duloxetine / Generic mfg. - LARVOL DELTA

QTc changes and early major adverse cardiovascular events associated with antidepressant treatment for major depressive disorder in adults: individual participant data network meta-regression of double blind randomised trials. (PubMed, BMJ) - "The effect of specific antidepressants on QTc interval differed between adults with depression. No evidence associated antidepressant use with early MACE and non-suicidal sudden death. To support shared decision making and taking into account the trade-off between benefits and harms, individual modifiable and non-modifiable risk factors should be considered when choosing antidepressants."

Adverse events • Clinical • Journal • Cardiovascular • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry

Alliance A221805: Duloxetine to prevent oxaliplatin-induced chemotherapy-induced peripheral neuropathy (CIPN)—A randomized, double-blind, placebo-controlled phase II study. (ASCO 2025) - P2/3 | "We were unable to show that any dose of duloxetine was more promising than placebo, possibly due to an unexpectedly high placebo response rate. Low duloxetine/placebo adherence may have compromised efficacy. Placebo-response mitigation methods should be considered in future CIPN clinical trials."

Clinical • P2 data • Colorectal Cancer • Fatigue • Oncology • Pain • Solid Tumor

Unrecognized Charcot-Marie-Tooth Disease Unmasked by Chemotherapy-Induced Neurotoxicity. (PubMed, Cureus) - "We report the case of a 68-year-old woman with luminal B, HER2-negative breast cancer who developed severe peripheral neuropathy during adjuvant chemotherapy with doxorubicin/cyclophosphamide followed by weekly paclitaxel...Despite cessation of the offending agent and initiation of duloxetine, symptoms continued to worsen, with progressive motor impairment and significant gait instability. Nerve conduction studies revealed a severe sensorimotor demyelinating polyneuropathy, atypical for the predominantly axonal pattern of taxane-induced CIPN...Genetic testing identified a peripheral myelin protein 22 (PMP22) duplication (17p11.2), confirming Charcot-Marie-Tooth disease type 1A (CMT1A), a hereditary demyelinating neuropathy previously subclinical. This case report underscores the value of serial clinical and electrophysiological assessment when neuropathy is atypical, disproportionately severe, or refractory to standard treatment."

Journal • Breast Cancer • Genetic Disorders • HER2 Breast Cancer • HER2 Negative Breast Cancer • HER2 Positive Breast Cancer • Oncology • Pain • Solid Tumor • HER-2

Utidelone-associated chemotherapy-induced peripheral neuropathy: an evidence-stratified narrative review of mechanisms, risk identification, and management strategies. (PubMed, Front Oncol) - "In the pivotal phase III BG01-1323L trial, utidelone plus capecitabine improved progression-free and overall survival versus capecitabine alone; however, peripheral neuropathy occurred in 59% of combination patients, including grade 3 in 22%, versus 8% and less than 1%, respectively, with capecitabine alone...Duloxetine has the strongest evidence base for treating established painful CIPN but has not been evaluated specifically for utidelone-associated neuropathy...On the basis of available evidence and established CIPN principles, we propose a practical framework integrating pretreatment neurologic and risk assessment, cycle-by-cycle monitoring, symptom-directed supportive care, fall prevention, rehabilitation, and individualized modification of anticancer treatment. Prospective studies are needed to define the onset, cumulative dose-toxicity relationship, persistence, recovery trajectory, and modifiable risk factors of utidelone-associated neuropathy."

Journal • Review • Breast Cancer • Metabolic Disorders • Oncology • Pain • Peripheral Neuropathic Pain • Solid Tumor • TRPA1

The Impact of Common Medications on Male Fertility: An Updated Systematic Review. (PubMed, Andrology) - "In this updated review, evidence-based recommendations for clinical management and for possible fertility preservation or contraception in men of reproductive age receiving common acute or chronic medical treatment are provided, with the goal of making these data more readily available to medical staff."

