Name an SNRI used as an adjuvant analgesic and summarize its analgesic rationale.

• A. Duloxetine; enhances descending inhibitory pathways via increased serotonin and norepinephrine; useful in neuropathic pain; monitor BP and liver function.
• B. Fluoxetine; primary SSRI with no analgesic effect.
• C. Sertraline; not used for analgesia.
• D. Amitriptyline; TCA with different mechanism.

Answer: (A)