Duloxetine in the treatment of major depressive disorder: an open-label study.

Abstract

BACKGROUND:

Major depressive disorder (MDD) is a chronic and highly disabling condition. Existing pharmacotherapies produce full remission in only 30% to 40% of treated patients. Antidepressants exhibiting dual reuptake inhibition of both serotonin (5-HT) and norepinephrine (NE) may achieve higher rates of remission compared with those acting upon a single neurotransmitter. In this study, the safety and efficacy of duloxetine, a potent dual reuptake inhibitor of 5-HT and NE, were examined.

METHODS:

Patients (N = 533) meeting DSM-IV criteria for MDD received open-label duloxetine (60 mg once a day [QD]) for 12 weeks during the initial phase of a relapse prevention trial. Patients were required to have a 17-item Hamilton Rating Scale for Depression (HAMD17) total score >or=18 and a Clinical Global Impression of Severity (CGI-S) score >or=4 at baseline. Efficacy measures included the HAMD17 total score, HAMD17 subscales, the CGI-S, the Patient Global Impression of Improvement (PGI-I) scale, Visual Analog Scales (VAS) for pain, and the Symptom Questionnaire, Somatic Subscale (SQ-SS). Quality of life was assessed using the Sheehan Disability Scale (SDS) and the Quality of Life in Depression Scale (QLDS). Safety was evaluated by recording spontaneously-reported treatment-emergent adverse events, changes in vital signs and laboratory analytes, and the Patient Global Impression of Sexual Function (PGI-SF) scale.

RESULTS:

The rate of discontinuation due to adverse events was 11.3%. Treatment-emergent adverse events reported by >or=10% duloxetine-treated patients were nausea, headache, dry mouth, somnolence, insomnia, and dizziness. Following 12 weeks of open-label duloxetine therapy, significant improvements were observed in all assessed efficacy and quality of life measures. In assessments of depression severity (HAMD17, CGI-S) the magnitude of symptom improvement continued to increase at each study visit, while for painful physical symptoms the onset of improvement was rapid and reached a maximum after 2 to 3 weeks of treatment.

CONCLUSION:

In this open-label phase of a relapse prevention study, duloxetine (60 mg QD) was shown to be safe and effective in the treatment of MDD.

• Authors: James I Hudson, David G Perahia, Inmaculada Gilaberte, Fujun Wang, John G Watkin, Michael J Detke
• Journal: BMC psychiatry (BMC Psychiatry) Vol. 7 Pg. 43 (Aug 28 2007) ISSN: 1471-244X [Electronic] England
• PMID: 17725843 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Serotonin Uptake Inhibitors
• Thiophenes
• Duloxetine Hydrochloride

Topics

• Chronic Disease
• Depressive Disorder, Major (diagnosis, drug therapy)
• Disability Evaluation
• Duloxetine Hydrochloride
• Humans
• Quality of Life (psychology)
• Remission Induction
• Selective Serotonin Reuptake Inhibitors (therapeutic use)
• Severity of Illness Index
• Sexual Dysfunction, Physiological (chemically induced, diagnosis, epidemiology)
• Surveys and Questionnaires
• Thiophenes (therapeutic use)
• Treatment Outcome