COMPARATIVE STUDY OF EFFECTIVENESS OF VENLAFAXINE, DULOXETINE AND SERTRALINE IN MANAGEMENT OF DIABETIC SENSORY NEUROPATHY

Abstract

Objective: To compare efficacy of 3 commonly prescribed anti-depressants from classes’ selective serotonin reuptake inhibitor and serotonin-nor epinephrine reuptake inhibitors i.e. Venlafaxine, Duloxetine and Sertraline in the management of diabetic sensory neuropathy in subjects with type 2 diabetes mellitus.

Study Design: Comparative, prospective study.

Place and Duration of Study: Combined Military Hospital Jhelum, Mar 2018 to Jul 2018.

Methodology: This study included 94 patients with metabolically stable type 2 Diabetes Mellitus with diabetic sensory neuropathy. Patients were randomly assigned into 3 treatment group, treatment group 1 (n1=29) receiving Venlafaxine 37.5mg × BD, treatment group 2 (n2=33) receiving duloxetine 30mg × BD and treatment group 3 (n3=25) receiving Sertraline 50mg × OD, each group being treated for 6 weeks, with optional dose titration fortnightly. The efficacy measure was done by revised Neuropathy Disability Score (NDS), measured at baseline and at the end of treatment period i.e. 6 weeks. The primary outcome of this study was “functional outcome” assessed by Disability Neuropathy scale (DNS) and overall improvement and adverse events were measured as secondary outcome measures.

Results: There was significant improvement in Neuropathy Disability scale (DNS) at the end of treatment period in all treatment groups from their baseline score, with comparable efficacy among all drug groups i.e. p-value between venlafaxine and duloxetine, venlafaxine and sertraline were non-significant i.e. p>0.05 except between Duloxetine and Sertraline group where there was significant difference in efficacy (p<0.05). Good, moderate and mild improvement in symptoms was noticed in all study groups.

Conclusion: Non-tricyclic Anti-depressants i.e. Venlafaxine...