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Painful Diabetic Neuropathy: Oral, Topical, & Other Treatments

From the American Academy of Neurology

What are the best treatments for painful diabetic neuropathy? The American Academy of Neuropathy, with an endorsement by the American Association of Neuromuscular & Electrodiagnostic Medicine, has updated its 2011 guidelines for oral and topical treatments. The recommendations, which may reduce as opposed to eliminating pain, include:

  • Tricyclic antidepressants—such as amitriptyline, nortriptyline, imipramine
  • Serotonin-norepinephrine reuptake inhibitors—such as duloxetine, venlafaxine, desvenlafaxine
  • Gabapentinoids—such as gabapentin, pregabalin
  • Sodium channel blockers—such as carbamazepine, oxcarbazepine, lamotrigine, lacosamide
  • Capsaicin
  • Glyceryl trinitrate spray
  • Citrullus colocynthis
  • Ginkgo biloba
  • Cognitive behavioral therapy, exercise, mindfulness, tai chi

“Painful diabetic neuropathy is very common,” commented guideline author Brian C. Callaghan, MD, MS, of the University of Michigan in Ann Arbor and a Fellow of the American Academy of Neurology. “People with diabetes who have nerve pain should discuss it with their doctor because treatment may help. New studies on sodium channel blockers published since the last guideline have resulted in these drugs now being recommended and considered as effective at providing pain relief as the other drug classes recommended in this guideline.”


Read the press release.

Holly Caster