Pharmacology of Duloxetine

Study Notes

Duloxetine is an effective option for neuropathic pain.
SSRIs, such as Paroxetine, are recommended for depression in patients with epilepsy and/or hypertension.
Bupropion should be avoided in patients with a history of seizures as it can increase seizure risk.
Bupropion and Venlafaxine are the first-choice options for obese patients dealing with depression.
Mirtazapine is the preferred choice for epileptic patients experiencing loss of appetite, offering less sedation.
Antidepressants primarily target postsynaptic receptors in the brain.

Citalopram and Dapoxetine are examples of SSRIs; Sertraline and Paroxetine are suitable for cardiac patients.
Escitalopram is a safe choice for patients with a history of seizures.
SSRIs, including Fluoxetine and Fluvoxamine, are commonly prescribed for anxiety disorders.

Mirtazapine and Paroxetine can be effective treatments for insomnia.
Sertraline is generally considered safe for use during pregnancy, while Sertraline and Paroxetine are advised for breastfeeding mothers (although Paroxetine has potential risks).

Secondary TCAs include Protriptyline and Nortriptyline, while tertiary options include Doxepin and Amitriptyline, the latter of which can cause arrhythmias.

MAOIs can be classified as non-selective (Phenelzine, Tranylcypromine) and selective (Moclobemide for MAO-A, Rasagiline, Selegiline for MAO-B).
Tyramine-rich foods can trigger hypertensive crises when combined with non-selective MAOIs.
A transdermal patch is available for depression, while Selegiline tablets are used for Parkinson's Disease.

A washout period of two weeks is required before switching from any antidepressant class to MAOIs, except for Fluoxetine, which necessitates a 4-5 week washout.

Bupropion is contraindicated for patients with a history of seizures and is not recommended for use during pregnancy.
It is beneficial for treating sexual dysfunction associated with SSRIs and assists in weight loss for obese patients experiencing depression.