Anti-Depressant Helps Manage Peripheral Neuropathy From Chemotherapy

ASCO Annual Meeting
June 4, 2012

In a new study, researchers found that the drug duloxetine (Cymbalta) helps treat a painful side effect of chemotherapy called peripheral neuropathy. Peripheral neuropathy is a condition that occurs when nerves in the body's peripheral nervous system (outside the brain and spinal cord) are damaged. Depending on where the damaged nerves are located, it can cause numbness and tingling in the hands and feet, pain, muscle weakness, constipation, and dizziness.

About 20% to 30% of patients who receive types of chemotherapy called taxanes and platinum-based chemotherapy develop peripheral neuropathy. This long-lasting side effect lowers a patient's quality of life during and after cancer treatment, and for a long time, there was no effective way to treat this condition.

This study included 231 patients who had high levels of pain caused by peripheral neuropathy from chemotherapy. They received either duloxetine followed by placebo (an inactive treatment) or a placebo followed by duloxetine. The dose was started low and then gradually increased to lessen the side effects of duloxetine, which include fatigue, dry mouth, sleepiness, and nausea. Patients completed a survey on the amount of pain they were experiencing before the study started and then weekly during the study. Researchers learned the following information from these surveys:

  • 59% of the patients given duloxetine and 39% of those given the placebo felt that they had less pain
  • 30% of the patients given duloxetine and 33% of those given the placebo felt no change in pain
  • 11% of the patients given duloxetine and 28% of those given the placebo felt that they had more pain

These results show that when patients took duloxetine, they were more likely to have less pain and less likely to have no change or an increase in pain than when they took the placebo. The most common side effect that patients experienced during this study was fatigue, and it was more common for those taking duloxetine.

What this means for patients

“Duloxetine isn't perfect and didn't work for every patient in our study, but it was effective for a majority of people, and this was the first randomized clinical trial to show that any drug is effective for this terrible pain,” said lead author Ellen M. Lavoie Smith, PhD, Assistant Professor in the School of Nursing at University of Michigan in Ann Arbor. “We now have a treatment that could improve the quality of life for many of our patients.” Duloxetine is currently available to treat depression and peripheral neuropathy from diabetes. Talk with your doctor about the use of this drug to treat peripheral neuropathy from chemotherapy.

Questions to Ask Your Doctor

  • What cancer treatments did I receive?
  • What are the possible side effects of those treatments, both in the short term and the long term?
  • How can the side effects be managed?
  • If I have or develop peripheral neuropathy, what are my treatment options? Would duloxetine be considered?

For More Information

Side Effects of Chemotherapy

Managing Side Effects

Managing Peripheral Neuropathy

Placebos in Cancer Clinical Trials