Efficacy, Safety and Cost Effectiveness of Amitriptyline and Pregabalin in Patients with Diabetic Peripheral Neuropathy

The tricyclic antidepressant, amitriptyline and the anticonvulsant, pregabalin are the most frequently used medications in general practice for diabetic peripheral neuropathy. This study compares the effectiveness of amitriptyline vs. pregabalin using neuropathic pain symptom inventory and visual analogue scale, the incidence of adverse drug reactions and the cost effectiveness. Effectiveness was measured using visual analogue scale and neuropathic pain symptom inventory scores both before and after therapy. Adverse drug reactions were documented after the therapy and cost effectiveness was measured using incremental cost effectiveness analysis ratio. Both drugs showed obvious pain relief. Visual analogue scale mean difference scores showed statistically significant difference in efficacy for amitriptyline and pregabalin. Incidences of adverse drug reactions were more or less similar in terms of magnitude. Furthermore the cost of amitriptyline is less than that of pregabalin. Hence we concluded that amitriptyline was a better choice of therapy than pregablin because it was well tolerated and has a lower cost for the additional effectiveness achieved.