Relief for Diabetic Neuropathy Pain

The anticonvulsant topiramate has been shown in several studies to relieve the neuropathic pain that is experienced by 50% of diabetic patients. One study reported that total neuropathy scores—including pressure sensations, prickling pain, and stabbing pain—and the risk of adverse complications in patients with diabetic neuropathy declines after 18 weeks of topiramate treatment.

For therapy of diabetic neuropathy, it is recommended that topiramate be prescribed in very low doses to decrease the risk of significant side effects that occur when the medication is used in recommended doses to prevent seizures.

The side effect of weight loss may be a concern for patients with type 1 diabetes, as many are excessively thin. However, the vast majority of patients with diabetic neuropathy have type 2 diabetes and are overweight, and weight loss is therefore a desirable side effect.

In a small pilot study, the anticonvulsant topiramate appeared to induce the growth of new nerve fibers and relieve symptoms of peripheral neuropathy while also improving components of metabolic syndrome, reported Aaron I. Vinik, MD, PhD, director of the Strelitz Diabetes Research Institutes at Eastern Virginia Medical School in Norfolk. “Topiramate may be the first drug to change the biology of diabetic neuropathy as well as treat other components of the metabolic syndrome that often precedes development of type 2 diabetes,” said Dr. Vinik.

Ask us about other customized therapies for diabetic neuropathy. We can expand the practitioner’s armamentarium by formulating medications that meet the specific needs of each patient.

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