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Tolerability and efficacy of duloxetine in a nontrial situation
Article first published online: 13 MAR 2007
DOI: 10.1111/j.1471-0528.2007.01288.x
RCOG 2007 BJOG An International Journal of Obstetrics and Gynaecology
Issue
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 114, Issue 5, pages 543–547, May 2007
Additional Information
How to Cite
Duckett, J., Vella, M., Kavalakuntla, G. and Basu, M. (2007), Tolerability and efficacy of duloxetine in a nontrial situation. BJOG: An International Journal of Obstetrics & Gynaecology, 114: 543–547. doi: 10.1111/j.1471-0528.2007.01288.x
Publication History
- Issue published online: 11 APR 2007
- Article first published online: 13 MAR 2007
- Accepted 8 January 2007. Published OnlineEarly 13 March 2007.
- Abstract
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Keywords:
- Detrusor overactivity;
- duloxetine;
- mixed incontinence;
- urodynamic stress incontinence
Objective To assess the tolerability and efficacy of duloxetine in a nontrial situation.
Design Prospective observational study.
Setting Urogynaecology Unit, District General Hospital, UK.
Population Two hundred and twenty-two women with a diagnosis of urodynamic stress incontinence (USI) or mixed USI and detrusor overactivity (DOA) took duloxetine for 4 weeks.
Methods The results of therapy were assessed with a Patient Global Impression of Improvement (PGI-I) questionnaire. One hundred and forty-eight (67%) women were initially treated with 40 mg twice a day, 67 (30%) women were treated with an escalating dose initially at 20 mg twice a day increasing to 40 mg twice a day after 2 weeks and seven (3%) women were started on a dose of 20 mg twice a day which they continued.
Main outcome measures Discontinuation rates and PGI-I scores.
Results Overall 146/222 (66%) women discontinued therapy due to adverse effects or lack of efficacy. Significantly more women starting on the 40 mg twice a day dose stopped due to adverse effects when compared with the escalating dose (P < 0.025). Of the women who tolerated therapy, 80 out of 120 (67%) had a PGI-I score indicating an improvement. However, the overall rate of improvement was 37%. PGI-I scores and discontinuation rates were not significantly different between the group with USI and the group with mixed USI and DOA (P > 0.05).
Conclusion In a nontrial situation duloxetine is poorly tolerated. Introducing an escalating dose may improve tolerability. A similar number of women with USI and mixed incontinence had a PGI-I score indicating improvement.