• Lee Hyer, Ciera Scott, Christine M Mullen, Laura C McKenzie, and Joe Sam Robinson.
• Georgia Neurosurgical Institute, Macon, Georgia; Clinical Medical Psychology, Mercer University School of Medicine, Macon, Georgia.
• J Opioid Manag. 2015 Mar 1;11(2):147-55.

ObjectiveThis study describes a single-site investigation on the effects of a randomized double-blind placebo trial targeting duloxetine added to opioid use (duloxetine + opioid) against a comparator (placebo + opioid) in spine surgery patients, independent of major depression.DesignThe double-blind comparator study assessed two groups on opioids: one using duloxetine and the other a placebo. Subjects were administered the respective medication 2 weeks prior to surgery and continued on this for more than 3 months. Subjects were assessed at three times: prior to surgery, 4 weeks postsurgery, and 12 weeks postsurgery. They completed a battery of tests assessing for pain, adjustment, and psychiatric problems.SettingNeurosurgical outpatient and inpatient setting.PatientsSixty-eight patients completed the study. They received one of three types of elective spine surgery.InterventionsSubjects were given duloxetine or placebo 2 weeks prior to surgery and continued with the regimen for more than 3 months.OutcomesThe primary focus was pain and second on adjustment factors and psychiatric symptoms: depression and anxiety. The amount of opioid use presurgery and postsurgery was also evaluated.ResultsThere were differences among the groups on Brief Pain Inventory (BPI)-Average, the core pain marker, and BPI-Sleep. Within-subject analyses showed that duloxetine subjects improved significantly from baseline. For function, post-CIBIC and post-Functional Adjustment Questionnaire were significant, favoring duloxetine. Reduction of opioid use was not a factor; both groups' utilization declined. For affect, both groups were significantly improved over time.ConclusionsDuloxetine seems to improve pain, assist with maintaining function, and reduce intensity of affect.

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