COMPARATIVE STUDY OF EFFECTIVENESS OF VENLAFAXINE, DULOXETINE AND SERTRALINE IN MANAGEMENT OF DIABETIC SENSORY NEUROPATHY

Objective: To compare efficacy of 3 commonly prescribed anti-depressants from classes’ selective serotoninreuptake inhibitor and serotonin-nor epinephrine reuptake inhibitors i.e. Venlafaxine, Duloxetine and Sertralinein the management of diabetic sensory neuropathy in subjects with type 2 diabetes mellitus. Study Design: Comparative, prospective study. Place and Duration of Study: Combined Military Hospital Jhelum, Mar 2018 to Jul 2018. Methodology: This study included 94 patients with metabolically stable type 2 Diabetes Mellitus with diabeticsensory neuropathy. Patients were randomly assigned into 3 treatment group, treatment group 1 (n1=29) receiving Venlafaxine 37.5mg × BD, treatment group 2 (n2=33) receiving duloxetine 30mg × BD and treatment group 3 (n3=25) receiving Sertraline 50mg × OD, each group being treated for 6 weeks, with optional dose titration fortnightly. The efficacy measure was done by revised Neuropathy Disability Score (NDS), measured at baseline and at the end of treatment period i.e. 6 weeks. The primary outcome of this study was “functional outcome” assessed by Disability Neuropathy scale (DNS) and overall improvement and adverse events were measured as secondary outcome measures. Results: There was significant improvement in Neuropathy Disability scale (DNS) at the end of treatment periodin all treatment groups from their baseline score, with comparable efficacy among all drug groups i.e. p-valuebetween venlafaxine and duloxetine, venlafaxine and sertraline were non-significant i.e. p>0.05 except betweenDuloxetine and Sertraline group where there was significant difference in efficacy (p<0.05). Good, moderate andmild improvement in symptoms was noticed in all study groups. Conclusion: Non-tricyclic Anti-depressants i.e. Venlafaxine