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A variety of drugs are used to treat painful diabetic neuropathy, and most have been evaluated in randomized trials. This systematic review provides a useful comparison of the efficacy of the various treatments.
Among eligible randomized controlled trials that compared one or more drugs with placebo in adults with painful diabetic neuropathy, 10 trials (1576 patients) evaluated anticonvulsants, 4 (94 patients) evaluated antidepressants, 3 (329 patients) evaluated opioids, 2 (805 patients) evaluated duloxetine, and 1 (277 patients) evaluated capsaicin cream. The treatment period in all studies was less than 6 months.
The efficacy of these drugs in reducing pain by 50%, in descending order from most to least effective, was as follows: tricyclic…