A study of the use of carbamazepine, pregabalin and alpha lipoic acid in patients of diabetic neuropathy

BACKGROUND: Diabetic peripheral neuropathy (DPN) is a common, symptomatic, long-term complication of diabetes mellitus. Many of the agents used to treat DN have not been compared with each other. This study was, therefore, undertaken to compare the efficacy and safety of carbamazepine, pregabalin and alpha-lipoic acid in diabetic neuropathy patients. METHODS: This was a prospective, observational study. The patients were categorized into three groups, Group I included those patients who were prescribed carbamazepine while group II included those on pregabalin and group III patients received alpha-lipoic acid. Each patient was followed up at every month for total duration of 6 months. Demographic details, presenting symptoms, history of diabetes, laboratory values pertaining to diabetes (Fasting blood sugar, Post prandial blood sugar and HbA1c) were recorded. Intensity of pain, using a visual analogue scale (VAS), diabetic neuropathy symptom (DNS) score and diabetic neuropathy examination (DNE) score were assessed at baseline and then at each monthly follow-up. Nerve conduction velocity (NCV) was also measured at baseline and then at the end of 3 and 6 months. RESULTS: A total of 101 patients were enrolled out of them 96 completed the study. Regarding VAS, the number of patients having pain was reduced substantially however, the speed and the quantum of this reduction were best in group II (pregabalin). Regarding DNS, also group II showed the best response in terms of number of patients as well as the speed of improvement. The results also imply that the relief from diabetic neuropathy (as per DNE score) is superior with pregabalin administration. However, no improvement in NCV was evident in any group. CONCLUSION: Results of this study suggest that treatment with pregabalin gives faster and better improvement in diabetic neuropathy.