Risks of Medications For People With CMT Questioned

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Risks of Medications For People With CMT Questioned

http://www.mdausa.org/research/060727cmt_medication_risks.html

Worsening of Charcot-Marie-Tooth (CMT) disease as a result of

medication use may not be as worrisome as popular belief has

portrayed it, say investigators who recently culled data from medical

literature and from 209 people in the CMT North American Database, an

MDA-funded registry.

Louis Weimer of Columbia University and Podwall of Albert

Einstein College of Medicine, both in New York, found the only drug

with certain and potentially severe adverse consequences, even after

a single dose, was vincristine, an anticancer drug.

Other drugs for which suspicions have been raised and for which

prudence is suggested are those used to treat HIV/AIDS; the

antibiotics metronidazole and nitrofurantoin; phenytoin, used to

treat seizures; statins, used to lower cholesterol; the

antidepressant sertraline, although not others in the same SSRI class

of drugs; and nitrous oxide anesthesia, commonly used in dentistry.

" As with any treatment, " the investigators write in the March 15

issue of the Journal of the Neurological Sciences, " the risk of

neuropathy exacerbation must be weighed against expected treatment

benefits and available equivalent, alternative treatments. "

They say alternatives to the suspect medications are available in

almost all instances; and when they aren't, the suspect drugs can be

used with caution and monitoring.

In general, they note, there's " considerable disparity between the

perceived risk of potentially neurotoxic medications and the number

of reports in the literature, other than for vincristine. "

Shy, a neurologist at Wayne State University, where he co-

directs an MDA clinic and is an MDA research grantee, calls the

recent paper " important for CMT patient management, since it provides

the first in-depth evaluation of medications that might potentially

exacerbate CMT.

" The fact that most medications have not adversely affected any form

of CMT is good news for patients and emphasizes the need for data

rather than theoretical concerns in management decisions involving

patients.

" These results also emphasize the importance of patient registries,

such as the CMT North American Database, without which much of this

information could not have been obtained. "