SAN ANTONIO, Jul 03 (Reuters Health) - A medication used to treat depression
and generalized anxiety disorder may have a role in managing painful diabetic
neuropathy, according to study results released recently at the 60th Scientific
Session of the American Diabetes Association.
In patients with neuropathy, a common complication of diabetes, nerves are
affected by the chronic disease. Neuropathy can involve any nerve outside the
brain, and the pain can be severe, and is often worse at night.
Dr. Veeraindar Goli, with Duke University Medical Center in Durham, North
Carolina, and associates elsewhere evaluated the efficacy and safety of
venlafaxine extended-release (XR) as a treatment for painful diabetic
neuropathy. The study included 244 nondepressed diabetic outpatients 18 years of
age or older who were randomly assigned to treatment with venlafaxine XR 75
milligrams per day (mg/d), venlafaxine XR 150 to 225 mg/d, or a placebo (dummy
pill), for up to 6 weeks.
Overall, venlafaxine XR, 150 to 225 mg/d, provided significantly better pain
relief compared with placebo, the researchers report. Higher doses of
venlafaxine XR (150 to 225 mg/d) significantly decreased pain intensity at weeks
3 to 6 compared with placebo, and at weeks 5 and 6 compared with the lower dose
of venlafaxine (75 mg/d). At week six, 56% of patients receiving venlafaxine,
150 to 225 mg/d, reported significantly decreased pain intensity versus 39% of
patients receiving venlafaxine, 75 mg/d, and 34% who were treated with placebo.
Nausea was the most common side effect associated with the active medication
and occurred in 5% of placebo-treated patients versus 22% of patients who
received venlafaxine XR, 75 mg/d, and 10% of patients who received venlafaxine
XR 150 to 225 mg/d.
Because patients with depression were excluded from the trial, symptomatic
improvement can only be ascribed to a pain-killing effect rather than
antidepressant effect, Goli said. The results suggest that doctors should
consider venlafaxine XR for the treatment of painful peripheral neuropathy in
diabetics.
