Amitriptyline vs pregabalin in painful diabetic neuropathy a randomised placebo-based study

Aim: to compare the efficacy of amitriptyline,pregabalin and placebo in alleviating pain associated with diabetic peripheral neuropathy. method: a total of 150 patients were randomly recruited for the study. assessment for pain relief was carried out on an 11-point,likert-like numeric rating scale [nrs]; 0= no pain to 10=worst possible pain) over a 7-day baseline period. following a 1-week washout period without study medications,the participants were divided into 3 groups,each consisting of 70 patients,receiving either placebo,amitriptyline or pregabalin for a period of 6-week. the initial doses of pregabalin and amitriptyline were 75 mg twice daily and 10 mg at bedtime,respectively. doses were titrated upward as necessary during weeks 1 and 3 of therapy the maximum doses of pregabalin and amitriptyline were 300 mg twice daily and 75 mg at bedtime,respectively. responders were patients who experienced 50% or more reduction in the baseline pain score on nrs. results: 210 patients were included in the study. 126(60%) were males and 84 (40%) were females. the age ranged from 22 to 76 years. 112(53.3%) had diabetes of <15 years duration,while the rest 98 (46.7%) had been suffering from dm for >15 years. 105 (50%) suffered from diabetic neuropathy for a duration <6 months,while the rest 50% had painful dn for a period exceeding 6 months. significant improvement in pain of dpn was observed in patients receiving pregabalin (48.1%) and amitriptyline (41.4%) as compared to the ones getting placebo (10.5%) conclusion: treating patients of dpn with pregabalin and amitriptyline results in better improvement in pain as compared to placebo. out of the two drugs,pregabalin demonstrated greater response.