Cymbalta: Antidepressant May Help Alleviate Chemo Pain

In a new study, researchers suggest that the antidepressant Cymbalta may help to ease the pain of peripheral neuropathy, a tingling in the extremities encountered by many chemotherapy patients.

Though the study was small, the fact that 59% of participants reported relief from peripheral neuropathy after taking Cymabalta (duloxetine), in comparison with 39% of patients who took a placebo. Study author Ellen Lavoie Smith, assistant professor at the University of Michigan’s School of Nursing, says that taking Cymbalta” decreases chronic chemotherapy-induced neuropathy and pain severity in the majority of patients who take it and improves function and quality of life.” Furthermore, Cymbalta is “very well tolerated” by the majority of patients.

Dr. Stephanie Bernik, chief of surgical oncology at Lennox Hill Hospital in New York City, also finds the study encouraging, stating, “Patients undergoing chemotherapy have to face a multitude of changes, both physically and mentally, and improving their quality of life during this phase of their lives is of utmost importance. It is extremely exciting that there is now a drug we can offer that can reduce this terrible side effect and make chemotherapy more tolerable.”

Peripheral neuropath involves tingling and numbness in the hands and feet, and is a common side effect of many chemotherapy drugs. Experts state that roughly 30% of patients who receive certain chemo drugs experience neuropathy, and that this is a large factor in why some patients cease treatment.

In some cases, according to Smith, “Patients endure this painful neuropathy for months and possibly as long as years following the completion of therapy. So it’s chronic, it’s very distressing and disabling, and then in addition there’s really nothing to date that we know is effective in treating the problem.”

This new study was sponsored by the U.S. National Cancer Institute. It focuses on 231 cancer patients who developed peripheral neuropathy after taking certain chemotherapy drugs. Of these patients, some were given a half-dose of Cymbalta per day for the first week, then a full dose for another four weeks. The rest of the study participants were given a placebo for five straight weeks.

Cymbalta alters levels of the brain neurotransmitters associated with nerve function, which causes neuropathy. The antidepressant is already used with diabetes patients to treat diabetes-related peripheral neuropathy.

In the study, researchers noted that more patients taking Cymbalta had a higher likelihood of reporting a decrease in neuropathic symptoms in comparison with the patients given a placebo. According to smith, “33 percent of patients in the duloxetine group had at least a 30 percent decrease in pain and 21 percent of patients had at least a 50 percent decrease in pain” — numbers much higher than those on the placebo pill.

Furthermore, patients who took the Cymbalta “had a greater decrease in the amount that pain interfered with some very important things — with general activity, with movement, walking, normal work, relations with people, sleep and enjoyment of life,” Smith said.

While many patients in the study experienced peripheral neuropathy relief after taking Cymbalta, not all patients gained benefit and a few even reported more tingling/numbness during the trial. Still, this complaint was less frequent in patients taking Cymbalta than in patients taking the placebo. Cymbalta side effects include fatigue, and 11 percent of the Cymbalta patients reported moderate to severe fatigue.

According to Dr. Cardinale Smith, from the division of hematology/medical oncology at the Tisch Cancer Institute and Mount Sinai School of Medicine in New York City, “It’s true there are not many great treatments for neuropathy, something that is a common side effect of some of the chemotherapy medications that we use for the most common cancers: lung, colon and breast. This study adds evidence of a medication that appears to have good efficacy in treating what can be a debilitating toxicity.”