Antidepressant Rinses Away Cancer Pain

Head and neck cancer treatment related oral mucositis relieved with doxepin

(RxWiki News) Radiation therapy is used to treat head and neck cancers – particularly those that aren’t good candidates for surgery. While effective, this treatment usually leaves painful mouth sores that can take weeks to heal.

When given as a rinse, the antidepressant doxepin - sold under the brand names: Adapin, Silenor and Sinequan - relieved painful mouth conditions in head and neck cancer patients who had been treated with radiation therapy.

These are the findings of a phase III clinical trial testing the effectiveness of a doxepin oral rinse to relieve oral mucositis - inflammation and swelling of tissues in the mouth – in patients who had received radiation for head and neck cancer.

"Ask about pain relief therapies."

“Radiation for head and neck cancer often causes painful mouth sores and oral mucositis,” said study lead author, Robert C. Miller, MD, a radiation oncologist at the Mayo Clinic in Rochester, Minn.

“Doxepin rinse has previously been proven to be a well-tolerated treatment for mouth pain due to radiation and chemotherapy treatment,” Dr. Miller said in a press release.

This study involved 140 head and neck cancer patients who were treated with radiation therapy (RT) between December 2010 and May 2012. More than one-third of the mouth received targeted radiation. The participants were randomly selected to receive either doxepin or a placebo. They received one, and then switched to the other the next day.

Researchers surveyed the patients regularly for four hours after the rinses were given. They graded their pain on a scale of one to ten. After statistical calculations, those who used the doxepin rinse said their pain was reduced by -9.1 points over the course of the study compared to -4.7 points over the study for those who were given a placebo. 

Some short-term side effects with the rinse were reported - stinging/burning sensation, bad taste in the mouth and drowsiness Patients were told they could continue with the doxepin after the study and 64 percent chose to do so.

“Our study validates doxepin rinse as an effective way to alleviate oral pain and sets a new standard of care,” Dr. Miller said.

This study was presented October 29 at the American Society for Radiation Oncology’s (ASTRO) 54th Annual Meeting. All research is considered preliminary before it's published in a peer-reviewed journal.

Review Date: 
November 6, 2012