Oral tricyclic antidepressants and traditional anticonvulsant drugs might be better for the short-term relief of painful diabetic neuropathy than newer-generation anticonvulsant agents.
In a Hong Kong study, researchers reviewed 25 reports on randomized controlled trials comparing placebo with topically applied and orally administered drugs. They defined clinical success as a 50% reduction in pain. Secondary outcomes were a 30% reduction in pain and the number of patients who withdrew as a result of adverse events.
The investigators caution that evidence of the long-term effects of oral antidepressants and anticonvulsants is still lacking. Further studies are needed on opioids, W-methyl-D-aspartate antagonists (e.g., dextromethorphan), and ion channel blockers.
(Source: BMJ2007;335:87, online version, June 11, 2007.)