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Prescrire Int., 2013 Duloxetine: withdrawal syndromes.


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Avoid prescribing duloxetine because of severe withdrawal syndrome, concludes Prescrire, an independent French medical journal.

 

The Institute for Safe Medication Practices http://www.ismp.org/

is an independent organization based in the US with branches elsewhere in the world http://www.intmedsafe.net/Contents/Home.aspx

with ties to the World Health Organization (WHO).

 

Duloxetine: withdrawal syndromes.

[No authors listed]

Prescrire Int. 2013 Oct;22(142):243. No abstract available.

http://www.ncbi.nlm.nih.gov/pubmed/24298592

 

Text of article:

Translated from Rev Prescrire July 2013; 33 (357): 517

in PRESCRIRE INTERNATIONAL OCTOBER 2013/VOLUME 22 No 142 PAGE 243

 

Duloxetine: withdrawal syndromes

 

....

In October 2012, the Institute for Safe Medication Practices (ISMP), as part of its regular review of the US Food and Drug Administration (FDA) pharmacovigilance database, drew attention to withdrawal symptoms following duloxetine discontinuation. Duloxetine is an antidepressant that is also used in some forms of urinary incontinence, neuropathic pain and generalised anxiety disorder, but it has no tangible advantages over other therapeutic options (1-4).

 

During the first three months of 2012, 48 cases of withdrawal symptoms were reported after duloxetine discontinuation(1). They included neuropsychological disorders such as paraesthesia, dizziness, suicidal thoughts, bouts of crying and anger, hallucinations, personality changes, and effects on appetite and weight. Several patients were hospitalised.

 

Withdrawal syndromes following duloxetine discontinuation had already been observed in clinical trials (2). According to the EU summary of product characteristics, these syndromes affected 44% of patients in the treatment groups in clinical trials of duloxetine for urinary incontinence, versus 24% of patients in the placebo groups (4).

 

Duloxetine, like venlafaxine and milnacipran, inhibits serotonin and norepinephrine reuptake and has the same adverse effects (4). Withdrawal syndromes are known adverse effects of serotonin reuptake inhibitors (4).

 

In practice. To spare patients the adverse effects of duloxetine, especially withdrawal symptoms, it is best to simply avoid using this drug.

 

Selected references from Prescrire's literature search.

 

1-Institute for Safe Medication Practices "Why reports of serious adverse drug events continue to grow" 3 October 2012: 30 pages.

2-Prescrire Editorial Staff "Duloxetine for stress urinary incontinence: too much risk, too little benefit" Prescrire Int 2005; 14(80): 218-220.

3-European Commission "SPC-Yentreve" 27 July2011: 16 pages + "SPC-Cymbalta" 28 July 2011: 16pages.

4-Prescrire Redaction "19-3. Patients deprimes" Prescrire 2012; 32 (350 suppl. interactions medicamenteuses).

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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