against diabetic neuropathic pain and indeed neuropathic pain as a whole.
