USO DE ANTIDEPRESSIVOS E ANTICONVULSIVANTES NO TRATAMENTO DA NEUROPATIA DIABÉTICA: UMA REVISÃO
DOI:
https://doi.org/10.25112/rco.v2i0.384Palavras-chave:
Dor crônica. Neuropatia diabética. Antidepressivos. Anticonvulsivantes.Resumo
Este trabalho tem por objetivo revisar a eficácia de antidepressivos e anticonvulsivantes na neuropatia diabética e estratificá-los. Foi realizada uma revisão de artigos publicados de 2000 a 2015 nas bases de dados PubMed, ScienceDirect, Portal de Periódicos Capes e Scielo. Entre os 34 estudos clínicos revisados, 44,18% estudaram o uso de anticonvulsivantes, 32,35% compararam a eficácia de antidepressivos com anticonvulsivantes e 23,52% estudaram o uso de antidepressivos. Estudos com anticonvulsivantes foram os mais numerosos, reduzindo a dor em 86,67%. Os antidepressivos, apesar do menor número de estudos, demonstraram eficácia no tratamento em 100%. Os estudos com antidepressivos e anticonvulsivantes apontam para uma eficácia semelhante.
Referências
AREZZO, J. C. et al. Efficacy and safety of pregabalin 600 mg/d for treating painful diabetic peripheral neuropathy: A double-blind placebo-controlled trial. BMC Neurology, New York, v. 8, n. 33, p. 1-13, set. 2008.
AXELERAD, A. D. & AXELERAD, D. D. Comparative Evaluation of Pregabaline, Gabapentine, Sertraline and Duloxetine in Painful Diabetic Non Insulin-Dependent Neuropathy. Procedia - Social and Behavioral Sciences, Constanta, v. 191. p. 469-472, abr. 2015.
BANSAL, D. et al. Amitriptyline vs. pregabalin in painful diabetic neuropathy: a randomized double blind clinical trial. Diabetic Medicine, Chandigarh, v. 26, n. 10, p. 1019-1026, out. 2009.
BOYLE, J. et al. Randomized, Placebo-Controlled Comparison of Amitriptyline, Duloxetine, and Pregabalin in Patients With Chronic Diabetic Peripheral Neuropathic Pain. Diabetes Care, Guildford, v. 35, n. 12, p. 2451–2458, dezembro 2012.
COWLES, V. E. et al. A gastroretentive gabapentin formulation for the treatment of painful diabetic peripheral neuropathy: efficacy and tolerability in a double-blind, randomized, controlled clinical trial. Diabetes Research and Clinical Practice, San Antonio, v. 97, n. 3, p. 438-445, set. 2012.
DALLOCCHIO, C. et al. Gabapentin vs. Amitriptyline in Painful Diabetic Neuropathy: An Open-Label Pilot Study. Journal of Pain and Symptom Management, New York, v. 20, n. 4, p. 280-5, out. 2000.
DELI, G. et al. Diabetic Neuropathies: Diagnosis and Management. Neuroendocrinology, Pécs, v. 98, n. 4, p. 267–280, jan. 2013.
DEVI, P. et al. Evaluation of efficacy and safety of gabapentin, duloxetine, and pregabalin in patients with painful diabetic peripheral neuropathy. Indian Journal of Pharmacology, Bangalore, v. 44, n. 1, p. 51–56, jan./fev. 2012.
DONOFRIO, P. D. et al. Safety and effectiveness of topiramate for the management of painfuldiabetic peripheral neuropathy in an open-label extension study. Clinical Therapeutics, Dallas, v. 27, n. 9, p. 1420-1431, set. 2005.
EARDLEY, W. & TOTH, C. An open-label, non-randomized comparison of venlafaxine and gabapentin as monotherapy or adjuvant therapy in the management of neuropathic pain in patients with peripheral neuropathy. Journal of Pain Research, Calgary, v. 3, p. 33–49, mar. 2010.
FREYNHAGEN, R. et al. Efficacy of pregabalin in neuropathic pain evaluated in a 12-week, randomised, double-blind, multicentre, placebo-controlled trial of flexible- and fixed-dose regimens. Pain, Dusseldorf, v. 115, p. 254–263, fev. 2005.
