Abstract
Background: Peripheral neuropathy is a painful condition deriving from many and varied
etiologies. Certain medications have been implicated in the iatrogenic development of Drug
Induced Peripheral Neuropathy (DIPN) and include chemotherapeutic agents, antimicrobials, cardiovascular
drugs, psychotropic, anticonvulsants, among others. This review synthesizes current
clinical concepts regarding the mechanism, common inciting medications, and treatment options for
drug-induced peripheral neuropathy.
Methods: The authors undertook a structured search of bibliographic databases for peer-reviewed
research literature using a focused review question and inclusion/exclusion criteria. The most relevant
and up to date research was included.
Results: Drug-induced peripheral neuropathy is a common and painful condition caused by many
different and frequently prescribed medications. Most often, DIPN is seen in chemotherapeutic
agents, antimicrobials, cardiovascular drugs, psychotropic, and anticonvulsant drugs. Certain drugs
exhibit more consistent neuropathic side effects, such as the chemotherapeutic compounds, but
others are more commonly prescribed by a larger proportion of providers, such as the statins. DIPN
is more likely to occur in patients with concomitant risk factors such as preexisting neuropathy,
diabetes, and associated genetically predisposing diseases. DIPN is often difficult to treat, however
medications including duloxetine, and gabapentin are shown to reduce neuropathic pain. Advanced
techniques of neuromodulation offer promise though further randomized and controlled studies are
needed to confirm efficacy.
Conclusion: Awareness of the drugs covered in this review and their potential for adverse neuropathic
effect is important for providers caring for patients who report new onset symptoms of pain,
paresthesia, or weakness. Prevention of DIPN is especially important because treatment often
proves challenging. While many pharmacologic therapies have demonstrated analgesic potential in
the pain caused by DIPN, many patients remain refractive to treatment. More studies are needed to
elucidate the effectiveness of interventional, neuromodulating therapies.
Keywords:
Drug induced peripheral neuropathy, chemotherapy, statins, gabapentinoids, pain, paresthesia, weakness.
Graphical Abstract
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