Comparison the effects of lamotrigine and nortriptyline on neuuropathic pain in diabetic patients with painful polyneuropathy

Diabetes mellitus is one of the most prevalent disease in this century. Obove middle age it's prevalence is near twenty percent and it is the most common cause of blindness and renal failure. Polyneuropathy is prevalent in diabetes and can be accompanied by severe polyneuropathic pains. Methods & materials : This clinical trial was conducted from 2005 to 2008 on 75 patients suffering painful diabetic polyneuropathy in shahid Mustafa Khomeini hospital (shahed university). All patients were more than eighteen years old with at least 3 months history of neuropathic pain in one part of body. Patients selected randomly in two groups. One group took nortriptyline 25-50mg/daily for six weeks and another group took lamotrigine 200mg/daily for the same duration.all patients visited weekly for evaluation of pain with VAS and drug tolerance and complications. All the data were analyzed with spss software. Seventy-five patients were selected in two groups and sixty patients completed study Twenty-seven patiets took nortriptilye and thirty-three patients took lamotrigine for six weeks.mean age was 61.3±8.2(68-45)and mean duration of diabetes was12.3±5,3. In nortriptyline group mean VAS in the beginning of study was 68.3±5.3and it was 34.5±4.7 at the end of sixth week.in lamotrigine group VAS was 71.3±8 and 37.6±4.9 At the beginning and end of sixth week respectively. Statistical analysis shows significant difference in each group in comparison of VAS results at beginning and end of sixth week. But there was no significant statistical difference in comparison of two groups respectively. This study shows us that both drugs are effective in reduction of neuropathic pains. Lamotrigine is at least as effective as nortriptilyline and this drug can be a good substitution for this drug especially when complication such as drowsiness appears.