Duloxetine In The Treatment of Neuropathic Pain
The use of duloxetine to treat general neuropathic pain is not yet widespread, but its use is becoming more common, particularly because it is so effective in treating diabetic neuropathic pain and early results are that it is indeed an effective treatment for neuropathic pain generally.
However, some patients, whether with general neuropathic pain or with diabetic neuropathic pain are slightly reluctant to try a treatment such as this because they are concerned about the possibility of side effects. Yet this risk should be assessed and discussed with a Pain Consultant, so that the risk can be professionally calculated.
What Is Diabetic Neuropathic Pain?
Diabetic neuropathic pain is a nerve disorder that is specifically caused by the condition of diabetes. Sometimes the neuropathy does not present with symptoms but usually patients may have pain in their feet, legs, arms or hands. In less severe cases this may be a tingling sensation or the patient may feel that the affected part of the body is numb.
What Is Neuropathic Pain?
Neuropathic pain is a pain that results from a damaged nervous system where pain is produced by the damaged nervous system and transmitted to the brain. It is different from nociceptive pain which is the pain that is produced as a result of trauma or direct injury.
What Is Duloxetine?
Duloxetine is a drug that is licensed for use in treating clinical depression as well as urinary incontinence that is caused by stress and it can also be useful in treating diabetic neuropathic pain, which is why it was identified as being potentially useful in treating other neuropathic conditions.
Although initially it may seem odd to use antidepressants to treat neuropathic pain, there is actually a long history of using antidepressants to treat conditions such as neuropathic pain.
Duloxetine actually works by helping serotonin and noradrenaline to continue to circulate within the brain and not be reabsorbed into the nerve cells that are in the brain. In short, this helps patients to feel better for longer.
What Dose Is Needed?
The optimum dose of duloxetine is 60 mg, with little effect on neuropathic pain being achieved if the dose is lowered to 20 mg or conversely increased to 120 mg.
Duloxetine And Side Effects
There are no major side effects to taking duloxetine, however, there are a number of side effects that many patients experience, to varying degrees: these include feeling nauseous, constipation, light-headedness or being too drowsy or even too wide awake and being unable to sleep.
However, patients should not be deterred from taking this medication due to the possibility of side effects, primarily because the efficacy of duloxetine in treating neuropathic pain may far outweigh the inconvenience of any relatively minor side effects.
Patients who are experiencing significant and chronic pain may be able to achieve significant levels of pain reduction from this drug and as such if recommended by a Pain Consultant, then patients should consider the potential benefits of this kind of treatment as opposed to simply being over cautious of the potential risk of side effects, which can all be discussed with your Pain Consultant prior to the medication being taken.