Duloxetine: a drug proven to reduce nerve damage in the hands and feet that can occur as a side effect of chemotherapy

Numbness in the hands and feet after chemotherapy

Some chemotherapy drugs can cause nerve damage in the hands and feet. This condition is called chemotherapy-induced peripheral neuropathy . Damage to the nerves that control our senses and movements can cause abnormal sensations such as pain, burning, stinging, and tingling, as well as weakness, constipation, inability to grasp objects, balance problems, and movement disorders. Chemotherapy-induced nerve damage impairs quality of life by restricting daily activities and causing stress. In this article, we will introduce duloxetine, a drug proven effective in treating this troublesome side effect of chemotherapy.

Peripheral nerves form a complex network connecting the brain and spinal cord to the muscles, skin, and internal organs. These nerves emerge from the spinal cord and spread to the extremities of the body along with their dermatomes. Some chemotherapy drugs can cause damage at various points along this journey of the peripheral nerves. This damage can occur at the nerve ganglion where the peripheral nerve emerges from the spinal cord, the microtubules along the peripheral nerve's long tail, the sheaths surrounding these nerves, and the small nerve endings. By disrupting the connection between the brain and body, this condition causes impaired muscle movement, loss of sensation in the arms and legs, abnormal sensations, pain, and difficulty moving.

Such symptoms can occur as side effects of chemotherapy drugs used to treat cancer, such as paclitaxel, vincristine, vinblastine, venorelbine, cisplatin, and oxaliplatin, and this side effect can last for months or even years. If this occurs, your doctor will make the necessary adjustments to your treatment according to the severity of the problem.

What are the symptoms?

Side effects after chemotherapy

• Numbness, burning, tingling, pain, and loss of sensation in the fingers and toes
• Extreme sensitivity to cold or heat
• Difficulty with movements such as picking up or grasping objects or fastening buttons
• Ringing in the ears, impaired balance, difficulty walking, changes in blood pressure, constipation

How can we cope?

Coping with side effects after chemotherapy

• The doctor readjusts the doses of chemotherapy drugs.
• If the condition worsens, the doctor changes the chemotherapy drugs.
• Drug treatment may be used to reduce side effects. For years, drugs intended to reduce chemotherapy-induced peripheral nerve damage and the symptoms arising from this damage have been tested. Although many drugs have been tried, only duloxetine has been found effective, reducing chemotherapy-induced peripheral nerve damage and associated symptoms by up to %60.

Duloxetine is actually a widely used medication for depression. It works by increasing the concentrations of substances called serotonin and norepinephrine in the area where nerves communicate with one another. It also has a pain-relieving effect independent of its antidepressant effect.

Taking 60 mg of duloxetine orally each day has been found to significantly reduce neuropathic pain, particularly that associated with paclitaxel and oxaliplatin use. Alongside this effectiveness, duloxetine was well tolerated, meaning that its side effects are limited and manageable.

In conclusion, duloxetine, has taken its place in our clinical practice as an option for treating chemotherapy-induced peripheral neuropathy that significantly reduces symptoms, is well tolerated, and improves quality of life.