Fraile-Martinez Oscar, Garcia-Montero Cielo, Alvarez-Mon Miguel Angel, Ortega Miguel A, Alvarez-Mon Melchor, Quintero Javier
Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Madrid, Spain.
Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain.
Brain Sci. 2025 Jul 17;15(7):757. doi: 10.3390/brainsci15070757.
Duloxetine is widely used for the treatment of major depressive disorder (MDD), generalized anxiety disorder (GAD), and various types of neuropathic pain. While its efficacy is well documented in clinical trials, less is known about how it is perceived and utilized in routine psychiatric practice. To address this knowledge gap, we conducted a cross-sectional observational study involving 80 psychiatrists from Spain to assess real-world clinical attitudes toward duloxetine.
Participants completed a 20-item multiple-choice questionnaire that examined familiarity, perceived efficacy in multiple conditions (MDD, GAD, neuropathic pain, somatization, and quality of life), and perspectives on tolerability, safety, adherence, and overall satisfaction.
Survey results indicated that a large majority of psychiatrists frequently prescribe duloxetine, particularly for patients with MDD and comorbid chronic pain. Notably, 94% rated it as either "more effective" or "much more effective" for diabetic peripheral neuropathic pain. Psychiatrists reported a high perceived efficacy of duloxetine: 94% rated it as "more effective" or "much more effective" for diabetic peripheral neuropathy, and 93% gave similarly positive ratings for general neuropathic pain. For somatization, 70% found it "effective" or "very effective", and 83% observed improvements in quality of life for many of their patients. Psychiatrists generally reported favorable perceptions of duloxetine's tolerability profile: 97.5% rated it as the antidepressant associated with the least weight gain, and 82.5% perceived fewer sexual side effects compared to other options. Sedation and gastrointestinal side effects were generally considered mild or less severe. In terms of treatment adherence, 69% rated it as "better" or "much better" than other antidepressants, and 80% found its combination with other antidepressants to be "favorable" or "very favorable". Overall satisfaction was high, with 99% of psychiatrists reporting being either "satisfied" or "very satisfied" with its use. The side effect profile was generally viewed as manageable, with low perceived rates of weight gain, sedation, and sexual dysfunction. Furthermore, 96% of respondents expressed a willingness to recommend duloxetine to their colleagues.
Psychiatrists reported highly favorable attitudes toward duloxetine, viewing it as a flexible treatment option in routine care. However, these findings reflect clinicians' subjective perceptions rather than objective clinical outcomes and should be interpreted accordingly.
度洛西汀广泛用于治疗重度抑郁症（MDD）、广泛性焦虑症（GAD）以及各类神经性疼痛。虽然其疗效在临床试验中有充分记录，但对于它在常规精神科实践中的认知和使用情况却知之甚少。为填补这一知识空白，我们对来自西班牙的80位精神科医生开展了一项横断面观察性研究，以评估对度洛西汀的现实临床态度。
参与者完成了一份包含20个项目的多项选择题问卷，该问卷考察了熟悉程度、在多种病症（MDD、GAD、神经性疼痛、躯体化及生活质量）中的感知疗效，以及对耐受性、安全性、依从性和总体满意度的看法。
调查结果表明，绝大多数精神科医生经常开具度洛西汀，尤其是用于患有MDD和合并慢性疼痛的患者。值得注意的是，94%的医生将其对糖尿病性周围神经病变性疼痛的疗效评为“更有效”或“有效得多”。精神科医生报告称度洛西汀的感知疗效很高：94%的医生将其对糖尿病性周围神经病变的疗效评为“更有效”或“有效得多”，93%的医生对一般性神经性疼痛也给出了类似的积极评价。对于躯体化，70%的医生认为它“有效”或“非常有效”，83%的医生观察到许多患者的生活质量有所改善。精神科医生普遍对度洛西汀的耐受性概况持积极看法：97.5%的医生将其评为与体重增加最少相关的抗抑郁药，82.5%的医生认为与其他药物相比其性副作用更少。镇静和胃肠道副作用通常被认为较轻或不太严重。在治疗依从性方面，69%的医生将其评为比其他抗抑郁药“更好”或“好得多”，80%的医生认为它与其他抗抑郁药联合使用“有利”或“非常有利”。总体满意度较高，99%的精神科医生报告对其使用“满意”或“非常满意”。副作用概况通常被认为是可控的，体重增加、镇静和性功能障碍的感知发生率较低。此外，96%的受访者表示愿意向同事推荐度洛西汀。
精神科医生对度洛西汀的态度非常积极，将其视为常规治疗中的一种灵活选择。然而，这些发现反映的是临床医生的主观认知，而非客观临床结果，应相应地进行解读。
