Comparison of efficacy and safety profile of Gabapentin and Carbamazepine in painful diabetic neuropathy.

Objective: Comparison of efficacy and safety profile of Gabapentin and Carbamazepine in painful diabeticneuropathy. Study Design : open label 12 weeks randomized controlled trial. Settings : The present study was conducted in Department of Pharmacology & Therapeutics Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Center (JPMC) in collaboration of Diabetic Clinic of Medical Unit III of JPMC Karachi. Study Period: December 2010 to May 2011. Subjects and Methods: 60 diagnosed patients of painful diabetic neuropathy were selected for 12 weeks trial after taking written consent. The patients were randomly placed into two groups, 30 patients each. One group received Gabapentin (n=30) while the other received Carbamazepine (n=30). Results: The primary outcome was reduction in pain scale. It was compared on 11-point numerical visual analog scale (VAS). In Gabapentin group the reduction in pain VAS was 6.17±0.15 on day 0 to 3.5±0.15 on day 90. The percentage of change was 43.3% from baseline (p-value 0.001). In carbamazepine group the reduction in pain VAS was 6.07±0.13 on day 0 to 4.23±0.13 on day 90. The percentage of change was 30.4% (p-value 0.001). The secondary outcome was improvement in sleep interference that is measured on 11-point numerical VAS of sleep interference. It also improved in both groups which is highly significant. Conclusion: In patients of diabetic painful neuropathy treatment of Gabapentin and Carbamazepine both are effective but Gabapentin is superior in relieving symptoms than Carbamazepine