Department of Radiation Oncology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Clinical Research Development Center, Imam Reza Hospital, Kermanshah, Iran.
Cancer Chemother Pharmacol. 2018 Nov;82(5):787-793. doi: 10.1007/s00280-018-3664-y. Epub 2018 Aug 13.
One of the complications of chemotherapy is peripheral neuropathy. Various studies have shown that potent norepinephrine and serotonin reuptake inhibitors such as gabapentin, venlafaxine and duloxetine have therapeutic effects on neuropathy. The aim of this study was to compare the effects of venlafaxine vs. duloxetine on chemotherapy-induced peripheral neuropathy.
In this clinical trial, cancer patients who were suffering from chemotherapy-induced peripheral neuropathy comprised the study population. They were randomly assigned to three pharmacotherapy groups including venlafaxine, duloxetine and placebo. Cranial, sensory, motor neuropathies as well as neuropathic pain were evaluated on day 1, week 2, and week 4 after enrollment.
Grade of cranial, motor, sensory and neuropathic pain decreased significantly in venlafaxine and duloxetine groups. This reduction was more considerable in duloxetine group compared to venlafaxine group (P < 0.05).
Duloxetine seems to be more effective than venlafaxine in decreasing the symptoms of chemotherapy-induced peripheral neuropathy. Duloxetine was more effective than venlafaxine in decreasing motor neuropathy and neuropathic pain grade.
化疗的并发症之一是周围神经病。各种研究表明，强效去甲肾上腺素和 5-羟色胺再摄取抑制剂，如加巴喷丁、文拉法辛和度洛西汀，对周围神经病有治疗作用。本研究旨在比较文拉法辛与度洛西汀对化疗引起的周围神经病的疗效。
在这项临床试验中，患有化疗引起的周围神经病的癌症患者为研究人群。他们被随机分配到三个药物治疗组，包括文拉法辛、度洛西汀和安慰剂组。在入组后第 1 天、第 2 周和第 4 周评估颅神经、感觉神经、运动神经病变以及神经病理性疼痛。
文拉法辛和度洛西汀组的颅神经、运动神经、感觉神经和神经病理性疼痛的严重程度显著降低。与文拉法辛组相比，度洛西汀组的降低更为明显（P<0.05）。
度洛西汀似乎比文拉法辛更能有效减轻化疗引起的周围神经病的症状。度洛西汀在降低运动神经病变和神经病理性疼痛程度方面比文拉法辛更有效。
