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Neurotoxic effects of medications: an update

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Research Abstract from Rev Med Liege. 2004;59 Suppl 1:118-23.

(note: 2nd paragraph is very important - GG)

Neurotoxic effects of medications: an update

Arne-Bes MC.

Unite des Maladies Musculaires et Electrophysiologie, Service de

Neurologie, Hopital Rangueil, Toulouse.

Peripheral neuropathy is a common neurotoxic effect of medications.

Antineoplastic agents and antiretroviral medications are most often

involved: platinum compounds, vinca alkaloids, taxols and nucleoside

reverse transcriptase inhibitors. These agents cause a dose-related

axonal polyneuropathy. Symptoms are indicative of a predominantly

sensory or sensory-motor neuropathy which in some cases is accompanied

by dysfunction of autonomic nervous system. Depending on dosage and

agent used symptoms resolve completely or not. Neurotoxic effect can

appear immediately during or shortly after administration of the drug

but sometimes after cessation of chemotherapy. In all cases the

neuropathy alters the quality of life. A general predisposition for

developing a neuropathy has been observed in nerves previously damaged

by diabetes mellitus, alcohol or in inherited neuropathy.

Within the past five years, some cases of neuropathy caused by

alpha-interferon, statins or tacrolimus have been reported. Although

rare, these aetiologies should be considered by physicians and the drugs

removed when others causes of neuropathy have been excluded. Few cases

of peripheral neuropathy have been recently reported with metronidazole,

dapsone, nitrofurantoin or colchicin. Thalidomide induces a

dose-dependant sensori-motor length-dependent axonal neuropathy. It

should be judiciously used with close neurologic monitorin. Little is

known about the mechanisms responsible for the development of

neuropathy. Up to now, no drug is available to prevent or cure

drug-induced neuropathies.

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