Iranian Red Crescent Medical Journal

Published by: Kowsar

Comparative Efficacy of Duloxetine Versus Nortriptyline in Patients with Diabetic Peripheral Neuropathic Pain: A Double Blind Randomized Controlled Trial

Mehrnoosh Zakerkish 1 , * , Fatemeh Amiri 1 , Nastaran Majdi Nasab 2 and Ali Ghorbani 2
Authors Information
1 Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
2 Department of Neurology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
Article information
  • Iranian Red Crescent Medical Journal: August 2017, 19 (8); e59995
  • Published Online: August 22, 2017
  • Article Type: Research Article
  • Received: February 6, 2017
  • Revised: April 14, 2017
  • Accepted: May 22, 2017
  • DOI: 10.5812/ircmj.59995

To Cite: Zakerkish M, Amiri F, Majdi Nasab N, Ghorbani A. Comparative Efficacy of Duloxetine Versus Nortriptyline in Patients with Diabetic Peripheral Neuropathic Pain: A Double Blind Randomized Controlled Trial, Iran Red Crescent Med J. 2017 ; 19(8):e59995. doi: 10.5812/ircmj.59995.

Copyright © 2017, Iranian Red Crescent Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Methods
4. Results
5. Discussion
  • 1. Barrett AM, Lucero MA, Le T, Robinson RL, Dworkin RH, Chappell AS. Epidemiology, public health burden, and treatment of diabetic peripheral neuropathic pain: a review. Pain Med. 2007; 8 Suppl 2-62[DOI][PubMed]
  • 2. Veves A, Backonja M, Malik RA. Painful diabetic neuropathy: epidemiology, natural history, early diagnosis, and treatment options. Pain Med. 2008; 9(6): 660-74[PubMed]
  • 3. Hoffman-Snyder C, Smith BE, Ross MA, Hernandez J, Bosch EP. Value of the oral glucose tolerance test in the evaluation of chronic idiopathic axonal polyneuropathy. Arch Neurol. 2006; 63(8): 1075-9[DOI][PubMed]
  • 4. Rutkove SB. A 52-year-old woman with disabling peripheral neuropathy: review of diabetic polyneuropathy. JAMA. 2009; 302(13): 1451-8[DOI][PubMed]
  • 5. King SA. Diabetic peripheral neuropathic pain: effective management. Consultant. 2008; 48(11): 825
  • 6. Jessica Robinson-Papp MD, David M, Simpson MD. Safety profile of treatment in DPNP. 2007;
  • 7. Tesfaye S, Selvarajah D. Advances in the epidemiology, pathogenesis and management of diabetic peripheral neuropathy. Diabetes Metab Res Rev. 2012; 28 Suppl 1: 8-14[DOI][PubMed]
  • 8. Smith RG. Painful diabetic peripheral neuropathy. J Am Podiatr Med Assoc. 2007; 97(5): 394-401[PubMed]
  • 9. Spallone V, Lacerenza M, Rossi A, Sicuteri R, Marchettini P. Painful diabetic polyneuropathy: approach to diagnosis and management. Clin J Pain. 2012; 28(8): 726-43[DOI][PubMed]
  • 10. Ziegler D, Fonseca V. From guideline to patient: a review of recent recommendations for pharmacotherapy of painful diabetic neuropathy. J Diabetes Complications. 2015; 29(1): 146-56[DOI][PubMed]
  • 11. Finnerup NB, Attal N, Haroutounian S, McNicol E, Baron R, Dworkin RH, et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol. 2015; 14(2): 162-73[DOI][PubMed]
  • 12. Lunn MP, Hughes RA, Wiffen PJ. Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia. Cochrane Database Syst Rev. 2014; (1)[DOI][PubMed]
  • 13. Abuaisha BB, Costanzi JB, Boulton AJ. Acupuncture for the treatment of chronic painful peripheral diabetic neuropathy: a long-term study. Diabetes Res Clin Pract. 1998; 39(2): 115-21[PubMed]
