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Results from small studies suggest that the anticonvulsant topiramate (Topamax) reduces pain among patients with diabetic neuropathy. Now, the effectiveness of topiramate has been examined in large randomized, double-blind, industry-sponsored multicenter trials among patients with painful diabetic neuropathy.
In one study, 323 patients received topiramate (doses titrated to 400 mg daily) or placebo. During 12 weeks, reduction in mean pain score in the topiramate group (from 68 to 46 mm on a 100-mm visual analog scale) was significantly greater than reduction in the placebo group (from 69 to 54 mm; P<0.04). Topiramate recipients were significantly more likely than placebo recipients to experience a 50% reduction in pain (36% vs. 21%). However…