Study Shows Duloxetine Reduces Pain from ChemotherapyApr 3, 2013
Researchers from several cancer centers in the US have found the depression drug duloxetine—known commercially as Cymbalta—can help people who develop a painful side effect from chemotherapy. Peripheral neuropathy is caused by damage to nerves that carry information about sensation to the brain. The researchers estimate 20% to 40% of cancer patients treated with certain chemotherapy drugs including taxanes, platinums, vinca alkaloids, and bortezomib will develop this kind of pain.
The study included 231 people with painful chemotherapy-induced peripheral neuropathy who were randomly assigned to receive duloxetine or a placebo (dummy pill). After 5 weeks, 59% of people taking duloxetine reported reduced pain compared to 38% of those taking the placebo.
The drug is an antidepressant that works by raising the levels of certain chemicals in the brain. Besides treating depression and anxiety, it is approved to treat pain from arthritis and from diabetes and fibromyalgia. Study participants took 30 milligrams a day for the first week and 60 milligrams a day for the next 4 weeks.
The study was published in the April 3, 2013 issue of the Journal of the American Medical Association (JAMA).
The pain of peripheral neuropathy
Painful chemotherapy-induced peripheral neuropathy can last from months to years after chemotherapy is completed and can interfere with everyday life. The pain itself is distressing, while impaired sensation can lead to problems with simple tasks like buttoning a shirt and tying shoelaces. Previous studies have not found drugs that provide enough pain relief to improve patients’ quality of life and functioning.
In the JAMA study, patients taking duloxetine reported decreases in joint pain, muscle cramps, weakness, and numbness and tingling in the feet. They reported improvement in walking, hearing, and buttoning buttons.
Although duloxetine is approved to treat pain from other conditions, use of the drug to treat chemotherapy-induced peripheral neuropathy would be considered off-label.
Common side effects include nausea and drowsiness.
Effect of Duloxetine on Pain, Function, and Quality of Life Among Patients With Chemotherapy-Induced Painful Peripheral Neuropathy. Published in the April 3, 2013 issue of the Journal of the American Medical Association (Vol. 309, No. 13). First author: Ellen M. Lavoie Smith, PhD, University of Michigan, Ann Arbor, Mich.