Treatment of erythromelalgia with a serotonin/noradrenaline reuptake inhibitor.

(Letter to the Editor) SIR, Erythromelalgia is an unusual disorder characterized by the triad of red, hot and painful extremities. The symptoms are exacerbated by heat and improved by cold. Its aetiology is not fully understood. Numerous different medications including aspirin, gabapentin, amitriptyline, benzodiazepines and opiates have been used in attempts to treat the symptoms of erythromelalgia, with varying success.[1] We report our experience with the use of venlafaxine (Efexor®; Wyeth Ayerst Pharmaceuticals, St Davids, PA, USA), a serotonin and noradrenaline reuptake inhibitor, in the treatment of primary erythromelalgia. Venlafaxine has previously been reported to improve the symptoms in one case of Raynaud's phenomenon [2] and two cases of erythromelalgia.[3]