Journal • Review • Infertility

Multimodal Pharmacologic Strategies for Chronic Cancer Pain: A Systematic Review. (PubMed, Cureus) - "In one trial, duloxetine was associated with clinically meaningful pain-response rates, although its primary mean pain-score analysis was not statistically significant. Low-dose gabapentin plus imipramine reduced pain and rescue-morphine use. Pregabalin reduced the morphine dose required to maintain pain control in one crossover trial, while other pregabalin studies showed numerical or non-significant benefits. Neither nabiximols trial met its primary efficacy endpoint, and nefopam did not significantly improve pain response or morphine consumption...Overall, the evidence remains heterogeneous and insufficient to support a standard multimodal pharmacological regimen. Selected antidepressant and gabapentinoid strategies, particularly in neuropathic cancer pain, may benefit selected patients."

Journal • Review • Addiction (Opioid and Alcohol) • Oncology • Pain

Evolving Concepts in the Diagnosis and Management of Fibromyalgia: A Moving Target. (PubMed, J Pain Res) - "Pharmacological therapies, including pregabalin, duloxetine, milnacipran, and cyclobenzaprine, are Food and Drug Administration-approved and provide clinically meaningful benefits to patients with FM. Although tramadol may be considered, the use of other opioids is generally not recommended because of their limited efficacy and potential risks...Therefore, this narrative review aims to provide a concise, updated, and clinically relevant overview of the current evidence regarding the pathogenesis, diagnosis, and multidisciplinary management of FM to improve diagnostic accuracy and support individualized patient management. Furthermore, future directions should prioritize improving diagnostic precision and developing mechanism-based interventions targeting the underlying pathophysiology of FM."

Journal • Review • CNS Disorders • Cognitive Disorders • Fatigue • Fibromyalgia • Musculoskeletal Diseases • Musculoskeletal Pain • Pain • Psychiatry • Rheumatology • Sleep Disorder

Effects of 2-Aticyto Complex and D-Ribose on Pain and Clinical Course in Patients With Fibromyalgia (clinicaltrials.gov) - P=N/A | N=200 | Not yet recruiting | Sponsor: Haydarpasa Numune Training and Research Hospital | Initiation date: May 2026 ➔ Oct 2026

Trial initiation date • Fibromyalgia • Musculoskeletal Pain • Pain • Rheumatology

Cross national pharmacovigilance analysis of drug-induced delirium: a comparative study using the US FAERS, Japanese JADER, and canadian CVAR datasets. (PubMed, Front Pharmacol) - "Duloxetine, lamotrigine, pregabalin, quetiapine fumarate, and zolpidem demonstrated consistent signals across databases. Time-to-onset analysis demonstrated early-onset clustering, suggesting an acute temporal pattern. Cross-database consistency in drug class signals and early-onset temporal patterns highlights the need for medication review and risk mitigation in high-risk populations."

Adverse events • Journal • CNS Disorders • Cognitive Disorders • Pain

The Role of the Antidepressants in Managing Chemotherapy-Induced Neuropathic Pain: A Systematic Review. (PubMed, Pharmacol Res Perspect) - "Combination therapies involving duloxetine and agents such as tapentadol, pregabalin, mirogabalin, or amitriptyline were associated with additional reductions in pain intensity; however, current evidence remains insufficient to establish additive or synergistic effects. Current evidence supports antidepressants, particularly duloxetine, associated with reductions in pain intensity in heterogeneous studies, whereas evidence for CIPN prevention remains inconclusive. These findings support their continued use in clinical practice and highlight the need for larger, well-designed randomized controlled trials to optimize treatment strategies and further define the role of combination therapies in CIPN management."

Journal • Review • Neuralgia • Oncology • Pain • Peripheral Neuropathic Pain

Chronic Prescribed Opioid Use and Adverse Audiovestibular Outcomes: Evidence From a Large Real-World Cohort (AAO-HNSF 2026) - "Chronic prescribed opioid use may be associated with higher rates of SNHL and vestibular dysfunction compared to the non-ototoxic analgesic duloxetine, supporting investigation of mechanisms of opioid ototoxicity to inform prescribing practices for pain management."

