Chemotherapy-induced peripheral neuropathy (CIPN)

Chemotherapy-induced peripheral neuropathy (CIPN) is common especially in patients taking paclitaxel (Taxol) or cisplatin (Platinol).  CIPN may begin weeks to months after the initiation of treatment and often presents with a sensory neuropathy, including numbness and pain. The most common affected part of the body is hand and feet.  Paclitaxel may also cause diffuse aching discomfort in the legs, hips, and lower back, which develop within 1 to 3 days of paclitaxel administration and largely resolve within 7 days.  Although symptoms may resolve after completion of treatment, they are often only partially reversible, and can remain for years.

Recent study assessed efficacy of oral medications on chronic peripheral neuropathic pain by reviewing various published studies.  Seventeen studies comprised of 5,975 subjects, totaling 38 active trial arms evaluating 7 drugs, and 17 drug-dosing combinations met inclusion criteria. Mean pain reduction over placebo ranked highest for duloxetine 120 mg (1.17 95% CI 0.77, 1.58) and pregabalin 600 mg (1.11 95% CI 0.77, 1.45). The indirect treatment comparison showed largest effect size for duloxetine at 120 and 60 mg followed by pregabalin 600 mg. The study conclusion was pregabalin (lyrica) and duloxetine (cymbalta) had the largest beneficial effects for chronic peripheral neuropathic pain.

Just be aware that duloxetine has an FDA black box warning of suicidality.   Therefore, you should ask your doctor if you have depression or other mental disorder.  Pregabalin has no black box warning - at least at this time.

Reference:   
Ney JP, Devine EB, Watanabe JH, Sullivan SD. Comparative efficacy of oral pharmaceuticals for the treatment of chronic peripheral neuropathic pain: meta-analysis and indirect treatment comparisons. Pain Med. 2013 May;14(5):706-19