Amitriptyline in the prevention of chemotherapy-induced neuropathic symptoms.
BACKGROUND
Neuropathy is a common adverse effect of chemotherapy. The tricyclic antidepressant, amitriptyline, is a gold standard in the treatment of neuropathic pain. This double-blind, randomized placebo-controlled trial assessed the efficacy of amitriptyline to prevent chemotherapy-induced neuropathic symptoms.


METHODS
Patients without previous neuropathy, who started chemotherapy with vinca alcaloids, platina derivatives or taxanes, were randomized to receive amitriptyline (target dose, 100 mg daily) or placebo for the duration of their chemotherapy. Chemotherapy-induced neuropathic symptoms were evaluated with a patient diary and after every third chemotherapy cycle with clinical examination. The diary data were transformed to a neuropathy score. A total of 114 patients fulfilling the inclusion criteria were randomly assigned to the treatment or control arm.


RESULTS
There was no difference in the appearance of chemotherapy-induced neuropathic symptoms between the groups. In general, the intensity of neuropathic symptoms was mild.


CONCLUSIONS
Amitriptyline does not prevent chemotherapy-induced neuropathy.
Kautio
Anna-Liisa
AL
Department of Oncology, Helsinki University Central Hospital, 00029 HUS, Finland.
Haanpää
Maija
M
Leminen
Arto
A
Kalso
Eija
E
Kautiainen
Hannu
H
Saarto
Tiina
T
D000328:Adult; D000368:Aged; D000639:Amitriptyline / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000188:drug therapy*; D010919:Placebos
D000970:Antineoplastic Agents; D010919:Placebos; D000639:Amitriptyline