Diabetic neuropathy, treatment

Politsky JM. Painful diabetic neuropathy treatment with modern anticonvulsants. Mature Med Can 2000 3 60-3. 

Used in treatment of diabetic neuropathy and retinopathy ponalrestat [72702-95-5] C2yH22BrFN202... 

Owing to the lag time between initiation and effect, capsaicin is not used for treatment of acute pain from injury. Instead, topical capsaicin is used for chronic pain from musculoskeletal and neuropathic disorders. Capsaicin preparations have been studied in the treatment of pain from diabetic neuropathy, osteoarthritis, rheumatoid arthritis, postherpetic neuralgia, and other disorders.48 It is often used as an adjuvant to systemic analgesics in these chronic pain conditions. 

In addition to treating MDD [51-53], duloxetine was approved as the first agent for the treatment of painful diabetic neuropathy in the U.S. [54-56]. It also has been used for stress urinary incontinence in women in Europe [57,58]. In 2007, duloxetine was approved for the treatment of generalized anxiety disorder in the U.S. 

The recent approval of the SNRI duloxetine for the treatment of diabetic neuropathy reinforces the utility of this drug class in the treatment of neuropathic pain. Other largely untapped areas which remain to be exploited with this drug class include sexual dysfunction, such as premature ejaculation, irritable bowel syndrome, obesity, neurodegenerative diseases such as Parkinson s disease, restless leg syndrome, and substance abuse and addiction. It is apparent that considerable opportunities for drug discovery will exist in this area for some time to come. 

Antiepileptic drugs as a class have been widely smdied and prescribed for the relief of acute and chronic pain. In general, there is the greatest support for the efficacy of antiepileptics in the treatment of trigeminal neuralgia and diabetic neuropathy and for migraine prophylaxis. 

Unlabeled Uses Relief of neuropathic pain, such as that experienced by patients with diabetic neuropathy or postherpetic neuralgia treatment of anxiety, bulimia nervosa, migraine, nocturnal enuresis, panic disorder, peptic ulcer, phantom limb pain... 

Unlabeled Uses Treatment of alcohol abuse, dementia, diabetic neuropathy, obsessive-compulsive disorder, panic disorder, smoking cessation... 

Geriatric Considerations - Summary Compared to placebo, duloxetine is effective for the treatent of depression and painful diabetic neuropathy Few head-to-head studies are available comparing duloxetine to other agents in the treatment of depression or painful neuropathy. Because this agent may increase urethral sphincter activity, it is now being assessed as an agent for the treatment of stress urinary incontinence. This same property may increase the risk of urinary retention, although this has not been well documented. Duloxetine has not been well studied with respect to falls. 

Over the years, antidepressant drugs have become an important treatment option in chronic pain states, in their own right and as adjuncts to opiate treatment. In fact, tricyclic antidepressants are the mainstay of treatment of neuropathic pain conditions such as polyneuropathy, diabetic neuropathy, postherpetic neuralgia and peripheral nerve injury (Sindrup, 1997 Sindrup and Jensen, 1999). Other chronic pain states responsive to antidepressants include osteo- and rheumatoid arthritis, fibromyalgia, and chronic tension headache. 

Sindrup, S.H., Gram, L.F., Skjold, T., Grodum, E., Brosen, K. Clomipramine vs desipramine vs placebo in the treatment of diabetic neuropathy symptoms. A double-blind cross-over study, Br. J. 

In fact, carbamazepine is recommended as the drug of first choice in the treatment of trigeminal neuralgia. Results from clinical trials have been positive in the treatment of painful diabetic neuropathy (Rull et al., 1969 Wilton, 1974 Gomez-Perez et al., 1996). After 4 weeks treatment with carbamazepine, central pain after stroke was improved only in five out of 14 patients (Leijon and Boivie, 1989). Carbamazepine was found to be effective for migraine prophylaxis (Rompel and Bauermeister,... 

Dejgard, A., Petersen, P., Kastrup, J Mexilitine for treatment of chronic painful diabetic neuropathy, Lancet 1988, 1, 9-11. 

Gomez-Perez, F. J., Choza, R., Rios, J. M., Reza, A., Huerta, E., Aguilar, C. A. Nortriptyline-fluphenazine vs. carbamazepine in the symptomatic treatment of diabetic neuropathy, Arch. Med. Res. 1996,... 

Rull, J., Quibrera, R., Gonzalez-Millan, H., Lozano Castaneda, O. Symptomatic treatment of peripheral diabetic neuropathy with carbamazepine doubleblind crossover study, Diabetologia 1969, 5, 215-220. 

Stracke, H., Meyer, U., Schumacher, H., Federlin, K.. Mexilitine in the treatment of diabetic neuropathy, Diabetes Care 1992, 15, 1550-1555. 

Ross, D.R. and Varipapa, R.J. Treatment of painful diabetic neuropathy with topical capsaicin, New Engl. J. Med. 1989, 321, 474-475. 

The Capsaicin Study Group Treatment of painful diabetic neuropathy with topical capsaicin a multicenter, double-blind, vehicle-controlled study, Arch. Intern. Med. 1991, 151, 2225-2229. 

Gabbay KH. Aldose reductase inhibition in the treatment of diabetic neuropathy where are we in 2004 Curr Diab Rep. 2004 4 405 108. 

Nerve Growth Factor for the Treatment of Diabetic Neuropathy What Went Wrong, What Went Right, and What Does the Future Hold ... 

ACE inhibitors are used in the treatment of hypertension, heart failure, and diabetic neuropathy. These drugs should not be used in patients with renovascular disease. Anaphylactic reactions may occur in patients. It has been reported that ACE inhibitors affect the fetus when administered to pregnant animals.52 ACE inhibitors can cause injury and even death to the developing fetus in the second and third trimesters of pregnancy.53 55... 

Administration of AG has also been shown to be able to normalise nerve blood supply and to improve conduction in streptozotocin-induced diabetic rats, thus showing potential for the treatment of diabetic neuropathy.581... 

---