Clinical • Real-world • Real-world evidence • Addiction (Opioid and Alcohol) • Atopic Dermatitis • CNS Disorders • Constipation • Depression • Dermatitis • Gastroenterology • Gastrointestinal Disorder • Immunology • Mental Retardation • Mood Disorders • Musculoskeletal Diseases • Musculoskeletal Pain • Osteoarthritis • Otorhinolaryngology • Substance Abuse

Drugs for prevention of migraine. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • CNS Disorders • Migraine • Pain

Comparison table: Some drugs for migraine prevention. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • CNS Disorders • Migraine • Pain

ADAPT: Algorithm-informed Decision-making to Advance Pain Treatment (clinicaltrials.gov) - P=N/A | N=500 | Recruiting | Sponsor: University of Michigan | Not yet recruiting ➔ Recruiting

Enrollment open • Back Pain • Lumbar Back Pain • Musculoskeletal Pain • Pain

Comparative Effectiveness of Pregabalin With Duloxetine Versus Pregabalin With Amitriptyline in Chronic Low Back Pain With Radiculopathy: A Prospective Comparative Study. (PubMed, Health Sci Rep) - "In this non-randomized cohort, the pregabalin-duloxetine combination was associated with greater crude improvement, and duloxetine-treated participants reported fewer episodes of sedation and drowsiness; however, the apparent efficacy advantage was substantially attenuated after accounting for baseline imbalance, and because adverse-event ascertainment was open-label and incomplete, the tolerability signal also remains exploratory. These findings should be regarded as hypothesis-generating and require confirmation in adequately powered randomized trials."

HEOR • Journal • Anesthesia • Back Pain • Lumbar Back Pain • Musculoskeletal Pain • Pain

Depression in Parkinson's Disease: Real-World Prescribing Patterns and Treatment Dynamics from a Nationwide Greek Cohort. (PubMed, Mov Disord Clin Pract) - "In PD depression, AAP outlast SSRIs in real-world persistence and non-SSRIs are more commonly switched or augmented."

Journal • Real-world evidence • CNS Disorders • Depression • Mood Disorders • Movement Disorders • Parkinson's Disease • Psychiatry

Analysis of the Use of Duloxetine in the High-dose Range (90 to 120 mg) in the Psychiatric Clinic for the Treatment of Patients With Major Depressive Disorder. (PubMed, J Psychiatr Pract) - "A greater than expected proportion of patients with advanced, marked, or severe disease, psychiatric comorbidity, sleep disorders, neuropathic pain, and cognitive impairment was observed among the subjects with MDD treated with high-dose duloxetine."

Clinical • Journal • Retrospective data • Alzheimer's Disease • Cardiovascular • CNS Disorders • Cognitive Disorders • Depression • Dyslipidemia • Fibromyalgia • General Anxiety Disorder • Hypertension • Major Depressive Disorder • Metabolic Disorders • Mood Disorders • Musculoskeletal Pain • Neuralgia • Pain • Personality Disorder • Psychiatry • Pulmonary Arterial Hypertension • Rheumatology • Sleep Disorder

Antidepressant composition change before bipolar disorder diagnosis among patients initially diagnosed with major depressive disorder. (PubMed, J Affect Disord) - "The duloxetine composition-change signal was not confined to the immediate 180-day prediagnostic period, whereas paroxetine and escitalopram signals were observed only in that period. These diagnosis-preceding prescribing patterns remain susceptible to protopathic bias and should not be interpreted as causal medication effects."

Journal • Bipolar Disorder • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry

Rapid Glycaemic Control Leading to Painful Neuropathy: A Case of Treatment-Induced Neuropathy of Diabetes in a Young Patient. (PubMed, Int Med Case Rep J) - "The patient's pain was refractory to duloxetine but showed significant improvement with gabapentin alongside clinical recovery observed over 4 weeks. Rapid glycemic correction in patients with high baseline HbA1c carries a significant risk of TIND. Clinicians should consider close monitoring and individualized adjustment of blood glucose descent in high-risk individuals, even when utilizing advanced AID systems, to prevent debilitating neurological complications."

