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duloxetine is a serotonin and norepinephrine reuptake inhibitor snri indicated for major depressive disorder mdd 1 1 generalized anxiety disorder gad 1 2 diabetic peripheral neuropathic pain dpnp 1 3 fibromyalgia fm 1 4 chronic musculoskeletal pain 1 5 duloxetine is indicated for the treatment of major depressive disorder mdd the efficacy of duloxetine was established in four short term and one maintenance trial in adults see clinical studies 14 1 a major depressive episode dsm iv implies a prominent and relatively persistent nearly every day for at least 2 weeks depressed or dysphoric mood that usually interferes with daily functioning and includes at least 5 of the following 9 symptoms depressed mood loss of interest in usual activities significant change in weight and or appetite insomnia or hypersomnia psychomotor agitation or retardation increased fatigue feelings of guilt or worthlessness slowed thinking or impaired concentration or a suicide attempt or suicidal ideation duloxetine is indicated for the treatment of generalized anxiety disorder gad the efficacy of duloxetine was established in three short term trials and one maintenance trial in adults see clinical studies 14 2 generalized anxiety disorder is defined by the dsm iv as excessive anxiety and worry present more days than not for at least 6 months the excessive anxiety and worry must be difficult to control and must cause significant distress or impairment in normal functioning it must be associated with at least 3 of the following 6 symptoms restlessness or feeling keyed up or on edge being easily fatigued difficulty concentrating or mind going blank irritability muscle tension and or sleep disturbance duloxetine is indicated for the management of neuropathic pain dpnp associated with diabetic peripheral neuropathy see clinical studies 14 3 duloxetine is indicated for the management of fibromyalgia fm see clinical studies 14 4 duloxetine is indicated for the management of chronic musculoskeletal pain this has been established in studies in patients with chronic low back pain clbp and chronic pain due to osteoarthritis see clinical studies 14 5
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