Efficacy of Pregabalin Alone and in Combination with Lacosamide in Pain Management of Diabetic Neuropathy

Background: Neuropathy involves the progressive loss of peripheral nerve function, typically beginning with nerves that innervate the toes and advancing proximally. Diabetes mellitus is the leading cause of peripheral neuropathies globally. While pregabalin has been widely used for managing painful diabetic peripheral neuropathy (DPN), recent research suggests a potential role for lacosamide in enhancing pain control. Objective: The aim of this study was to compare the effectiveness of pregabalin monotherapy versus a combination of pregabalin and lacosamide in the pain management of diabetic neuropathy. Methodology: This randomized clinical trial included 134 patients divided equally into two groups: Group A received pregabalin 150 mg daily for six weeks, and Group B received pregabalin 100 mg combined with lacosamide 100 mg daily for the same duration. Results: Group A consisted of 27 males (40.3%) and 40 females (59.7%), while Group B included 19 males (28.4%) and 48 females (71.6%). The mean age was 55.63 ± 12.76 years for Group A and 54.12 ± 11.14 years for Group B. Pre- and post-treatment Visual Analog Scale (VAS) scores showed significant improvement: Group A had a mean post-treatment score of 3.07 ± 1.32, and Group B had 2.30 ± 1.16 (p < 0.05). Treatment was effective in 58.2% of Group A and 80.6% of Group B (p < 0.05). Conclusion: Both pregabalin alone and its combination with lacosamide were effective in reducing pain in DPN patients. However, the combination therapy showed greater efficacy, suggesting a potential benefit of adjunctive lacosamide. Further studies are needed to confirm these findings.