Clinical activity of venlafaxine and topiramate against oxaliplatin-induced disabling permanent neuropathy.

Venlafaxine (Effexor; Wyeth Lederle), a serotoninergic-like anti-depressant, and Topiramate (Epitomax; Jansen Cilag), a new anti-epileptic drug, share some evidence of clinical activity in the treatment of neuropathic pain. Several anti-cancer agents have neurosensory toxicity as limiting toxicity of their repeated administration. One of the most recent and the most widely used is oxaliplatin. No medication is presently known to be active against oxaliplatin permanent neurosensory toxicity. We observed that venlafaxine hydrochloride or low-dose topiramate could be active against the permanent neuropathy-related symptoms of oxaliplatin. Both agents allowed pain relief and a significant autonomy improvement. These preliminary results invite us to evaluate further venlafaxine hydrochloride and topiramate for the treatment of permanent anti-cancer chemotherapy-induced neuropathies.