Venlafaxine HCl in the treatment of painful peripheral uremic neuropathy: A case report

Background: It is well known that uremia may lead symmetric sensorimotor polyneuropathy that tends to affect the lower limbs compared to upper limbs. It typically involves the legs than the arms. Clinical manifestations include paresthesia, painful dysesthesia, weakness in the legs and arms. The traditional tricyclic antidepressants (TCA) are commonly used in the treatment of painful peripheral polyneuropathy. Venlafaxine is a serotonin-noradrenaline reuptake inhibitor that may have analgesic effect on painful peripheral polyneuropathy. Case Report: Venlafaxine extended release capsule (Effexor 75mg XR, Wyeth) was administered to a 49 years old female patient who has been under hemodialysis therapy for 7 years. She complained of bilateral numbness, pain, pin-pricking and burning in her feet that increasing in the evening. She was also suffered from insomnia for two months. The patient's symptoms were resolved in two weeks after beginning to the therapy but the intensity of pain continued minimaly and the patients demonstrated effective improvements at her insomnia in this period. Venlafaxine was well tolerated and there were no side effects such as nasuea, elevated blood pressure and dizziness. Conclusions: Venlafaxine relieved the symptoms of the uremic polyneuropathy and it was effective in insomnia.