skip to main content

Duloxetine Dual — MRCPsych Paper B MCQ

Instant feedback + full explanation. One question, done properly.

ModerateMood DisordersDuloxetine DualMRCPsych Paper B

A 52-year-old woman with major depressive disorder also has painful diabetic peripheral neuropathy. Following assessment of contraindications and discussion of treatment options, duloxetine is being considered. Which pairing of UK-licensed indications and pharmacological mechanism is correct?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Major depressive disorder and diabetic peripheral neuropathic pain; serotonin and noradrenaline reuptake inhibition

Duloxetine is licensed in UK adults for major depressive disorder, generalised anxiety disorder and diabetic peripheral neuropathic pain. It inhibits serotonin and noradrenaline reuptake; enhancement of descending inhibitory pain pathways is thought to contribute to its analgesic effect. This makes option E the correct pairing for a patient with depression and painful diabetic neuropathy. Fibromyalgia is not a licensed indication in the cited UK SmPC, excluding C and D. Alpha-2-delta calcium-channel subunit binding is associated with gabapentinoids rather than duloxetine. Duloxetine is neither a mu-opioid receptor agonist nor an irreversible monoamine oxidase inhibitor, excluding A and E.

Reference: electronic Medicines Compendium, Duloxetine 60 mg gastro-resistant capsules, hard, Summary of Product Characteristics, sections 4.1 and 5.1, updated 6 June 2025. https://www.medicines.org.uk/emc/product/13593/smpc