The buried, older literature on Lithium continues to amaze me, published in a vast array of peer-reviewed papers. There seems to be little interaction of the medical community in applying its uses.
One of the most frustrating pains is that of post-chemotherapy neuritis especially of the lower legs. This pain is extremely distressing as a mixture of sensory disturbances – burning, hypersensitivity, pain etc. together with at times of “epileptic bursts” of pain in the feet. This is extremely distressing to patients as it seems to occur or is more noticed when attempting to sleep. The use of the standard AEDs such as Lyrica, Neurontin, and Cymbalta in my experience is of limited use in severe cases.
Many cases of post-chemotherapy neuritis come on after many years, often decades.
One of the most useful treatments is the topical application of 5,10 or 15% Phenytoin in a variety of bases often of a liposomal nature. This work has been spearheaded and raised to a level of “go to” treatment by a double-blind study by Professor Jan Hesselink. Time will only tell how well this treatment is accepted. The main form of topical Phenytoin is patented in Europe. From my limited use of this product, it is of an outstanding value with continuing effect which may increase with time and break the pain cycle.
In many ways, this article was going to end at this point however readers of the various articles of mine will appreciate that Lithium has a high standing in my present view of medical problems ranging from Alzheimer’s, depression, anxiety, not to mention the potential of cell regeneration in many neurological conditions.
As far as I am aware, Lithium has not been used in the treatment of latent, over 1 or 2 decades, of post-chemotherapy neuritis. Thus, it was with considerable interest that I read the paper by Petrini “Is Lithium able to reverse neurological damage by vinca alkaloids”. This was an interestingly crafted paper administering Lithium in the form of carbonate to both humans and mice and measuring the neurotoxicity as in neuropathy. Both humans and mice showed a marked improvement or abolition of neuropathic toxicity from chemotherapy. All the human patients started Lithium after they developed symptoms of neurotoxicity. One wonders if Lithium was given closely associated with the chemotherapy if this would have been avoided? In conclusion to their paper, “both results from animal experiments and human observation show that Lithium administered may counteract the acute or semi-acute neurotoxicity of vinca alkaloids”. There seems to have been no effect on the decrease in chemotherapy effect on the myeloid disorders that they were treating.
The big question and the study that needs to be done especially since Lithium in the doses that were used cause no concern, the equivalent of 600 mg of carbonate, is should this be used as a routine in a series of patients receiving chemotherapy? This seems to be no antagonism of Lithium to the chemotherapy. This paper was mainly concerned with the semi-acute neuropathies but I think a long-term study would be rewarding and needs to be completed. It seems that the Lithium effect from the past work of this group does not affect the inhibition of the chemotherapy agents on their lymphoid tissue targets.
The simple question to be asked is, is there a place for Lithium during chemotherapy? I can see little downside!