[Note: nortriptyline is a tricyclic antidepressant prescribed for diabetic neuropathy.]
Introduction: Despite many therapeutic options, painful diabetic neuropathy is still a common and challenging complication of diabetes mellitus and is often resistant to treatment with current modalities.
Methods: In this randomized, single-blind clinical trial we compared the efficacy of parenteral vitamin B-12 and nortriptyline, for symptomatic improvement of pain, paresthesia [“pins and needles”], burning, freezing, stabbing and electrical sensation.
Changes in nerve conduction parameters of amplitude, duration and latency were also compared.
Results: One hundred patients (50 in each group) completed the study. After treatment, the pain score based on a visual analogue scale decreased 3.66 units in the vitamin B-12 group and 0.84 units in the nortriptyline group (P < 0.001).
Similarly, the paresthesia score decreased 2.98 units versus 1.06 units (P < 0.001).
The decrements of tingling sensation were 3.48 units versus 1.02 units (P < 0.001).
Changes in vibration, position, pinprick and nerve conduction parameters were not significant in two groups.
Conclusion: In conclusion, vitamin B-12 is more effective than nortriptyline for the treatment of symptomatic painful diabetic neuropathy.
Source: International Journal of Food Sciences and Nutrition, Feb 12, 2009. PMID: 19212856, by Talaiei A, Siavash M, Majidi H, Chehrei A. Department of Endocrinology, Arak University of Medical Sciences, Arak, Iran. [E-mail: firstname.lastname@example.org]