Publication Name	World Journal of Psychiatry
Manuscript ID	116224
Country	Japan

Category	Psychiatry
Manuscript Type	Letter to the Editor
Article Title	Unpacking the promise and peril of celecoxib and duloxetine in knee osteoarthritis management
Manuscript Source	Invited Manuscript
All Author List	Takahiko Nagamine
Funding Agency and Grant Number
Corresponding Author	Takahiko Nagamine, Department of Psychiatric Internal Medicine, Sunlight Brain Research Center, 4-13-18 Jiyugaoka, Hofu 7470066, Yamaguchi, Japan. tnagamine@outlook.com
Key Words	Celecoxib; Duloxetine; Insomnia; Osteoarthritis; Adverse events
Core Tip	Combining celecoxib and duloxetine is more effective than celecoxib alone for pain, depression, and anxiety in knee osteoarthritis. However, its assertion of safety after only eight weeks is overly optimistic. Prescribers must be warned about the serious long-term risks that were not adequately covered. Celecoxib carries established cardiovascular and gastrointestinal risks, while duloxetine poses significant risks for hepatotoxicity, central nervous system side effects (like dizziness and falls), and a severe discontinuation syndrome. Given the older people, often comorbid knee osteoarthritis population, the combination requires thorough cardiovascular and hepatic screening, meticulous review for drug-drug interactions, and informed consent regarding the mandatory slow tapering of duloxetine. The evidence is preliminary; this dual-action treatment should be reserved for patients who have failed simpler strategies.
Citation	Nagamine T. Unpacking the promise and peril of celecoxib and duloxetine in knee osteoarthritis management. World J Psychiatry 2026; In press

Received	2025-11-06 06:11
Peer-Review Started	2025-11-06 06:26
First Decision by Editorial Office Director	2025-12-19 08:03
Return for Revision	2025-12-19 08:03
Revised	2025-12-20 06:10
Publication Fee Transferred
Second Decision by Editor	2026-02-05 02:44
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-02-05 10:10
Articles in Press	2026-02-05 10:10
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2220-3206 (online)
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