Does duloxetine treat depression? (+11 alternatives)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will discuss the role of duloxetine in the management of depression and its associated symptoms. We will also explore research suggesting the effectiveness of this medication in depression, as well as alternatives to duloxetine if it fails to manage depression.
Does duloxetine treat depression?
Yes, duloxetine does treat depression. Duloxetine, also known as Cymbalta, is effective in the management of depression and its associated symptoms, including sadness, hopelessness, and agitation.
Its therapeutic effects may be attributed to its interference with neurotransmitters in the brain, namely serotonin and norepinephrine. Duloxetine works by increasing the concentration of these neurotransmitters, contributing to the regulation of mood and behavior in individuals with underlying depression (1).
While considered a generally safe medication with a lower incidence of serious side effects, it may cause certain mild side effects in some individuals. These can include dizziness, vomiting, headaches, tiredness, and sleep disturbances (1).
What is the dosage of duloxetine for depression?
Duloxetine has proven to be effective in managing symptoms of depression within the dosage range of 60 to 120 mg. Typically, a cautious approach is taken during the initial stages of treatment, with a low dosage administered to mitigate potential unwanted side effects as the body adjusts to the medication. If symptoms persist with the initial low dosage, a gradual increment is considered, up to an optimum level that yields therapeutic benefits (2).
The dosage and duration of duloxetine treatment are personalized based on the individual response of the patient. Generally, the treatment course extends from a few months to a year. Notably, noticeable improvements in symptoms are often observed after 3 to 4 weeks of initiating duloxetine therapy (1).
What does research suggest?
According to research, duloxetine is considered a choice of medication for managing symptoms of mental disorders, including depression. In a research study, the effectiveness of duloxetine was analyzed at a dosage of 60 mg daily for the management of depression and its associated symptoms (3).
The results revealed that approximately 40% of patients experienced improvement in their symptoms. However, it is noteworthy that around 10% of patients discontinued the medication due to the occurrence of side effects (3).
In another study, a higher dosage of duloxetine was employed to manage the symptoms of depression. Remarkably, around 60% of patients exhibited improvement in their symptoms after just a few days of treatment, and an even more substantial 80% responded positively to the treatment, showing significant improvement after 2 to 3 weeks (4).
Despite these encouraging results, it’s important to note that 20% of participants discontinued the medication due to the occurrence of side effects.
What to do if duloxetine fails to treat depression?
Duloxetine is generally considered an effective medication for depression. It’s important to remain patient during the initial phase of treatment, as it may take a few weeks to start improving your symptoms.
However, if you find that your symptoms are not improving even after weeks of treatment, it is advisable to consult with your healthcare professional. Your healthcare provider can analyze your symptoms and determine the potential reasons for the ineffectiveness of duloxetine.
In some cases, gradually increasing the dosage may help improve symptoms. However, if a higher dosage proves ineffective, your healthcare provider may recommend alternative medications for the management of depression.
Alternative medications may also be prescribed in situations where the use of duloxetine should be avoided, such as in individuals with underlying liver toxicities, allergies to duloxetine, or during pregnancy (1).
What are alternatives to duloxetine if it fails to treat depression?
There are alternatives to duloxetine for the management of depression in cases where it is not effective. These alternatives may include (5):
- fluoxetine
- sertraline
- citalopram
- venlafaxine
- desvenlafaxine
- bupropion
- mirtazapine
- agomelatine
- doxazocin
- amitriptyline
- nortriptyline
It’s important to note that while these medications can serve as substitutes for duloxetine in depression management, they also come with some side effects that should be taken into consideration before starting treatment.
Additionally, the choice of an appropriate medication should be specific to individual needs and overall health status. Consulting with a healthcare provider is crucial for determining the most suitable alternative based on an individual’s unique circumstances.
It’s essential to be vigilant and report any unusual symptoms that may arise during depression treatment to ensure both the safety and efficacy of the chosen treatment plan.
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References
1.-
Dhaliwal JS, Spurling BC, Molla M. Duloxetine. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549806
2.-
Burt VK, Wohlreich MM, Mallinckrodt CH, Detke MJ, Watkin JG, Stewart DE. Duloxetine for the treatment of major depressive disorder in women ages 40 to 55 years. Psychosomatics. 2005 Jul-Aug;46(4):345-54. doi: 10.1176/appi.psy.46.4.345. PMID: 16000678. https://pubmed.ncbi.nlm.nih.gov/16000678/
3.-
Raskin J, Wiltse CG, Siegal A, Sheikh J, Xu J, Dinkel JJ, Rotz BT, Mohs RC. Efficacy of duloxetine on cognition, depression, and pain in elderly patients with major depressive disorder: an 8-week, double-blind, placebo-controlled trial. Am J Psychiatry. 2007 Jun;164(6):900-9. doi: 10.1176/ajp.2007.164.6.900. PMID: 17541049. https://pubmed.ncbi.nlm.nih.gov/17541049/
4.-
Raskin J, Goldstein DJ, Mallinckrodt CH, Ferguson MB. Duloxetine in the long-term treatment of major depressive disorder. J Clin Psychiatry. 2003 Oct;64(10):1237-44. doi: 10.4088/jcp.v64n1015. PMID: 14658974. https://pubmed.ncbi.nlm.nih.gov/14658974/
5.-
Sheffler ZM, Patel P, Abdijadid S. Antidepressants. 2023 May 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 30844209. https://pubmed.ncbi.nlm.nih.gov/30844209/
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