Antidepressant Works in Treating Painful Neuropathy

Patients who experience chemotherapy-induced peripheral neuropathy (CIPN), an often painful side effect that can involve numbness and tingling in the hands and feet, may find relief with the antidepressant Cymbalta (duloxetine), according to results from a phase 3 study. Although currently approved for the treatment of diabetic peripheral neuropathic pain, Cymbalta is the first drug that has proven effective in treating CIPN.

Experienced by about one-third of patients treated with taxanes and platinum-based chemotherapy, CIPN can develop weeks, months or years after treatment. Symptoms generally resolve completely, although healing of damaged nerves can take a few weeks to many months or even years.

In the study, 231 patients who had previously reported high levels of pain from CIPN were randomized to one of two arms. Participants in Arm A received Cymbalta for five weeks. After a one-week “washout” period, they received a placebo for five weeks. Participants in Arm B did the opposite, beginning with a placebo and ending with Cymbalta. Researchers reported a statistically significant decrease in pain for those taking Cymbalta in the initial treatment period. The most common side effect was fatigue.

Unfortunately, the drug didn’t work for everyone, which presents the next challenge, says lead investigator Ellen Lavoie Smith, PhD, APRN, AOCN, of the University of Michigan School of Nursing. “We’ll try to identify who will respond so we can target this drug to those who are most likely to benefit.”