The therapeutic potential of duloxetine in prostate cancer-related fatigue

The therapeutic potential of duloxetine in prostate cancer-related fatigue Rita De Sanctis1, Alessandro Viganò2,3 1Department of Medical Oncology and Haematology, Humanitas Clinical and Research Center, IRCCS, 20089 Rozzano, Italy. 2Department of Neurology and Psychiatry, Sapienza University, 00185 Rome, Italy. 3Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University, 00185 Rome, Italy. Correspondence to: Dr. Rita De Sanctis, Department of Medical Oncology and Haematology, Humanitas Clinical and Research Center, IRCCS, 20089 Rozzano, Italy. E-mail: rita.de_sanctis@cancercenter.humanitas.it Cancer-related fatigue (CRF) is a common polysymptomatic syndrome with no standard therapy. The authors present the case of a prostate cancer patient in whom, during hormone therapy, disabling CRF and urinary incontinence occurred. CRF was assessed according to the brief fatigue inventory (BFI). The patient received duloxetine, 60 mg daily, due to its impact on both CRF and incontinence. After 2 months, the BFI score decreased (from 9 to 2) and urinary incontinence resolved. After duloxetine discontinuation, the patient maintained a low BFI score. The authors conclude that, as a serotonin-noradrenaline reuptake inhibitor, duloxetine could be active on prostate CRF, especially with associated urinary symptoms. Therefore, a pilot placebo-controlled trial with duloxetine to treat prostate CRF may be worthwhile.