Analysis of the Use of Duloxetine in the High-dose Range (90 to 120 mg) in the Psychiatric Clinic for the Treatment of Patients With Major Depressive Disorder.

BACKGROUND AND OBJECTIVES: Duloxetine is a serotonin and norepinephrine reuptake inhibitor antidepressant drug. The goal of this project was to analyze the characteristics of patients with major depressive disorder (MDD) treated with duloxetine in the high-dose range (90 to 120 mg). METHODS: A retrospective, multicenter study was designed to analyze 20 indicators on the clinical use of duloxetine (90 to 120 mg) in adults with MDD who were referred to the psychiatric clinic. RESULTS: A total of 175 psychiatrists participated in the study and collected information on 1050 patients with a mean age of 51.3 years (62.9% women). A total of 55.4% had comorbid psychiatric conditions, with dysthymia (17.2%), generalized anxiety disorder (15%), and personality disorders (13.1%) being the most common. A total of 84.7% had nonpsychiatric conditions, including chronic pain (28.8%), fibromyalgia (22.4%), sleep disorders (20.5%), arterial hypertension (17.8%), dyslipidemia (16.3%), neuropathic pain (11.4%), and cognitive impairment (5.8%). In all, 45.3% of the sample were found to be markedly to extremely ill. A total of 84.3% had received 1 to more than 4 prior lines of therapy. The most common reason for prescribing duloxetine in the high-dose range was a lack of efficacy of previous treatment (41%) or because the patient showed only a partial response to lower doses of duloxetine (30.7%). CONCLUSION: A greater than expected proportion of patients with advanced, marked, or severe disease, psychiatric comorbidity, sleep disorders, neuropathic pain, and cognitive impairment was observed among the subjects with MDD treated with high-dose duloxetine.