The evaluation of the protective effect of venlafaxine against chemotherapy induced neuropathy

Abstract

Objective: Taxanes are widely used chemotherapeutic agents in the treatment of several malignancies including breast, non-small cell lung, ovarian and head and neck cancers. Toxicity of these agents includes bone marrow suppression (principally neutropenia), hypersensitivity reactions, cutaneous reactions, edema and neurotoxicity. Neurotoxicity develops cumulatively and is among the most important and dose limiting toxicity of these agents. The most prominent neurotoxicity is sensory neuropathy. The precise mechanism for taxane-induced neuropathy is still unknown. The taxanes are known to promote aggregation of intracellular microtubules. Abnormal aggregation of microtubules in the neuronal cells may cause this neuropathy. Recently, a novel antidepressant agent venlafaxine was reported to have a preventive role in the chemotherapy-induced neurotoxicity. In this study, we aimed to investigate the protective effect of venlafaxine against paclitaxel- and docetaxel-induced neurotoxicity while using it with paclitaxel and docetaxel. Material and Methods: Between January 2004 and September 2004 in the Department of Oncology, School of Medicine, Uludag University, 22 patients with solid tumors planned to receive paclitaxel or docetaxel based chemotherapy were enrolled in the study. 12 patients in group A were treated with chemotherapy alone while 10 patients in group B were treated with chemotherapy plus venlafaxine (75 mg/day). Total neuropathy scores (TNS) and pain scores (VAS) were determined for all patients before chemotherapy and after the last course of chemotherapy. Results: There was no statistically significant difference in terms of TNS and VAS scores between groups A and B. Conclusion: As a result, we decided that venlafaxine had no protective effect on neuropathy induced by taxane-dependent chemotherapy regimes. Copyright © 2008 by Türkiye Klinikleri.