Duloxetine for the early manifestations of brain damage in babies with brain damage

The main effect of duloxetine is to treat brain injury, especially closed brain injury. It can achieve a certain therapeutic effect on open brain injury and effectively prevent various problems such as internal infection. However, it is not suitable for infants. Like many patients with brain injury, their vision and brain development are often affected in the early stages of the disease, so it is necessary to pay attention to it in normal times.

Closed head injuries can be divided into concussion, cerebral contusion and brainstem injury according to the degree and location of injury. Concussion refers to a brief brain dysfunction after head trauma. The coma after the injury is short-lived, and the patient usually recovers within a few minutes or 30 minutes. There may be mild headache, nausea, and vomiting within a few days after the injury, but no positive neurological signs. Cerebral contusion and laceration is a morphological damage to brain tissue caused by violence, and the patient will be in a coma for a long time. Depending on the location of the brain tissue damage, different neurological symptoms and signs may occur, such as quadriplegia, facial paralysis, and aphasia. When accompanied by skull base fracture, cranial nerve damage in the corresponding parts is likely to occur, such as olfactory nerve, oculomotor nerve, facial nerve, and auditory nerve damage. When there is subarachnoid hemorrhage, there will be headache and signs of meningeal irritation. When the injury causes cerebral edema and leads to acute increase in intracranial pressure, the patient's headache will worsen, the coma will deepen, and even vital signs will change. In severe cases, brain herniation may also be induced. Brainstem injury can be divided into primary and secondary. The former is caused directly by external force and symptoms appear immediately after the injury. The latter is caused by the compression of the brainstem by the displaced brain tissue during brain herniation. Patients with brainstem injury show persistent coma, rigidity, variable pupil size, both eyes staring in the same direction or eye separation, paralysis of most cranial nerves and bilateral pyramidal tract signs.

The clinical manifestations of open brain injury are similar to those of closed brain injury, but have the following characteristics: the primary disturbance of consciousness is relatively mild; there is bleeding in the wound tract, with overflow of brain tissue and cerebrospinal fluid; the symptoms of increased intracranial pressure are relatively mild, and the focal symptoms in the brain are relatively severe; foreign bodies may be retained in the brain, making intracranial infection prone to occur; and the incidence of long-term epilepsy is relatively high.

Suitable for people

Dosage in patients with impaired renal function - This product is not recommended for patients with advanced renal disease (requiring dialysis) or patients with severe renal impairment (estimated creatinine clearance <30 mL/min) (see Pharmacology and Toxicology).

Dosage for Elderly Patients - For elderly patients, no dosage adjustment based on age is recommended. As with any medication, caution should be used when treating elderly patients. When individualizing the dose in elderly patients, extra caution should be used when increasing the dose.

Treatment of Third Trimester Female Patients - Neonates exposed to SSRIs or SNRIs (serotonin and norepinephrine reuptake inhibitors) during the third trimester of pregnancy may develop complications leading to prolonged hospitalization, the need for respiratory support, and tube feedings (see PRECAUTIONS). When duloxetine is used to treat pregnant women, physicians should carefully review the potential risks and benefits of treatment during the third trimester of pregnancy. Physicians should consider tapering duloxetine during late pregnancy.