Pharmacotherapy of painful diabetic neuropathy.
The scope of this review is to describe the epidemiology, physiology, symptomatology, and treatment of diabetic painful neuropathy, which is a common complication of diabetes with significant morbidity. This article focuses on treatment options. Various clinical trials of several classes of medications (eg, antidepressants, anticonvulsants, and topical medications) and alternative treatments (eg, acupuncture, electrostimulation, magnets) are reviewed. Physicians have a large panel of medications that can be used effectively solely or in combination at their disposal. However, a number of these treatments have significant side effects, which are noted, that limit their use. As the understanding of the pathophysiologic mechanisms of diabetic neuropathy improves, new medications are under investigation, which are reviewed in this article. There is great hope that the future may hold treatments that would prevent nerve damage.
Barbano
Richard
R
University of Rochester, Department of Neurology, 601 Elmwood Avenue, Rochester, NY 14642, USA. Richard_Barbano@URMC.Rochester.edu
Hart-Gouleau
Stephanie
S
Pennella-Vaughan
Janet
J
Dworkin
Robert H
RH
D003929:Diabetic Neuropathies / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D010146:Pain / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology