In a recent study, the antidepressant drug duloxetine (Cymbalta) helped ease pain from chemotherapy-induced peripheral neuropathy in 59% of patients. For about 30% of patients, this tingling feeling is more than uncomfortable; it’s a painful sensation. This is the first clinical trial to find an effective therapy for this pain.
For the trial, researchers studied patients who, after receiving the chemotherapy drugs oxaliplatin or paclitaxel, reported painful neuropathy. The 231 patients were randomly assigned to receive either duloxetine or a placebo for 5 weeks. Duloxetine is thought to inhibit pain by boosting neurotransmitters that interrupt pain signals to the brain. Patients were asked to report weekly on their pain levels.
Study results showed that 59% of patients who received duloxetine reported reduced pain compared with only 39% of those taking placebo.
“These drugs don’t work in everyone. The good news is it worked in the majority of patients. We need to figure out who are the responders. If we can predict who they are, we can target the treatment to the people it’s going to work for,” said lead study author Ellen M. Lavoie Smith, PhD, APRN, AOCN, assistant professor at the University of Michigan School of Nursing and a researcher at the U-M Comprehensive Cancer Center.
In this study, participants received 30 mg of duloxetine per day the first week. Then, the dosage was doubled to 60 mg daily for 4 more weeks. With this approach, few severe side effects were reported. Fatigue was the most common side effect.
Because severe and painful peripheral neuropathy can lead doctors to limit the patient’s chemotherapy dose, finding a treatment is critical. According to Smith, patients often avoid disclosing the pain to their doctors because they do not want their chemotherapy dose decreased.
Smith says, “In addition to improving symptoms and quality of life, treating peripheral neuropathy pain potentially improves quantity of life if it helps patients avoid decreasing their chemotherapy medications.”
In the future, researchers hope to determine which patients are most likely to benefit from duloxetine.
Source: University of Michigan Health System.