Antidepressants in painful diabetic neuropathy: P1505

Background:The incidence of diabetic neuropathy increases withthe duration of diabetes and the degree of hyperglycaemia. Pain isone of the most common and incapacitating symptoms of diabeticneuropathy and its pharmacological control is complex. The effec-tiveness of antidepressive agents has been described in differenttypesofneuropathicpain,buttheir effectivenesswhenused asanal-gesics in painful diabetic neuropathy still remains controversial.

The objective was to review the possible role of antidepressiveagents for the treatment of pain in diabetic peripheral neuropathy.Thus, this work has consisted of meta-analysis for determiningwhichantidepressive agenthadthebestanalgesicpotentialforman-aging pain in patients suffering from painful diabetic neuropathy.

Methods:The search covered the Cochrane, MEDLINE,EMBASE and LILACS databases, between January 2000 andAugust 2007. The following information was obtained from eacharticle: criteria for diagnosing diabetic neuropathy, patients’ aver-age age, antidepressant drug received and dose, sample size, dura-tion of the disease and treatment follow-up, outcome measure-ment, evaluation of pain and rescue medication.

Results:A combined RR: 1.67 (95% CI 1.38–2.02) was obtained;this result indicated that the antidepressive agents studied wereeffective for controlling pain in diabetic neuropathy. The corre-sponding NNT for Duloxetine was established, according to ourinterests; NNT = 6 (95% CI 5–8) for achieving greater than 50%analgesia in patients suffering from painful diabetic neuropathy.

Conclusion:Antidepressive agents are frequently employed in thespecific case of diabetic neuropathy; the combined result of thismeta-analysis has demonstrated their analgesic benefit.