We administered venlafaxin HCl in 10 patients who had unremitting painful chemotherapy-induced peripheral neuropathy and 2 patients who had paresthesia, numbness, walking difficulty but no pain. None of the patients were receiving chemotherapy at the time of venlafaxin HCl administration. Six patients had stable disease, 4 patients were in remission, and 2 patients had progressive disease and were on supportive treatment. Before venlafaxin HCl was started, peripheral sensory neuropathy was demonstrated with physical examination and electromyography in all of them. During the first week of the treatment patients were administered daily 37.5 mg venlafaxine peroral and 75 mg extended release capsules (Efexor, Wyeth) daily thereafter. The patients were observed and symptoms were reevaluated after eight weeks of treatment. Before the treatment, all patients were evaluated with standard visual analogue scale (VAS) (a 100 mm horizontal line marked ¡¡ãno pain¡¡À at one end and ¡¡ãworst possible pain¡¡À at the other). Follow up assessment with VAS was done at 2nd
weeks. Paresthesia and numbness were measured by the patients¡¯ judgment as mild, moderate or severe. Walking difficulty was evaluated to be present or not. On each visit the patients were asked about any possible adverse effects. Specially to evaluate toxicity, we asked patients to note whether they having any of the following symptoms during each week; sleepiness or sleeping difficulty, nausea, vomiting, drowsiness and dry mouth.
Change in pain score and severity of toxicity over time was assessed by Friedman's test or Cochrane's Q where appropriate. A p value of < 0.05 was considered as significant. SPSS 10.0 was used for the statistical analysis.