Duloxetine Safety and Efficacy in Children

FDA-Approved Indications and Safety Considerations

The American Academy of Child and Adolescent Psychiatry indicates that duloxetine is the only SNRI with FDA indication for treatment of any anxiety disorder in children 1, 2
Duloxetine should be discontinued and not restarted in patients who develop jaundice or other evidence of clinically significant liver dysfunction, and severe skin reactions can occur with duloxetine, requiring discontinuation at the first appearance of blisters, peeling rash, or mucosal erosions 1, 2
The American Academy of Child and Adolescent Psychiatry recommends that duloxetine may interact with drugs metabolized by CYP1A2 and CYP2D6, and concomitant administration of duloxetine with MAOIs is contraindicated due to increased risk of serotonin syndrome 1, 2

For ADHD, the American Academy of Pediatrics recommends stimulants (methylphenidate and amphetamines) as first-line pharmacological treatment for elementary school-aged children (6-11 years), although this fact is from a less preferred source, non-stimulant medications like atomoxetine, extended-release guanfacine, and extended-release clonidine are alternative options for ADHD with sufficient evidence 3