Journal ArticleDOI
Amitriptyline relieves diabetic neuropathy pain in patients with normal or depressed mood
Mitchell B. Max,Mary Culnane,Susan C. Schafer,Richard H. Gracely,D. J. Walther,B. Smoller,Ronald Dubner +6 more
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It is concluded that amitriptyline relieves pain in diabetic neuropathy; this effect is independent of mood elevation.Abstract:
In a randomized, double-blind crossover study, 29 patients with painful diabetic neuropathy received 6 weeks of amitriptyline and 6 weeks of an "active" placebo that mimicked amitriptyline side effects. Amitriptyline was superior to placebo in relieving pain in weeks 3 through 6. Both steady, burning pain and lancinating pains were relieved. Patients able to tolerate higher amitriptyline doses reported greater relief, through the maximum dose of 150 mg nightly. Amitriptyline analgesia was similar in depressed and nondepressed subgroups and was not associated with mood improvement. We conclude that amitriptyline relieves pain in diabetic neuropathy; this effect is independent of mood elevation.read more
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Pharmacologic management of neuropathic pain: evidence-based recommendations.
Robert H. Dworkin,Alec B. O'Connor,Miroslav Backonja,John T. Farrar,Nanna B. Finnerup,Troels S. Jensen,Eija Kalso,John D. Loeser,Christine Miaskowski,Turo Nurmikko,Russell K. Portenoy,Andrew S.C. Rice,Brett R. Stacey,Rolf-Detlef Treede,Dennis C. Turk,Mark S. Wallace +15 more
TL;DR: Patients with neuropathic pain are challenging to manage and evidence‐based clinical recommendations for pharmacologic management are needed, and medications should be individualized, considering side effects, potential beneficial or deleterious effects on comorbidities, and whether prompt onset of pain relief is necessary.
Journal ArticleDOI
Gabapentin for the Symptomatic Treatment of Painful Neuropathy in Patients With Diabetes Mellitus: A Randomized Controlled Trial
Miroslav Backonja,Ahmad Beydoun,Keith R. Edwards,Sherwyn Schwartz,Vivian Fonseca,Marykay Hes,L. LaMoreaux,Elizabeth A. Garofalo +7 more
TL;DR: Gabapentin monotherapy appears to be efficacious for the treatment of pain and sleep interference associated with diabetic peripheral neuropathy and exhibits positive effects on mood and quality of life.
Journal ArticleDOI
Diabetic Neuropathy: A Position Statement by the American Diabetes Association
Rodica Pop-Busui,Andrew J.M. Boulton,Eva L. Feldman,Vera Bril,Roy Freeman,Rayaz A. Malik,Jay M. Sosenko,Dan Ziegler +7 more
TL;DR: Although screening for rarer atypical forms of diabetic neuropathy may be warranted, DSPN and autonomic neuropathy are the most common forms encountered in practice and the strongest available evidence regarding treatment pertains to these forms.
Journal ArticleDOI
Algorithm for neuropathic pain treatment:: an evidence based proposal.
TL;DR: NNT and NNH are currently the best way to assess relative efficacy and safety, but the need for dichotomous data, which may have to be estimated retrospectively for old trials, and the methodological complexity of pooling data from small cross‐over and large parallel group trials, remain as limitations.
Journal ArticleDOI
Efficacy of pharmacological treatments of neuropathic pain: an update and effect related to mechanism of drug action.
TL;DR: It is concluded that tricyclic antidepressants in optimal doses appear to be the most efficient treatment of neuropathic pain, but some of the other treatments may be important due to their better tolerability.
References
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