Journal of Psychiatry

Abstract

Pretreatment with Duloxetine May Prevent Chemotherapy-Induced Neuropathic Pain: A Pilot Study

Janean E. Holden

Statement of the Problem: Approximately 70% of patients receiving oxaliplatin for colorectal cancer develop painful oxaliplatin- induced peripheral neuropathy (OIPN-P).  OIPN-P can persist up to 11 years after treatment is stopped, affecting quality of life, and contributing to falls, depression, and sleep loss. OIPN-P also necessitates decreased dosage during treatment, thereby decreasing treatment effectiveness and increasing mortality risk. Recent work is suggestive that pretreating with tricyclic drugs can prevent onset of OIPN-P, but these drugs have serious side effects.

Methodology: Rats were pretreated with duloxetine (15 mg; PO) for 7 days prior to and through oxaliplatin treatment, and for 20 days post oxaliplatin treatment. Rats were then tested for 6 days after all treatment stopped. The measure used was a 15 g von Frey filament applied to the left foot, which measures hyperalgesia, a sign of neuropathic pain.

Findings: We found that rats pretreated with duloxetine presented with significantly less hyperalgesia through the testing period compared to control, and notably for the six days after all treatment stopped (p ≤ 0.003; p ≤ 0.13; males and females resp.).

Conclusion and Significance: These pilot study findings are suggestive of the need for further study to determine whether pretreatment with duloxetine can prevent onset of OIPN-P

Published Date: 2020-08-29; Received Date: 2020-08-05