Drugs to treat peripheral neuropathy

In the previous week, I dealt with two cases of patients presenting with peripheral neuropathy and they were not the only ones. It seems there is a growing number of patients presenting with this condition.
The symptoms of peripheral neuropathy include numbness, tingling in the fingers and/or in the toes with some patients explaining it as “heat” or “electricity” in these places. Some even experience it in the joints especially those of the legs. This refers to the conditions that result when nerves carrying messages to and from the brain and spinal cord from and to the rest of the body are damaged or diseased. Sexual dysfunction and low blood pressure might also occur sometimes.

This condition is often seen in patients with diabetes, those with cancers in the blood, and those with arthritis (inflammation of the joints) classified as rheumatoid arthritis. It is also seen with people who misuse drugs as well as alcoholics. It can also occur when persistent pressure is applied to the nerve in question.
For some people though, it is not that they are abusing drugs, rather, it is due to the nature of the prescribed treatment they are using. An example of this is tuberculosis patients who are being treated with Isoniazid. The drug is known to deplete levels of vitamin B6 in the body. This is results into peripheral neuropathy mentioned above.

This is even so with patients who are HIV positive. It is for this reason that people taking isoniazid are also given vitamin B6 to avoid its depletion in the body at all costs. And if the tingling occurs when one has been prescribed both isoniazid and vitamin B6, neither treatment should be stopped.
The patient should, on the other hand, go back to the medical facility and explain their symptoms to either their doctor or pharmacist who will most likely make some adjustments.

Peripheral neuropathy is managed by a specific type of a group of drugs as well as physiotherapy.
A class of drugs called tricyclic antidepressants, anti-anxiety drugs, certain painkillers called opioids as well as anticonvulsants are recommended for this condition. The different drugs could be given alone or in combination.
One’s doctor or pharmacist will choose the best combination of drugs depending on how one responds. The downside to these drugs is that one tends to feel sleep or drowsy and they are best taken at night as one goes to bed.

The writer is a pharmacist