Minocycline May Reduce Pain of Some Patients With Neuropathic Pain

Neuropathic pain may potentially be reduced with minocycline. These findings from a narrative review were published in the Journal of Pain Research.

Researchers from 3 universities in South Korea searched publication databases through January 2021 for articles (N=9) on minocycline and neuropathic pain. The studies included in this review included 232 individuals who were given minocycline for their pain in randomized clinical trials (n=7) or prospective observational studies (n=2).

Among patients with chemotherapy-induced neuropathy, 2 studies reported a positive effect and 1 study showed no effect. One positive effect was reported in a study of patients (n=22) with breast cancer receiving minocycline 100 mg twice daily for 12 weeks. These patients reported less pain and used less opioid medication.

Another positive effect was found in patients (n=19) with non-small cell lung cancer receiving chemoradiation for 6 to 7 weeks. Those receiving minocycline 100 mg twice daily had significantly less pain, fatigue, and shortness of breath. In the last study, patients (n=32) with locally advanced or metastatic colorectal cancer receiving 100 mg twice daily for 4 months reported no beneficial effects.

Patients with lumbar pain reported either a positive effect or no effect. Patients (n=43) with lumbar radicular pain who had received 8 days of minocycline at the time of surgery reported no improvement in pain compared with control group participants when surveyed 3 months later. Patients (n=17) who had subacute lumbar radicular pain reported a positive effect (1.47-point reduction of pain) after 100 mg of minocycline for 2 weeks. The positive effect was determined to be of little clinical significance.

Minocycline did not appear to be effective for the treatment of carpal tunnel among 43 patients who underwent surgery. They received 200 mg of the drug 2 hours before surgery and then 100 mg twice daily for 5 days.

A reduction in pain was reported by patients (n=25) with diabetic neuropathy. After 6 weeks of twice-daily 100 mg minocycline, their pain measured on the visual analog scale was reduced from 6.7 to 2.9.

Patients (n=11) who took 100 mg minocycline daily for 3 months for their leprotic neuropathy reported a 75% or greater reduction of pain, and all but 2 patients had functional improvement as well.

A study that included patients who had various etiologies of neuropathic pain found that after 4 weeks of escalating minocycline doses from 100 mg to 200 mg, pain was moderately reduced from 5.6 to 5.3.

No study reported negative side effects.

These data indicated some patients with neuropathic pain, especially those with leprotic neuropathy or diabetic neuropathy, may benefit from minocycline therapy with little risk for adverse effects.

Reference

Shin DA, Kim TU, Chang MC. Minocycline for controlling neuropathic pain: a systematic narrative review of studies in humans. J Pain Res. 2021;14:139-145. doi:10.2147/JPR.S292824