Duloxetine vs Desipramine for Chronic Pain
Trial Summary
Will I have to stop taking my current medications?
The trial information does not specify if you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the drug duloxetine for chronic pain?
Duloxetine has been shown to be effective in relieving pain associated with major depressive disorder and diabetic peripheral neuropathic pain, and it is also used for fibromyalgia, which involves chronic pain. This suggests it may help with chronic pain, although more research is needed to confirm its effectiveness specifically for chronic pain conditions.12345
What safety data exists for duloxetine and desipramine in humans?
Duloxetine has been studied for safety in various conditions, including major depressive disorder, diabetic peripheral neuropathic pain, and fibromyalgia. Common side effects include nausea, headache, dry mouth, insomnia, fatigue, constipation, diarrhea, and dizziness. There is no specific safety data provided for desipramine in the research articles.46789
How does the drug duloxetine differ from other treatments for chronic pain?
Duloxetine is unique because it works by directly affecting pain pathways in the brain, providing both pain relief and antidepressant effects, which is beneficial for conditions like fibromyalgia and diabetic neuropathic pain. It is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI), which means it increases the levels of these neurotransmitters to help reduce pain and improve mood.1011121314
What is the purpose of this trial?
Over 100 million Americans suffer from chronic pain resulting in annual cost of roughly $635 billion. Limited treatments are available for this widespread disease. The data supporting these treatments lack generalizability to patients with more serious medical and psychological comorbidities who are often excluded from explanatory efficacy trials. Our work aims to integrate randomized comparative effectiveness research with patient care. The investigators will randomize the patients and collect data using an open-source learning healthcare system already in use in our department to monitor patients' progress: Collaborative Health Outcomes Information Registry (CHOIR). Collaborative Health Outcomes Information Registry uses the National Institute of Health Patient Reported Outcomes Measurement Information System item banks for comparative metrics through computer adaptive testing. The investigators will leverage the advantage of this novel system to compare effectiveness of duloxetine and desipramine in decreasing pain in patients with chronic pain. The investigators will also compare adherence of patients to these two commonly used medications over a period of six months. This will evaluate feasibility of integrating randomized comparative effectiveness research with patient care in subspecialty clinics. Collaborative Health Outcomes Information Registry can then be applied for numerous future trials to advance our knowledge in perioperative and pain medicine.
Research Team
Vafi Salmasi, MD.
Principal Investigator
Stanford University
Eligibility Criteria
This trial is for adults over 18 with chronic pain lasting more than 3 months who could benefit from antidepressant treatment. It's not for those who've previously had no success with Duloxetine or Desipramine, have conditions that make these drugs unsafe, or choose not to participate.Inclusion Criteria
Exclusion Criteria
Timeline
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants are randomized to receive either duloxetine or desipramine, with dosages adjusted as tolerated, to assess effectiveness in decreasing pain
Follow-up
Participants are monitored for safety and effectiveness after treatment
Treatment Details
Interventions
- Desipramine
- Duloxetine
Desipramine is already approved in United States for the following indications:
- Depression
- Irritable Bowel Syndrome
- ADHD
- Dysautonomia
- Vulvodynia
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Who Is Running the Clinical Trial?
Stanford University
Lead Sponsor