High-dose duloxetine as an effective treatment for painful chemotherapy-induced peripheral neuropathy: a case report

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  • ABE Hiroaki
    Department of Anesthesiology and Pain Relief Center, the University of Tokyo Hospital
  • SUMITANI Masahiko
    Department of Pain and Palliative Medicine, the University of Tokyo Hospital
  • HOZUMI Jun
    Department of Anesthesiology and Pain Relief Center, the University of Tokyo Hospital
  • OBUCHI Maiko
    Department of Anesthesiology, Toranomon Hospital
  • KOGURE Takamichi
    Department of Anesthesiology and Pain Relief Center, the University of Tokyo Hospital
  • YAMADA Yoshitsugu
    Department of Anesthesiology and Pain Relief Center, the University of Tokyo Hospital

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Other Title
  • 有痛性化学療法誘発性末梢神経障害に対し高用量デュロキセチンが著効した1例
  • 症例 有痛性化学療法誘発性末梢神経障害に対し高用量デュロキセチンが著効した1例
  • ショウレイ ユウツウセイ カガク リョウホウ ユウハツセイ マッショウ シンケイ ショウガイ ニ タイシ コウヨウリョウ デュロキセチン ガ チョコウシタ 1レイ

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Abstract

Chemotherapy-induced peripheral neuropathy (CIPN) can lead to neuropathic pain, which is usually drug-resistant and difficult to manage. Painful CIPN could sustain after chemotherapy and profoundly impair patients' quality of life. Novel treatment strategies are needed. Duloxetine, which is an antidepressant and the first-line drug for diabetic neuropathy, is expected to have efficacy for painful CIPN. In Japan, the maximum daily dose of duloxetine is 60 mg. However, in the United States a dose of 120 mg per day is approved as an antidepressant, and its safety is established. In this clinical study, we applied high-dose duloxetine (120 mg/day) to a CIPN patient. Her pain was improved prominently, and few adverse events were observed. The degree of pain-related functional interference was improved completely. Further, after cessation of duloxetine, pain again became worse, but the completely improved pain-related functional interference continued. Although further studies are needed, high-dose duloxetine would be promising for a novel treatment of painful CIPN.

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