Drug-Induced Peripheral Neuropathy, a Narrative Review

: 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. In many cases, DIPN develops in a dose dependent fashion following continued use of a neurotoxic agent. The development of DIPN should be suspected in patients who are receiving drug treatment and report new onset symptoms of pain, paresthesia, or weakness. In patients in whom a history of DIPN is suspected, motor and sensory nerve conduction studies may support the clinical diagnosis. While difficult to prevent, 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.