Marked improvement of the aromatase induced arthralgia syndrome following treatment with dextroamphetamine sulfate

Abstract

Marked improvement of the aromatase induced arthralgia syndrome following treatment with dextroamphetamine sulfate J.H. Check 1,2 , D.L. Check 2 , M.P. Dougherty 3 1Cooper Medical School Of Rowan University, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Camden, NJ 2Cooper Institute For Reproductive Hormonal Disorders, P.C. Marlton, NJ 3The Commonwealth Medical College, Scranton, PA (USA) Summary Purpose: To evaluate a novel treatment for aromatase induced arteralgia (AIA) syndrome. Materials and Methods:A woman already treated with dextroamphetamine sulfate for many years for a form of fibromyalgia developed AIA after 15 months of taking letrozole following mastectomy for breast cancer. Though she had already been taking dextroamphetamine sulfate 30mg extended release capsules for 25 years for other issues, her dosage was increased to 45mg. Results:Within a short length of time, the AIA manifesting as severe bilateral shoulder pain markedly improved. Conclusions: About 20% of women stop aromatase inhibitor therapy before the ideal 5 year time period because of bone pain and arthralgia. Sympathomimetic therapy should be considered. Hopefully this case will stimulate a larger prospective series. Content: Increasing the dosage of dextroamphetamine sulfate improved the pain from aromatase-induced arthralgia manifesting with severe bilateral shoulder pain. Key words: Aromatase inhibitor, arthralgia, dextroamphetamine sulfate, letrozole, sympathetic nervous system