New Generation Antidepressants in Painful Diabetic Neuropathy

The incidence of diabetic neuropathy increases with the duration of diabetes and the degree of hyperglycaemia. Pain is one of the most common and incapacitating symptoms of diabetic neuropathy and its pharmacological control is complex. The effectiveness of antidepressive agents has been described i...

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Autores Principales: Gutiérrez-Álvarez, Ángela-María, Moreno, Carlos B.
Formato: Artículo (Article)
Lenguaje:Español (Spanish)
Publicado: Universidad del Rosario 2011
Materias:
Acceso en línea:http://revistas.urosario.edu.co/index.php/revsalud/article/view/1547
http://repository.urosario.edu.co/handle/10336/7459
id ir-10336-7459
recordtype dspace
institution EdocUR - Universidad del Rosario
collection DSpace
language Español (Spanish)
topic “diabetic neuropathies”, “pain”, “antidepressive agents”, “neuropathy”, “metaanalysis”
Neuropatías diabéticas, dolor, agentes antidepresivos, neuropatía, metanálisis
neuropatias diabéticas, dor, agentes antidepressivos, neuropatia, meta-análise.
spellingShingle “diabetic neuropathies”, “pain”, “antidepressive agents”, “neuropathy”, “metaanalysis”
Neuropatías diabéticas, dolor, agentes antidepresivos, neuropatía, metanálisis
neuropatias diabéticas, dor, agentes antidepressivos, neuropatia, meta-análise.
Gutiérrez-Álvarez, Ángela-María
Moreno, Carlos B.
New Generation Antidepressants in Painful Diabetic Neuropathy
description The incidence of diabetic neuropathy increases with the duration of diabetes and the degree of hyperglycaemia. Pain is one of the most common and incapacitating symptoms of diabetic neuropathy and its pharmacological control is complex. The effectiveness of antidepressive agents has been described in different types of neuropathic pain, but their effectiveness, when used as analgesics in painful diabetic neuropathy, still remains controversial. Objective: To review the possible role of new-generation antidepressive agents in the treatment of pain in diabetic peripheral neuropathy. This work has thus consisted of a meta-analysis for determining which antidepressive agent had the best analgesic potential in managing pain in patients suffering from painful diabetic neuropathy. Methods: This search covered the Cochrane, MEDLINE, EMBASE and LILACS databases, between January 2000 and August 2007. The following information was obtained from each article: criteria for diagnosing diabetic neuropathy, patients' age average, antidepressant drug received and dose, sample size, duration of the disease and treatment follow-up, outcome measurement, evaluation of pain and rescue medication. Results: A combined RR: 1.67 (95% CI 1.38 - 2.02) was obtained; this result indicated that the antidepressive agent duloxetine, was effective for controlling pain in diabetic neuropathy. The corresponding NNT for Duloxetine was established, according to our interests; NNT = 6 (95% CI 5- 8) for achieving greater than 50% analgesia in patients suffering from painful diabetic neuropathy. Discussion: Antidepressive agents are frequently employed in the specific case of diabetic neuropathy; their analgesic benefit has been demonstrated.
format Artículo (Article)
author Gutiérrez-Álvarez, Ángela-María
Moreno, Carlos B.
author_facet Gutiérrez-Álvarez, Ángela-María
Moreno, Carlos B.
author_sort Gutiérrez-Álvarez, Ángela-María
title New Generation Antidepressants in Painful Diabetic Neuropathy
title_short New Generation Antidepressants in Painful Diabetic Neuropathy
title_full New Generation Antidepressants in Painful Diabetic Neuropathy
title_fullStr New Generation Antidepressants in Painful Diabetic Neuropathy
title_full_unstemmed New Generation Antidepressants in Painful Diabetic Neuropathy
title_sort new generation antidepressants in painful diabetic neuropathy
publisher Universidad del Rosario
publishDate 2011
url http://revistas.urosario.edu.co/index.php/revsalud/article/view/1547
http://repository.urosario.edu.co/handle/10336/7459
_version_ 1645141901913882624
spelling ir-10336-74592019-09-19T12:37:01Z New Generation Antidepressants in Painful Diabetic Neuropathy Antidepresivos de nueva generación en neuropatía diabética dolorosa Antidepressivos de nova geração na neuropatia diabética dolorosa Gutiérrez-Álvarez, Ángela-María Moreno, Carlos B. “diabetic neuropathies”, “pain”, “antidepressive agents”, “neuropathy”, “metaanalysis” Neuropatías diabéticas, dolor, agentes antidepresivos, neuropatía, metanálisis neuropatias diabéticas, dor, agentes antidepressivos, neuropatia, meta-análise. The incidence of diabetic neuropathy increases with the duration of diabetes and the degree of hyperglycaemia. Pain is one of the most common and incapacitating symptoms of diabetic neuropathy and its pharmacological control is complex. The effectiveness of antidepressive agents has been described in different types of neuropathic pain, but their effectiveness, when