Duloxetine Dual — MRCPsych Paper B MCQ

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EasyLiaison PsychiatryDuloxetine DualMRCPsych Paper B

An adult has major depressive disorder and painful diabetic peripheral neuropathy. Which antidepressant has UK marketing authorisation for the treatment of both conditions in adults?

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Correct answer: A — Duloxetine

Duloxetine is the correct answer. Its UK Summary of Product Characteristics lists both major depressive disorder and diabetic peripheral neuropathic pain as licensed indications in adults. Duloxetine is a serotonin–noradrenaline reuptake inhibitor, and NICE also includes it among initial pharmacological options for neuropathic pain other than trigeminal neuralgia. Fluoxetine, paroxetine, sertraline and citalopram are selective serotonin reuptake inhibitors: although they have antidepressant indications, they do not have the same licensed indication for diabetic peripheral neuropathic pain. The question concerns UK marketing authorisation rather than whether a medicine might have off-label effects on other types of chronic pain.

Reference: Electronic Medicines Compendium, Duloxetine Zentiva 30 mg gastro-resistant hard capsules, Summary of Product Characteristics, section 4.1 Therapeutic indications; last updated 10 April 2025. https://www.medicines.org.uk/emc/product/100749/smpc