[Neurotoxic effects of medications: an update].
Peripheral neuropathy is a common neurotoxic effect of medications. Antineoplastic agents and antiretroviral medications are most often involved: platinum compounds, vinca alkaloids, taxols and nucleoside reverse transcriptase inhibitors. These agents cause a dose-related axonal polyneuropathy. Symptoms are indicative of a predominantly sensory or sensory-motor neuropathy which in some cases is accompanied by dysfunction of autonomic nervous system. Depending on dosage and agent used symptoms resolve completely or not. Neurotoxic effect can appear immediately during or shortly after administration of the drug but sometimes after cessation of chemotherapy. In all cases the neuropathy alters the quality of life. A general predisposition for developing a neuropathy has been observed in nerves previously damaged by diabetes mellitus, alcohol or in inherited neuropathy. Within the past five years, some cases of neuropathy caused by alpha-interferon, statins or tacrolimus have been reported. Although rare, these aetiologies should be considered by physicians and the drugs removed when others causes of neuropathy have been excluded. Few cases of peripheral neuropathy have been recently reported with metronidazole, dapsone, nitrofurantoin or colchicin. Thalidomide induces a dose-dependant sensori-motor length-dependent axonal neuropathy. It should be judiciously used with close neurologic monitorin. Little is known about the mechanisms responsible for the development of neuropathy. Up to now, no drug is available to prevent or cure drug-induced neuropathies.
Arné-Bès
M C
MC
Unité des Maladies Musculaires et Electrophysiologie, Service de Neurologie, Hôpital Rangueil, Toulouse. arne-bes.mc@chu-toulouse.fr
D044966:Anti-Retroviral Agents / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D016190:Carboplatin / Q000009:adverse effects; D002945:Cisplatin / Q000009:adverse effects; D003078:Colchicine / Q000009:adverse effects; D000077143:Docetaxel; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects; D020258:Neurotoxicity Syndromes / Q000209:etiology*; D009944:Organoplatinum Compounds / Q000009:adverse effects; D000077150:Oxaliplatin; D017239:Paclitaxel / Q000009:adverse effects; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced*; D043823:Taxoids / Q000009:adverse effects; D013792:Thalidomide / Q000009:adverse effects
D044966:Anti-Retroviral Agents; D000970:Antineoplastic Agents; D016898:Interferon-alpha; D009944:Organoplatinum Compounds; D043823:Taxoids; D000077150:Oxaliplatin; D000077143:Docetaxel; D013792:Thalidomide; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin; D003078:Colchicine