Duloxetine for neuropathic pain based on recent clinical trials

The treatment of neuropathic pain with antidepressants has a long history. Early studies were contradictory and were limited by small numbers of patients. When evaluated meta-analytically, these studies indicated that antidepressants do have efficacy for neuropathic pain. However, none of the antidepressants used in these studies have gained approval by the US Food and Drug Administration (FDA) for this indication, and were generally associated with a high side-effect burden. Recently, duloxetine, a dual-action reuptake inhibitor, has demonstrated significant efficacy in the management of diabetic peripheral neuropathic pain in three double-blind, placebo-controlled trials and was approved by the FDA for this indication. These studies are discussed in this article.