Which of the following is the commonest side effect of duloxetine?A. Hot flushes
Duloxetine is a serotonin and noradrenaline reuptake inhibitor. Inhibition of serotonin and noradrenaline reuptake is thought to improve stress incontinence by increasing tone in the pudendal nerve, thereby increasing tone in the rhabdosphincter during bladder filling. A Cochrane Review in 2009 evaluated the use of serotonin and noradrenaline reuptake inhibitors in ten randomised controlled trials, showing a significant improvement in quality of life and reduction in incontinence episode frequency by 50% compared with placebo. Objective cure (as measured by pad test) however failed to demonstrate a benefit over placebo. Amongst the trials in this review, approximately one in three participants experienced adverse events. Side effects of duloxetine include hot flushes, anorexia, dry mouth and constipation but the commonest is nausea.
Mariappan P, Alhasso AA, Grant A, N’Dow JMO. Serotonin and noradrenaline reuptake inhibitors (SNRI) for stress urinary incontinence in adults (review). Cochrane Database of Systematic Reviews 2005; Issue 3. Art. No.: CD004742. doi:10.1002/14651858.CD004742.pub2.