GOLDSTEIN, D. J. et al. Duloxetine vs. placebo in patients with painful diabetic neuropathy. Pain, Indianapolis, v. 116, n. 1-2, p. 109-118, jul. 2005.
GU, L. et al. Treatment of patients with diabetic peripheral neuropathic pain in China: a double-blind randomised trial of duloxetine vs. Placebo. International Journal of Clinical Practice, Shanghai, v. 69, n. 9, p. 957-966, set. 2015.
GUAN, Y. et al. Efficacy of pregabalin for peripheral neuropathic pain: results of an 8-week, flexible-dose, double-blind, placebo-controlled study conducted in China. Clinical Therapeutics, Beijing, v. 33, n. 2, p. 159-166, fev. 2011.
JAVED, S. et al. Treatment of painful diabetic neuropathy. Therapeutic Advences in Chronic Disease, Manchester, v. 6, n. 1, p. 15–28, ago. 2015.
KAUR, H. et al. A Comparative Evaluation of Amitriptyline and Duloxetine in Painful Diabetic Neuropathy. A randomized, double-blind, cross-over clinical trial. Diabetes Care, Chandigarh, v. 34, p. 818–822, jan. 2011.
KO, S. H. et al. Comparison of the efficacy and safety of tramadol/acetaminophen combination therapy and gabapentin in the treatment of painful diabetic neuropathy. Diabetic Medicine, Seoul, v. 27, n. 9, p. 1033-1040, set. 2010.
KOCHAR, D. K, et al. Sodium valproate for painful diabetic neuropathy: a randomized double-blind placebo-controlled study. QJM, Bikaner, v. 97, n. 1, p. 33–38, out. 2004.
MARTINEZ, J. E.; GRASSI, D. C.; MARQUES, L. G. Análise da aplicabilidade de três instrumentos de avaliação de dor em distintas unidades de atendimento: ambulatório, enfermaria e urgência. Revista Brasileira de Reumatologia, Sorocaba, v. 51, n. 4, p. 299-308, abr. 2011.
MOON, D. E. et al. Efficacy and Tolerability of Pregabalin Using a Flexible, Optimized Dose Schedule in Korean Patients With Peripheral Neuropathic Pain: A 10-Week, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study. Therapeutics, Seoul, v. 32, n. 14, p. 2370-2385, nov. 2010.
MOSCA, L. M. et al. Dor óssea no hiperparatireoidismo secundário: impacto inicial da paratireoidectomia. Revista Brasileira Cirurigia Cabeça Pescoço, São Paulo, v. 42, n. 4, p. 190-193, out./nov./dez. 2013.
PATEL, N. et al. A study of the use of carbamazepine, pregabalin and alpha lipoic acid in patients of diabetic neuropathy. Journal of Diabetes & Metabolic Disorders, Ahmedabad, v. 13, n. 62, p. 1-7, jan. 2014.
MS - PROTOCOLO CLÍNICO E DIRETRIZES TERAPÊUTICAS - DOR CRÔNICA. Portaria SAS/MS, n. 1083, out 2012. Disponível em: .
Acesso em: 07 jun. 2015.
RASKIN, J. et al. A Double-Blind, Randomized Multicenter Trial Comparing Duloxetine with Placebo in the Management of Diabetic Peripheral Neuropathic Pain. Pain Medicine, Indianápolis, v. 6, n. 5, p. 346–356, fev. 2005.
RASKIN J. et al. Duloxetine for patients with diabetic peripheral neuropathic pain: a 6-month open-label safety study. Pain Medicine, Indianápolis, v. 7, n. 5, p. 373-385, set./out. 2006.
RAZAZIAN, N. et al. Evaluation of the efficacy and safety of pregabalin, venlafaxine, and carbamazepine in patients with painful diabetic peripheral neuropathy A randomized, double-blind trial. Neurosciences, Kermanshah, v. 19, n. 3, p. 192-198, abr. 2014.
RICHTER, R. W. et al. Relief of painful diabetic peripheral neuropathy with pregabalin: a randomized, placebo-controlled trial. The Journal of Pain, New York, v. 6, n. 4, p. 253-260, abr. 2005.
ROSENSTOCK, J. et al. Pregabalin for the treatment of painful diabetic peripheral neuropathy: a double-blind, placebo-controlled trial. Pain, Dallas, v. 110, n. 3, p. 628-38, ago. 2004.
