COMPARISON OF EFFICACY OF NORTRIPTYLINE VERSUS TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION ON PAINFUL PERIPHERAL NEUROPATHY IN PATIENTS WITH DIABETES

  • Mehrnoosh Zakerkish Department of Endocrinologist, Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  • Davood Raeisi
  • Shahram Rafie
  • MohammadJafar Shaterzadeh Yazdi
  • Zahra Kosarian
  • Shirin Rahimzadeh Telegrafchi
  • Saeed Hesam
Keywords: Transcutaneous Electrical Nerve Stimulation, Nortriptyline, Diabetic neuropathy, Diabetic peripheral neuropathic pain

Abstract

Background and aims: Diabetic peripheral neuropathic pain (DPNP) is one of the most common microvascular complications of diabetes and is difficult to treat. Existing treatments are often inadequate at controlling pain and limited by side-effects and drug tolerance. This study assessed the efficacy of nortriptyline versus Transcutaneous Electrical Nerve Stimulation (TENS) in patients with DPNP. Material and method: This is a randomized clinical trial study conducted on 39 patients with DPNP referring to Golestan Hospital in Ahvaz in 2017. Patients were randomly treated with TENS (18 sessions, each session 30 minutes; n=20) or nortriptyline (25 to 75 mg, once daily; n=19) for 6 weeks. Patients were evaluated for side effects and pain relief using visual analog scale (VAS). Results: There was a significant improvement in pain with both treatments compared with baseline (p˂0.001). The patients in nortriptyline group experienced more pain relief (7.21±1.51 to 0.84±1.34) than the TENS group (7.6±1.47 to 2.75 ±2.43) (P=0.001). The 50% pain relief was observed in 14 patients (73%) in nortriptyline group, 6 patients (30%) in TENS group. Moreover, the side effects were seen in 15% of TENS and 55% of patients in nortriptyline groups (P=0.019).  Conclusion: Both TENS and nortriptyline were effective and safe in the management of DPNP. But nortriptyline showed a better performance on pain relief.

Published
2020-02-01
How to Cite
Zakerkish, Mehrnoosh, Davood Raeisi, Shahram Rafie, MohammadJafar Shaterzadeh Yazdi, Zahra Kosarian, Shirin Rahimzadeh Telegrafchi, and Saeed Hesam. 2020. “COMPARISON OF EFFICACY OF NORTRIPTYLINE VERSUS TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION ON PAINFUL PERIPHERAL NEUROPATHY IN PATIENTS WITH DIABETES”. Romanian Journal of Diabetes Nutrition and Metabolic Diseases 26 (4), 401-11. http://rjdnmd.org/index.php/RJDNMD/article/view/683.
Section
Original Research Articles