Peripheral neuropathy (also called chemotherapy-associated peripheral neuropathy) is a side effect that can be caused by some chemotherapy medicines. Peripheral neuropathy is nerve damage in the hands, feet, arms, or legs caused by chemotherapy. Symptoms include burning, tingling, or numbness in the hands and feet. Neuropathy symptoms can be severe and painful.
A study has found that most people with peripheral neuropathy got some relief from the antidepressant medicine Cymbalta (chemical name: duloxetine).
The study was presented at the American Society of Clinical Oncology 2012 Annual Meeting. Read the abstract of CALGB 170601: A phase III double blind trial of duloxetine to treat painful chemotherapy-induced peripheral neuropathy (CIPN).
Some chemotherapy medicines commonly used to treat breast cancer are more likely to cause peripheral neuropathy. These include platinum-based chemotherapy medicines:
- Paraplatin (chemical name: carboplatin)
- Eloxatin (chemical name: oxaliplatin)
and taxane chemotherapy medicines:
- Taxol (chemical name: paclitaxel)
- Abraxane (chemical name: albumin-bound paclitaxel)
- Taxotere (chemical name: docetaxel)
All 231 people in the study were being treated for a variety of cancers, including breast cancer, and had been treated with either Eloxatin or Taxol; they all also were experiencing painful neuropathy symptoms because of chemotherapy.
Half the participants were randomly assigned to be treated with Cymbalta. The other half got a placebo (sugar pill).
All the participants were asked to rate their pain using a pain scale at the study’s start and during the study:
- 59% of people who got Cymbalta said they got some pain relief compared to 38% of people who got the placebo
- pain scores were cut by half or more in 21% of people who got Cymbalta compared to 9% of people who got the placebo
Better quality of life -- mood, enjoyment of life, comfort in walking, work performance, sleep -- also was more likely in people who got Cymbalta compared to people who got the placebo.
Fatigue was the most common side effect associated with taking Cymbalta. Sleep problems, dizziness, and nausea were other side effects. About 7% of people getting Cymbalta said their side effects were severe; 11% of people getting Cymbalta stopped taking Cymbalta because of troubling side effects.
Peripheral neuropathy can be painful and can hamper your quality of life during and after breast cancer treatment. If you’re having painful neuropathy symptoms related to chemotherapy treatment, you might want to talk to your doctor about the results of this study and ask if Cymbalta might make sense for you. Your doctor may suggest a different treatment. Other antidepressant medicines are sometimes used to treat neuropathy:
- Norpramin (chemical name: desipramine)
- nortriptyline (brand names: Aventyl, Pamelor)
- Elavil (chemical name: amitriptyline)
Some seizure medications also are used to treat neuropathy:
- Neurontin (chemical name: garbapentin)
- Tegretol (chemical name: carbamazepine)
- Dilantin (chemical name: diphenylhydantoin)
None of these medicines have been conclusively shown to help ease peripheral neuropathy, but they may be worth a try. Always talk to your doctor about the potential side effects and risks of any treatment you try and weigh them against the potential benefits.
On the Breastcancer.org Neuropathy page, you can learn about some non-medicinal approaches to managing neuropathy symptoms.