Abstract

COMPARATIVE ANALYSIS OF EFFECT OF PREGABALIN, GABAPENTIN AND AMITRIPTYLINE IN PATIENTS WITH DIABETIC PERIPHERAL NEUROPATHY BY MICHIGAN NEUROPATHY SCREENING INSTRUMENT AND NEUROPATHY DEFICIT SCORE

Rajesh M.*, Mohapatra S, Swain TR and Mallik AK

Abstract

OBJECTIVE: Diabetic peripheral neuropathy (DPN) is the most common and distressing late complication of diabetes mellitus affecting nearly 50% of diabetic patients and treatment failure cases may develop foot ulcers and gangrene requiring amputation. DPN is responsible for 50% to 75% of non-traumatic amputations. For DPN cases anticonvulsants and antidepressant group of drugs are commonly prescribed with doubtful efficacy. Hence this study was designed to assess the efficacy of Pregabalin, Gabapentin and Amitriptyline in patients with DPN in a tertiary care hospital. METHOD: Diabetic peripheral neuropathy cases were diagnosed by Nerve conduction study (NCS) and data was collected in a preformed proforma. Efficacy of Pregabalin, Gabapentin and Amitriptyline was assessed by Michigan Neuropathy Screening Instrument (MNSI) and Neuropathy Deficit Score (NDS) at 0 week, 4th week and 12th week in a tertiary care hospital. The results were analysed statistically. RESULT: Pregabalin (75 to 300mg per day) produced significant improvement in objective neurological scores (MNSI & NDS scores) in DPN patients at 4th week and 12th week. Gabapentin (300 to 600 mg per day) Amitriptyline (30 mg per day) did so only at 12th week. CONCLUSION: The effect of Pregabalin was significantly greater than Gabapentin and Amitriptyline in the management of diabetic peripheral neuropathy.

Keywords: Diabetic peripheral neuropathy, MNSI, NDS, Efficacy.