Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH
Duloxetine, venlafaxine, pregabalin, oxcarbazepine, tricyclic antidepressants, atypical opioids (e.g., tapentadol), and botulinum toxin are all more effective than placebo in reducing pain associated with diabetic peripheral neuropathy, according to a Neurology review.
Researchers examined 50 new trials of various diabetic peripheral neuropathy medications, along with 50 studies that were part of a 2011 review.
Ineffective treatments for pain included dextromethorphan, gabapentin, typical opioids (e.g., oxycodone), topical capsaicin, and mexiletine. The evidence wasn’t strong enough to make recommendations on treatments’ effects on quality of life.
Most of the trials lasted less than 3 months, so the review couldn’t address long-term harms. The authors write: “This is particularly important for atypical opioids, which we found were effective in short-term studies, as new guidelines … now recommend against the use of opioids for chronic pain conditions given lack of evidence for long-term benefit and increasing evidence of serious risks.”