Comparative Study of Efficacy and Safety of Gabapentin Versus Nortriptyline for Diabetic Neuropathy in a Tertiary Care Hospital of Eastern India

Introduction: Diabetic Peripheral Neuropathy (DPN) is among the most common diabetic consequence, and it is an important contributor of foot ulcers, disabilities, and amputation.Many studies have shown that nortriptyline is effective in treating neuropathic pain; however, due to its wider range of action and potential side effects, its usage may be restricted.Gabapentin has shown significant efficacy in therapy of neuropathic pain.Aims/ objective: To compare efficacy and safety of gabapentin versus nortriptyline in patients of diabetic peripheral neuropathy.Materials and Method: 100 patients with peripheral diabetic neuropathy were randomised into two groups.50 patients in Group G were prescribed Gabapentin 10 mg once daily whereas 50 patients in Group N were prescribed Nortriptyline 10 mg once daily.Pain intensity was measured with help of visual analogue scale.Sleep disruption due to neuropathy was measured by insomnia severity index.Safety was compared with respect to incidence of adverse events.Results: At baseline and 1 month, there was no significant difference between group G and group N with respect to VAS pain level (p>0.05).At 3 months and 6 months of follow-up, patients receiving gabapentin had significantly lesser pain level with respect to VAS (P<0.05).At 6 months of follow-up, patients receiving gabapentin had significantly lesser disruption in sleep due to neuropathy (P<0.05).There was more incidence of drug related constipations, fatigue, weight gain and blurred vision in patients receiving nortriptyline.There was more incidence of ataxia in patients receiving gabapentin. Conclusion:gabapentin was found to be significantly more effective with respect to pain scores and disruption of sleep.Safety was gabapentin was also found to better in gabapentin group with respect to incidence of adverse effects.