Journal • Diabetes • Diabetic Neuropathy • Metabolic Disorders • Neuralgia • Pain • Type 1 Diabetes Mellitus

Efficacy and Safety of Duloxetine in Chinese Solid Tumor Patients With Taxanes-induced Painful Peripheral Neuropathy (clinicaltrials.gov) - P2 | N=100 | Recruiting | Sponsor: Yan Yang, MD, Ph.D | Trial completion date: Dec 2025 ➔ Dec 2027 | Trial primary completion date: Jul 2025 ➔ Jul 2027

Trial completion date • Trial primary completion date • Oncology • Pain • Peripheral Neuropathic Pain • Solid Tumor

Bilateral Parsonage-Turner Syndrome in a Young Adult Man Due to Parvovirus B19 Infection. (PubMed, Cureus) - "He was given analgesics, gabapentin, nortriptyline, and duloxetine for pain. He received intravenous methylprednisolone (1000 mg) followed by oral steroids (1 mg/kg) along with intravenous immunoglobulin (IVIG) and physiotherapy. Clinicians must consider parvovirus B19-associated PTS as a possibility, especially when evaluating rapidly progressive bilateral brachial plexitis, even in the absence of typical viral prodromal symptoms such as fever, rash, and arthralgia."

Journal • CNS Disorders • Genetic Disorders • Infectious Disease • Musculoskeletal Pain • Pain • Turners Syndrome

Longitudinal patient-reported outcomes and predictors of improvement in chemotherapy-induced peripheral neuropathy a secondary analysis of a randomized trial. (PubMed, Front Pharmacol) - "Higher baseline pain predicted worse CIPN, lower QoL, and higher anxiety; metastatic disease and chemotherapy dose reduction were associated with poorer outcomes; missingness showed no strong baseline predictors. Duloxetine-based management was associated with rapid, sustained improvement in CIPN symptoms, pain, anxiety, and QoL over 8 weeks, supporting risk-stratified supportive care pathways."

Journal • Gynecologic Cancers • Mood Disorders • Oncology • Pain • Peripheral Neuropathic Pain • Psychiatry

Age related differences in efficacy of first line neuropathic pain medications in the Option DM trial (EASD 2026) - "Clinical Trial Registration Number: ISRCTN17545443 Background and aims: The OPTION DM trial compared amitriptyline supplemented with pregabalin (A-P), pregabalin supplemented with amitriptyline (P-A), and duloxetine supplemented with pregabalin (D-P) treatment pathways for diabetic peripheral neuropathic pain (DPNP) and found there were no difference in efficacy although the P-A pathway had less treatment emergent adverse events leading to discontinuation. Taken together, these findings highlight a key trade-off: older adults tend to experience greater pain relief but are also more susceptible to functional adverse events that may undermine quality of life. Conversely, younger adults achieve smaller reductions in pain but appear less vulnerable to serious functional harms. All three pathways are effective, but in older patients, the potential for stronger analgesia must be balanced against higher risk of functional adverse events."

Clinical • Diabetic Neuropathy • Metabolic Disorders

Duloxetine for postoperative pain management in total hip and knee arthroplasty: a systematic review and meta-analysis. (PubMed, J Orthop Surg Res) - "Perioperative duloxetine produces statistically significant, though sub-threshold, analgesic effects across all assessed timepoints and a selective opioid-sparing effect spanning 48 to 72 h postoperatively when incorporated into multimodal analgesia for THA and TKA. All findings are subject to substantial heterogeneity and should be interpreted with caution. Duloxetine significantly reduced the incidence of nausea/vomiting and increased the risk of drowsiness/somnolence, the latter warranting preoperative patient counseling; a borderline reduction in fatigue was also observed. However, on leave-one-out sensitivity analysis, the long-term (≥ 3-month) reduction in pain at rest, the nausea/vomiting reduction, and the fatigue reduction each lost statistical significance upon exclusion of a single high-risk trial (Inamullah 2023) and should be interpreted with corresponding caution."

Clinical • Journal • Retrospective data • Review • Addiction (Opioid and Alcohol) • Fatigue • Orthopedics • Pain

Efficacy of Topical Lidocaine Gel vs. Oral Duloxetine for Painful Diabetic Peripheral Neuropathy (clinicaltrials.gov) - P4 | N=80 | Not yet recruiting | Sponsor: Wah Medical college , POF hospital

New P4 trial • Diabetes • Diabetic Neuropathy • Metabolic Disorders • Peripheral Neuropathic Pain • Type 2 Diabetes Mellitus