What medications cause neuropathy
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Medications That Cause Neuropathy
Peripheral neuropathy, a condition characterized by pain, paresthesia, and weakness, can be induced by various medications. This article synthesizes the findings from multiple research studies to highlight the medications most commonly associated with drug-induced peripheral neuropathy (DIPN).
Chemotherapeutic Agents and Neuropathy
Chemotherapy-Induced Neuropathy: Chemotherapeutic agents are among the most frequently implicated in causing peripheral neuropathy. Drugs such as cisplatin, paclitaxel, oxaliplatin, and thalidomide are known to induce neuropathy, often as a dose-limiting side effect 156. These agents can cause both axonal and demyelinating neuropathies, with symptoms often persisting even after discontinuation of the drug 56.
Antimicrobials and Neuropathy
Antibiotics and Antiviral Drugs: Certain antibiotics, such as linezolid, and antiviral drugs, particularly nucleoside reverse transcriptase inhibitors used in HIV treatment, are also associated with neuropathy. These drugs can affect mitochondrial function, leading to sensory neuropathy 256.
Cardiovascular Drugs and Neuropathy
Statins and Beta-Blockers: The use of statins, commonly prescribed for lowering cholesterol, has been linked to neuropathy, although the risk is considered low compared to their cardiovascular benefits 26. Additionally, cardiovascular drugs, including beta-adrenergic antagonists, have been associated with an increased risk of neuropathy, particularly in older patients undergoing chemotherapy .
Psychotropic and Anticonvulsant Drugs
Psychotropic Medications: Drugs used to treat psychiatric conditions, such as certain antidepressants and antipsychotics, can also cause neuropathy. The tricyclic antidepressants, while effective for neuropathic pain, have been noted for their potential to induce neuropathy 19.
Anticonvulsants: Medications like gabapentin and pregabalin, although used to treat neuropathic pain, can paradoxically cause neuropathy in some cases. These drugs are generally well-tolerated, but their long-term use requires monitoring 19.
Other Medications and Toxins
Miscellaneous Drugs: Other medications, including tumor necrosis factor-α blockers (e.g., infliximab, etanercept), the inflammatory arthritis agent leflunomide, and dichloroacetate, have been implicated in causing neuropathy 23. Additionally, chronic exposure to certain toxins can lead to neuropathy, with mechanisms varying from axonal damage to demyelination 38.
Conclusion
Drug-induced peripheral neuropathy is a significant and often challenging condition to manage. Awareness of the medications that can cause neuropathy is crucial for healthcare providers to prevent and mitigate this adverse effect. While many pharmacologic therapies are available to alleviate neuropathic pain, prevention remains key, as treatment can be difficult and not always effective. Further research is needed to develop better preventive and therapeutic strategies for DIPN.
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