Psychiatry & Psychotherapy Podcast Duloxetine and the SNRIs Deep Dive Part 1 with Dr. Cummings
Mar 11, 2021
Dr. Michael Cummings, a leading psychopharmacologist specializing in SNRIs, dives deep into duloxetine's role as an antidepressant. He discusses the history and mechanics of SNRIs, sharing insights on their effects on serotonin and norepinephrine reuptake. Cummings highlights side effects like nausea and sexual dysfunction, stressing the importance of careful monitoring. He also addresses risks like hepatotoxicity and withdrawal symptoms, along with the significance of personalized treatment plans for managing mental health and pain disorders.
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Duloxetine's Uses
- Duloxetine treats depression, anxiety, and pain.
- Part 2 will cover its efficacy in detail.
History of Antidepressants
- Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) were the first antidepressants.
- They had safety issues: TCAs' lethal dose is close to the therapeutic dose, and MAOIs risk hypertensive crisis.
SNRI Mechanism of Action
- SNRIs inhibit serotonin and norepinephrine reuptake, but at different ratios depending on the specific medication.
- Venlafaxine's ratio is highest, while levomilnacipran is more noradrenergic.