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STUDY TO KNOW THE EFFICACY OF PREGABALIN VERSUS AMITRIPTYLINE FOR THE TREATMENT OF PAINFUL DIABETIC NEUROPATHY

Dr Ghulam Subhani, Dr Pir Zada, Dr Maksalmina Reshtin.

Abstract: Objective: To associate the efficacy of amitriptyline, pregabalin and placebo in relieving pain linked with diabetic peripheral neuropathy. Study Design: A Randomised Placebo-Based Study. Place and Duration: In the Medicine Unit I of Jinnah Hospital Lahore for one year duration from February 2017 to February 2018. Methodology: 150 patients were randomly assigned to the study. Pain relief was assessed on an 11-point Likert scale [NRS]; 0 = no pain during a reference period of 7 days "10 = worst possible pain"). After a 1 week wash period without study drug, participants were divided into 3 groups of 70 patients each receiving placebo, amitriptyline or pregabalin for six weeks. The first dose of amitriptyline and pregabalin was 75 mg twice daily and 10 mg before bedtime. Doses were increased as required during the 1st and 3rd weeks of treatment. The maximum dose of pregabalin and amitriptyline was 300 mg twice daily and 75 mg before bedtime. Responders were those who experienced a 50% or more reduction in the initial pain score in NRS. Results: 210 patients were included in the study. 126 (60%) were male and 84 (40%) were female. The age ranged from 22 to 76 years. 112 (53.3%) had diabetes for <15 years and the remaining 98 (46.7%) had DM for 15 years. 105 (50%) experienced diabetic neuropathy for more than 6 months, while the remaining 50% had painful DN for more than 6 months. A significant improvement was observed in PNG pain in patients receiving pregabalin (48.1%) and amitriptyline (41.4%) than those receiving placebo (10.5%). Conclusion: Pregabalin and amitriptyline treatment of patients with PND provides better pain relief than placebo. Of the two drugs, pregabalin showed a greater response. Key Words: poly diabetic neuropathy (DPN), numerical rating scale (NRS).

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