Duloxetine (Cymbalta) has been restricted for use in Scotland by the Scottish Medicines Consortium.
This decision is based upon limited evidence of efficacy in comparison to other antidepressants in major depression. The product is therefore restricted to use in patients who are unable to tolerate or have not responded to initial treatment options.
The recommendation made here still stands that treatment with this drug in Primary Care is not recommended based on the fact that most patients in primary care have mild depression.
Action: Duloxetine should not be used as an antidepressant in a Primary Care Setting.