Treatment of early manifestations of sensorimotor polyneuropathy involves improving glycemic control. Tight control of blood glucose can reverse the changes of diabetic neuropathy. Despite advances in the understanding of the metabolic causes of neuropathy, treatments aimed at interrupting these pathological processes have been limited by side effects and lack of efficacy. . The drugs- imipramine, amitriptyline, desipramine and nortriptyline- are effective at decreasing painful symptoms but suffer from multiple side effects that are dosage dependent. One notable side effect is cardiac toxicity, which can lead to fatal arrhythmias.
SSRIs (Selective serotonin reuptake inhibitors) include fluoxetine, paroxetine, sertraline and citalopram. They are less effective in relieving pain, but are better tolerated. Side effects are rarely serious, and do not cause any permanent disabilities. They cause sedation and weight gain, which can worsen a diabetis's glycemic control.
"The SSNRI Duloxetine (Cymbalta) is approved for Diabetic neuropathy."
By targeting both Serotonin and Norepinephrine. It targets the painful symptomes of diabetic neuropathy, and also treats depression if it exists.
Carbamazepine (Tegretol®) is effective but not necessarily safe for diabetic neuropathy. Its first metabolite, oxcarbazepine, is both safe and effective in other neuropathic disorders, but has not been studied in diabetic neuropathy.
· 1 decade ago