used as analgesics in painful diabetic neuropathy, still remains controversial. Objective: To review the possible role of new-generation antidepressive agents in the treatment of pain in diabetic peripheral neuropathy. This work has thus consisted of a meta-analysis for determining which antidepressive agent had the best analgesic potential in managing pain in patients suffering from painful diabetic neuropathy. Methods: This search covered the Cochrane, MEDLINE, EMBASE and LILACS databases, between January 2000 and August 2007. The following information was obtained from each article: criteria for diagnosing diabetic neuropathy, patients' age average, antidepressant drug received and dose, sample size, duration of the disease and treatment follow-up, outcome measurement, evaluation of pain and rescue medication. Results: A combined RR: 1.67 (95% CI 1.38 - 2.02) was obtained; this result indicated that the antidepressive agent duloxetine, was effective for controlling pain in diabetic neuropathy. The corresponding NNT for Duloxetine was established, according to our interests; NNT = 6 (95% CI 5- 8) for achieving greater than 50% analgesia in patients suffering from painful diabetic neuropathy. Discussion: Antidepressive agents are frequently employed in the specific case of diabetic neuropathy; their analgesic benefit has been demonstrated. La incidencia de neuropatía diabética aumenta con la duración de la diabetes y el grado de hiperglicemia. El dolor es uno de los síntomas más comunes e incapacitantes de la neuropatía diabética y su control farmacológico es complejo. La efectividad de los antidepresivos ha sido descrita en diferentes tipos de dolor neuropático, pero su verdadera efectividad, al ser usados como analgésicos en el dolor en la neuropatía diabética, aún es controvertida. Objetivo: Realizar una revisión sistemática y meta-análisis para determinar el nivel de evidencia en relación con la potencia analgésica de estos nuevos antidepresivos para el manejo del dolor en el paciente con neuropatía diabética dolorosa. Métodos: La búsqueda cubrió las bases de datos Cochrane, MEDLINE, EMBASE y LILACS entre enero de 2000 y agosto de 2007. De cada artículo se obtuvo la siguiente información: criterios para diagnóstico de neuropatía diabética, edad promedio de los pacientes, antidepresivo recibido y dosis, tamaño de la muestra, duración de la enfermedad, seguimiento del tratamiento, medidas de desenlace, evaluación del dolor y medicación de rescate. Resultados: Se obtuvo un RR combinado de 1,67 (IC 95% 1,38 - 2,02). El NNT correspondiente para la Duloxetina fue de 6 (95% CI 5- 8), para obtener una analgesia superior a 50% en pacientes con dolor por neuropatía diabética. Discusión: Se ha demostrado que los antidepresivos son empleados con frecuencia y efectivos como analgésicos para el dolor por neuropatía diabética. A incidência de neuropatia diabética aumenta com a duração da diabetes e o grau de hiperglicemia. A dor é um dos sintomas mais comuns e incapacitantes da neuropatia diabética e seu controle farmacológico é complexo. A efetividade dos antidepressivos tem sido descrita em diferentes tipos de dor neuropática, mas sua verdadeira efetividade, quando utilizados como analgésicos na dor na neuropatia diabética, ainda é controvertida. Objetivo: realizar uma revisão sistemática e meta-análise para determinar o nível de evidencia em relação com a potência analgésica destes novos antidepresivos para o manejo da dor no paciente com neuropatia diabética dolorosa. Métodos: A procura cobriu as bases de dados Cochrane, MEDLINE, EMBASE e LILACS entre janeiro de 2000 e agosto de 2007. De cada artigo se obteve a seguinte informação: critérios para diagnóstico de neuropatia diabética, idade em media dos pacientes, antidepressivo recebido e dose, tamanho da amostra, duração da enfermidade, seguimento do tratamento, medidas de desenlace, avaliação da dor e medicação de resgate. Resultados: obteve-se um RR combinado de 1,67 (IC 95% 1,38 - 2,02). O NNT correspondente  para a Duloxetina foi de 6 (95% CI 5- 8), para obter uma analgesia superior a 50% em pacientes com dor por neuropatia diabética. Discussão: tem se demonstrado que os antidepressivos são empregados com freqüência e efetivos como analgésicos para a dor por neuropatia diabética. 2011-05-27 2011-05-27 2014-07-09T15:56:01Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://revistas.urosario.edu.co/index.php/revsalud/article/view/1547 http://repository.urosario.edu.co/handle/10336/7459 spa http://creativecommons.org/licenses/by-nc/4.0 info:eu-repo/semantics/openAccess application/pdf Universidad del Rosario Revista Ciencias de la Salud; Vol. 9, núm. 1 (2011); 33-42 Revista Ciencias de la Salud; Vol. 9, núm. 1 (2011); 33-42 Revista Ciencias de la Salud; Vol. 9, núm. 1 (2011); 33-42 2145-4507 1692-7273 instname:Universidad del Rosario reponame:Repositorio Institucional EdocUR
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