In a randomized controlled trial, Duloxetine was shown to have a substantially better pain reduction effect than Pregabalin in the treatment of diabetic neuropathy. Researchers intended to evaluate the mean reduction in pain score with Pregabalin and Duloxetine use in diabetic neuropathy patients.

Overall, 180 individuals (age range: 18 to 75 years, mean age: 40.87±13.67 years) who had been diagnosed with diabetes for a minimum of five years were recruited.

People experiencing ischemic pain, as well as those who also experienced arthritic pain, phantom pain from amputations, chronic renal failure & chronic liver disease, were not included in the study. Pregabalin 150 mg was given to patients in Group A before bedtime, with the dosage increasing to 150 mg two times a day after the second week if the decline in visual analog scale (VAS) pain score was < 50% from baseline.

People in Group B were administered 60 mg of Duloxetine at bedtime, and if the VAS pain score was < 50% after 4 weeks, the dose was raised to 120 mg. Following another four weeks, the patients were reassessed to see whether the VAS pain score had decreased. Pain evaluated by VAS post-four weeks after commencing medication was the major endpoint ascertained.

Patients in the Pregabalin group had a mean age of 38.80 ± 13.01 years, whereas those in the Duloxetine group had a mean age of 41.07 ± 13.85 years. The majority of the volunteers (n=34, 56.67%) were between 20-40 years of age. Compared to Pregabalin, Duloxetine exhibited better pain relief. The mean pain reduction of the Pregabalin and Duloxetine groups is depicted in Figure 1:

Hence, Duloxetine may be preferred over Pregabalin for the management of painful diabetic neuropathy.