ROWBOTHAM, M. C. et al. Venlafaxine extended release in the treatment of painful diabetic neuropathy: a double-blind, placebo-controlled study. Pain, San Francisco, v. 110, p. 697–706, mai. 2004.
SAEED, T. et al. Efficacy and tolerability of carbamazepine for the treatment of painful diabetic neuropathy in adults: a 12-week, open-label, multicenter study. International Journal of General Medicine, Karachi, v. 7, p. 339–343, jul. 2014.
SAID, G. Diabetic neuropathy a review. Nature Clinical Practice Neurology, Paris, v. 3, n. 6, p. 331-340, jun. 2007.
SATOH, J. et al. Efficacy and safety evaluation of pregabalin treatment over 52 weeks in patients with diabetic neuropathic pain extended after a double-blind placebo-controlled trial. Journal of Diabetes Investigation, Morioka, v. 2, n. 6, p. 457-463, nov. 2011a.
SATOH, J. et al. Efficacy and safety of pregabalin for treating neuropathic pain associated with diabetic peripheral neuropathy: a 14 week, randomized, double-blind, placebo-controlled trial. Diabetic Medicine, Morioka, v. 28, n. 1, p. 109-116, jan. 2011b.
SHREIBER, K. S. et al. Diabetic neuropathic pain: Physiopathology and treatment. World Journal of Diabetes, Curitiba, v. 6, n. 3, p. 432-444, abr. 2015.
SHUNG, S. A. & GODDARD, C. Recent advances in the pharmacological management of acute and chronic pain. Annals of Palliative Medicine, Perth, v. 3, n. 4, p. 263-275, out. 2014.
TANENBERG, R. J. et al. Duloxetine, Pregabalin, and Duloxetine Plus Gabapentin for Diabetic Peripheral Neuropathic Pain Management in Patients With Inadequate Pain Response to Gabapentin: An Open-Label, Randomized, Noninferiority Comparison. Mayo Clinic Proceedings, Indianápolis, v. 86, n. 7, p. 615-624, jul. 2011.
TANENBERG, R. J. et al. Duloxetine Compared with Pregabalin for Diabetic Peripheral Neuropathic Pain Management in Patients with Suboptimal Pain Response to Gabapentin and Treated with or without Antidepressants: A Post Hoc Analysis. Pain Practice, Greenville, v. 14, n. 7, p. 640-648, set. 2014.
TESFAYE, S. et al. Duloxetine and pregabalin: High-dose monotherapy or their combination? The “COMBO-DN study” – a multinational, randomized, double-blind, parallel-group study in patients with diabeticperipheral neuropathic pain. Pain, Sheffield, v. 154, n. 12, p. 2616–2625, mai. 2013.
TIAN, H. et al. Effects of Venlafaxine and Carbamazepine for Painful Peripheral Diabetic Neuropathy: A Randomized, Double-blind and Doubledummy, Controlled Multi-center Trial. Chinese Journal of Evididence-based Medicine, Chengdu, v. 6, n. 5, p. 321-328, mai. 2006.
WERNICKE, J. F. et al. A randomized controlled trial of duloxetine in diabetic peripheral neuropathic pain. Neurology, Indianapolis, v. 67, n. 8, p. 1411-1420, out. 2006.
YASUDA, H. et al. Superiority of duloxetine to placebo in improving diabetic neuropathic pain: Results of a randomized controlled trial in Japan. Journal of Diabetes Investigation, Shiga, v. 2, n. 2, p.132–139, set. 2011.
ZIEGLER, D. & FONSECA, V. From guideline to patient: a review of recent recommendations for pharmacotherapy of painful diabetic neuropathy. Journal of Diabetes and Its Complications, Dusseldorf, v. 29, n. 1, p. 146-156, ago. 2015.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
• Os autores mantêm os direitos autorais e concedem à revista o direito de primeira publicação com o trabalho licenciado sob a Licença Creative Commons - Attribution 4.0 International (CC BY 4.0).
• Os autores são estimulados a publicar e distribuir seu trabalho online (ex.: em repositórios institucionais ou na sua página pessoal), pois isso pode aumentar o impacto e a citação do trabalho publicado.