Which two of my conditions—major depressive disorder, fibromyalgia, post‑traumatic stress disorder, or functional urinary incontinence—are treated with duloxetine?

Duloxetine Treats Major Depressive Disorder and Fibromyalgia

Duloxetine is FDA-approved for both major depressive disorder and fibromyalgia, making these the two conditions from your list that this medication treats. 1

FDA-Approved Indications

Duloxetine has five FDA-approved indications, two of which match your conditions 1:

• Major depressive disorder in adults 1
• Fibromyalgia in adults 1
• Diabetic peripheral neuropathic pain in adults 1
• Generalized anxiety disorder in adults and children ≥7 years 1
• Chronic musculoskeletal pain in adults 1

Why These Two Conditions Respond to Duloxetine

For major depressive disorder, duloxetine works through dual serotonin and norepinephrine reuptake inhibition, which is the mechanism that treats depression 2, 3. The standard dose is 60 mg once daily 1.

For fibromyalgia, duloxetine provides pain relief through the same dual mechanism, but the analgesic effect is independent of its antidepressant properties 4. Multiple high-quality studies demonstrate that duloxetine 60 mg daily achieves ≥50% pain reduction in fibromyalgia with a number-needed-to-treat of 8 at 12 weeks 2, 5. The EULAR (European League Against Rheumatism) guidelines specifically recommend duloxetine as a first-line pharmacological treatment for fibromyalgia 6.

What Duloxetine Does NOT Treat From Your List

• Post-traumatic stress disorder: Duloxetine is not FDA-approved for PTSD 1, and evidence for its use in PTSD is modest or conflicting 7
• Functional urinary incontinence: While duloxetine is approved for stress urinary incontinence in some countries 2, 3, it is not approved for functional urinary incontinence and this is not among the FDA-approved indications in the United States 1

Dosing for Your Two Conditions

• Start at 30 mg once daily for one week to minimize nausea, then increase to 60 mg once daily 8, 9
• Both major depressive disorder and fibromyalgia respond to the same 60 mg daily dose 1, 4
• Taking 120 mg daily does not provide additional benefit over 60 mg for fibromyalgia 6

Common Pitfall to Avoid

Do not confuse stress urinary incontinence (which duloxetine treats in some countries) with functional urinary incontinence (which it does not treat) 1, 2. These are distinct conditions with different pathophysiology.