Peripheral neuropathy (PN) numbs many an HIVer’s feet, hands or legs, making them tingle and swell, too. We’ve had painfully few PN therapies—and nukes like Zerit (d4T) or Videx (ddI) can worsen the condition. So here’s a sight for sore limbs: One month after getting the FDA OK for treating depression, Eli Lilly’s Cymbalta (duloxetine) was approved in September as the first pain reliever for diabetic PN. The drug regulates serotonin and norepinephrine, brain chemicals thought to rule both mood and pain sensation.
Cymbalta hasn’t been tested in HIVers, but similar meds have been shown to interact with protease inhibitors (PIs). However, David Simpson, MD, director of Mount Sinai’s Neuro-AIDS Program in Manhattan, calls the drug “worth pursuing in HIV PN.”
In two 12-week studies of more than 1,000 diabetics with PN, once-daily Cymbalta quickly reduced the amount of pain suffered over the course of a day. It also paid its snooze dues, helping trial subjects sleep without PN’s common night misery. Few stopped the med due to its minor side effects: nausea, constipation, dry mouth, diarrhea. Better a few runs than having feet that can’t.