Chemotherapy Neuropathy – Drug Combo Helps Pains

Combo Pregabalin(lyrica) and Duloxetine(Cymbalta) was able to control paclitaxel induced peripheral neuropathy.

Am J Hosp Palliat Care. 2013 Nov;30(7):734-6.
Successful treatment by adding duloxetine to pregabalin for peripheral neuropathy induced by Paclitaxel.
Takenaka M, Iida H, Matsumoto S, Yamaguchi S, Yoshimura N, Miyamoto M.
http://www.ncbi.nlm.nih.gov/pubmed/23064035

  • Paclitaxel is isolated from Pacific Yew tree and is used in solid tumors – “lung, ovarian, breast, head and neck cancer, and advanced forms of Kaposi’s sarcoma” according to Wikipedia.
  • Peripheral neuropathy is a common occurrence and difficult to treat
  • Patient was treated with pregabalin 150 mg and later 50 mg due to tolerance
  • Severe pain/disability
  • adding duloxetine 20-30 mg gained good control

Comment –  problem might have been completely avoided had L-Acetyl Carnitine been used during chemotherapy:
Prevent Chemotherapy Neuropathy With L-Acetyl Carnitine (LAC) – Please Take
http://painmuse.org/?p=2748

It is, however, nice to have options for this pain that I have found resistant to treatment.

 Venlafaxine might be used in cases that cannot afford Cymbalta – as per:

 Tasmuth, Tiina, Brita Härtel, and Eija Kalso.
“Venlafaxine in neuropathic pain following treatment of breast cancer.”
European Journal of Pain 6, no. 1 (2002): 17-24.
http://www.ncbi.nlm.nih.gov/pubmed/11888224

“The average daily pain intensity as reported in the diary (primary outcome) was not significantly reduced by venlafaxine compared with placebo. However, the average pain relief (diary) and the maximum pain intensity (retrospective assessment by the computer program) were significantly lower with venlafaxine compared with placebo.” – OK,  not a great review but maybe when combined with lyrica could work?

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