McCormack Paul L, Keating Gillian M
Adis International Limited, Auckland, New Zealand.
Drugs. 2004;64(22):2567-73; discussion 2574-5. doi: 10.2165/00003495-200464220-00005.
Duloxetine is an orally administered, balanced, dual serotonin and norepinephrine (noradrenaline) reuptake inhibitor that increases neural input to the urethral sphincter, thereby relieving the symptoms of stress urinary incontinence (SUI). Duloxetine 40 mg twice daily for 12 weeks reduced the median incontinence episode frequency (IEF) to a significantly greater extent than placebo in women with predominant symptoms of SUI. In most studies, Incontinence Quality of Life (I-QOL) questionnaire total scores were significantly improved compared with placebo. In a dose-escalation study in women with severe SUI scheduled for continence surgery, duloxetine 80-120 mg/day for 8 weeks significantly reduced IEF and increased I-QOL total scores compared with placebo, and caused 20% of recipients to reconsider their willingness to undergo surgery. Duloxetine or duloxetine plus pelvic floor muscle training (PFMT) were more effective in reducing the median IEF than PFMT alone or no treatment in women with SUI. Mean I-QOL total scores suggested that combination therapy was more effective than either therapy alone. Nausea was the most frequent adverse event and was the main cause for discontinuing duloxetine therapy.
度洛西汀是一种口服的、兼具平衡作用的5-羟色胺和去甲肾上腺素（去甲肾）再摄取抑制剂，可增加尿道括约肌的神经输入，从而缓解压力性尿失禁（SUI）的症状。对于以SUI为主要症状的女性，每日两次服用40mg度洛西汀，持续12周，与安慰剂相比，可显著降低尿失禁发作频率中位数（IEF）。在大多数研究中，与安慰剂相比，尿失禁生活质量（I-QOL）问卷总分显著改善。在一项针对计划进行尿失禁手术的重度SUI女性的剂量递增研究中，与安慰剂相比，每天服用80-120mg度洛西汀，持续8周，可显著降低IEF并提高I-QOL总分，且使20%的受试者重新考虑其接受手术的意愿。在患有SUI的女性中，度洛西汀或度洛西汀联合盆底肌训练（PFMT）在降低IEF中位数方面比单独进行PFMT或不进行治疗更有效。I-QOL总分均值表明联合治疗比单独任何一种治疗更有效。恶心是最常见的不良事件，也是停止度洛西汀治疗的主要原因。
