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Title: Continuation treatment of major depressive disorder: is there a case for duloxetine?
Austin Authors: Norman, Trevor R ;Olver, James S 
Affiliation: Department of Psychiatry, University of Melbourne, Austin Hospital, Heidelberg 3084, Victoria, Australia
Issue Date: 18-Feb-2010
Publication information: Drug Design, Development and Therapy 2010; 4(): 19-31
Abstract: Duloxetine is a serotonin-noradrenaline reuptake inhibitor with established efficacy for the short-term treatment of major depressive disorder. Efficacy in continuation treatment (greater than six months of continuous treatment) has been established from both open and placebo-controlled relapse prevention and comparative studies. Seven published studies were available for review and showed that in both younger and older populations (aged more than 65 years) the acute efficacy of duloxetine was maintained for up to one year. Response to treatment was based on accepted criteria for remission of depression and in continuation studies remission rates were greater than 70%. Comparative studies showed that duloxetine was superior to placebo and comparable to paroxetine and escitalopram in relapse prevention. Importantly a study of duloxetine in patients prone to relapse of major depressive disorder showed that the medication was more effective than placebo in this difficult to treat population. Side effects of duloxetine during continuation treatment were predictable on the basis of the known pharmacology of the drug. In particular there were no significant life-threatening events which emerged with continued use of the medication. On the other hand vigilance is required since the data base on which to judge very rare events is limited by the relatively low exposure to the drug. Duloxetine has established both efficacy and safety for continuation treatment but its place as a first-line treatment of relapse prevention requires further experience. In particular further comparative studies against established agents would be useful in deciding the place of duloxetine in therapy.
Gov't Doc #: 20368904
Journal: Drug design, development and therapy
Type: Journal Article
Subjects: clinical trials
continuation treatment
major depression
placebo studies
relapse prevention
Antidepressive Agents.adverse effects.pharmacology.therapeutic use
Clinical Trials as Topic
Depressive Disorder, Major.drug therapy.prevention & control
Thiophenes.adverse effects.pharmacology.therapeutic use
Appears in Collections:Journal articles

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