  • 14. Hamza MA, White PF, Craig WF, Ghoname ES, Ahmed HE, Proctor TJ, et al. Percutaneous electrical nerve stimulation: a novel analgesic therapy for diabetic neuropathic pain. Diabetes Care. 2000; 23(3): 365-70[DOI]
  • 15. Health and Social Care Information Centre. Prescription cost analysis, England 2013. 2014;
  • 16. Lindsay TJ, Rodgers BC, Savath V, Hettinger K. Treating diabetic peripheral neuropathic pain. Am Fam Physician. 2010; 82(2): 151-8[PubMed]
  • 17. Sultan A, Gaskell H, Derry S, Moore RA. Duloxetine for painful diabetic neuropathy and fibromyalgia pain: systematic review of randomised trials. BMC Neurol. 2008; 8: 29[DOI][PubMed]
  • 18. Wernicke JF, Pritchett YL, D'Souza DN, Waninger A, Tran P, Iyengar S, et al. A randomized controlled trial of duloxetine in diabetic peripheral neuropathic pain. Neurology. 2006; 67(8): 1411-20[DOI][PubMed]
  • 19. Dunner DL, Wohlreich MM, Mallinckrodt CH, Watkin JG, Fava M. Clinical consequences of initial duloxetine dosing strategies: Comparison of 30 and 60 mg QD starting doses. Curr Ther Res Clin Exp. 2005; 66(6): 522-40[DOI][PubMed]
  • 20. Devi P, Madhu K, Ganapathy B, Sarma G, John L, Kulkarni C. Evaluation of efficacy and safety of gabapentin, duloxetine, and pregabalin in patients with painful diabetic peripheral neuropathy. Indian J Pharmacol. 2012; 44(1): 51-6[DOI][PubMed]
  • 21. Ziegler D. Painful diabetic neuropathy: treatment and future aspects. Diabetes Metab Res Rev. 2008; 24 Suppl 1-7[DOI][PubMed]
  • 22. Kaur H, Hota D, Bhansali A, Dutta P, Bansal D, Chakrabarti A. A comparative evaluation of amitriptyline and duloxetine in painful diabetic neuropathy: a randomized, double-blind, cross-over clinical trial. Diabetes Care. 2011; 34(4): 818-22[DOI][PubMed]
  • 23. Goldstein DJ, Lu Y, Detke MJ, Lee TC, Iyengar S. Duloxetine vs. placebo in patients with painful diabetic neuropathy. Pain. 2005; 116(1-2): 109-18[DOI][PubMed]
  • 24. Raskin J, Pritchett YL, Wang F, D'Souza DN, Waninger AL, Iyengar S, et al. A double-blind, randomized multicenter trial comparing duloxetine with placebo in the management of diabetic peripheral neuropathic pain. Pain Med. 2005; 6(5): 346-56[DOI][PubMed]
  • 25. Quilici S, Chancellor J, Lothgren M, Simon D, Said G, Le TK, et al. Meta-analysis of duloxetine vs. pregabalin and gabapentin in the treatment of diabetic peripheral neuropathic pain. BMC Neurol. 2009; 9: 6[DOI][PubMed]
  • 26. Boyle J, Eriksson ME, Gribble L, Gouni R, Johnsen S, Coppini DV, et al. Randomized, placebo-controlled comparison of amitriptyline, duloxetine, and pregabalin in patients with chronic diabetic peripheral neuropathic pain: impact on pain, polysomnographic sleep, daytime functioning, and quality of life. Diabetes Care. 2012; 35(12): 2451-8[DOI][PubMed]
  • 27. Tanenberg RJ, Irving GA, Risser RC, Ahl J, Robinson MJ, Skljarevski V, et al. Duloxetine, pregabalin, and duloxetine plus gabapentin for diabetic peripheral neuropathic pain management in patients with inadequate pain response to gabapentin: an open-label, randomized, noninferiority comparison. Mayo Clin Proc. 2011; 86(7): 615-26[DOI][PubMed]
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