Comparison of efficacy of carbamazepine and duloxetiene for the treatment of diabetic neuropathy.

Abstract

Objective: To compare the efficacy of carbamazepine and duloxetiene for the treatment of diabetic neuropathy. Study Design: Single-center study. Setting: Services Hospital, Lahore. Period: 15-08- 2023 to 20-11-23. Methods: It involved 100 participants split into two groups, with one group receiving 60 mg daily of duloxetine and the other group taking oral carbamazepine (CBZ) twice daily at a recommended daily dose of 400 mg. CBZ dosing began at 100 mg on the first day and was gradually increased to 400 mg by the end of the first week (days 6 and 7). Subsequent dose adjustments, up to a maximum of 800 mg daily, were determined based on individual clinical responses and tolerability. Participants were followed for 12 weeks, during which changes in neuropathic pain were compared to baseline using a comprehensive pain severity score. This score was calculated by averaging pain intensity ratings at its most severe, least severe, average, and specific time points. Results: In the CBZ and Duloxetiene group, the mean VAS score at baseline was 5.38+0.49 and 5.40+0.49 which reduced after 12 weeks of treatment to 3.26+0.44 in CBZ and 3.82+0.89 in Duloxetiene group, (P<0.001). Conclusion: Treatment with carbamazepine for neuropathic pain in adults with diabetes for 12 weeks demonstrated a substantial pain-relieving benefit, with lower mean pain intensity compared to treatment with Duloxetiene 60 mg/daily, in this real-world experience trial.