A COMPARATIVE STUDY ON THE EFFICACY OF DULOXETINE WITH AMITRIPTYLINE IN PATIENTS OF DIABETIC NEUROPATHY

Aim: To compare efficacy of flap anchoring with suction drains alone after modified radical mastectomy. Methods: A total of 200 cases (100 in each group) between the age 20-65 years of any gender, ≥ 5 years’ history of diabetes, symptoms of peripheral neuropathy for at least six months, having HbA1c >7.5% were included while those with co-existing other causes of peripheral neuropathy (porphyria, chronic renal failure, amyloidosis, leprosy, hypothyroidism), pregnant and lactating women and use of Duloxetine or amitriptyline in previous three months were excluded from the study. Randomization was done by computer generated random number table, to allocate patients to either group A (Duloxetine group) or group B (Amitriptyline group). Patients were instructed to take study medication in the morning, with a glass of water for up to 6 weeks. Group A was given 60mg Duloxetine each day and Group B was given 75mg amitriptyline in a single dose. Baseline pain was recorded on VAS. Diary card was provided to all patients at the baseline visit. Each morning during the 1st 3 weeks, patients would be instructed to record the severity of the symptoms in term of reduction in pain score recorded by visual analogue scale. After 3 weeks, an additional three weeks supply of medication was dispensed and patient were scheduled to return at week 6 for the final evaluation that recorded by me in terms of reduction in pain score and also assessed for 50% reduction in pain score from base line that was labeled as reduced. Patients were followed up by keeping telephonic contacts of patients. Results: In this study, out of 200 cases (100 in each group) 21%(n=21) in Group-A and 17%(n=17) in Group-B were between 20-40 years of age while 79%(n=79) in Group-A and 83%(n=83) in Group-B were between 41-65 years of age, mean + sd was calculated as 47.08+11.43 and 48.37+10.83 respectively, 56%(n=56) in Group-A and 49%(n=49) in Group-B were male while 44%(n=44) in Group-a and 51%(n=51) in Group-B were females, comparison of efficacy in both groups was done which shows that 62%(n=62) in Group-A and 35%(n=35) in Group-B were treated effectively, which shows a significant difference between the two groups. Conclusion: It is concluded that the efficacy of duloxetine as compare to the amitriptyline in terms of reduction in frequency of pain in the management of patients of diabetic neuropathy is significantly higher. Keywords: Diabetic Neuropathy, Management, Duloxetine, Amitriptyline, Efficac