Efficacy and Safety Outcome (in Terms of Hyponatremia) of Duloxetine in the Treatment of Diabetic Peripheral Neuropathic Pain

Objective: To determine the efficacy and safety outcomes (in terms of hyponatremia) of Duloxetine among patients with diabetic peripheral neuropathic pain at a tertiary care hospital.

Material and methods: This descriptive case series study using non-probability purposive sampling technique was done at diabetic outdoor of Nishtar hospital, Multan. Detailed history and physical examination of study participants was done and all the relevant baseline investigations were carried out and patients were prescribed with Duloxetine 60 mg once daily for 12 weeks. Data was entered and analyzed using SPSS-25.

Results: Three seventy-seven patients with diabetic peripheral neuropathic pain were taken in the study, of which 70.6% (n=266) were males and 29.4% (n=111) were female patients with their mean age; 61.71 ± 9.21 years (range; 45-79 years) and 52.5% (n=198) were aged>60 years. Of these 377 patients, 52% (n=196) were from urban localities, 63.9% (n=241) were poor and 53.1% (n=200) were hypertensive. Mean duration of DPNP was 4.31 ± 2.12 years and 63.9% (n=241) had duration more than 2 years. Mean BMI was 26.34 ± 2.23 kg/m2 and 30% (n=113) were obese. Efficacy was noted in 57.6% (n=217) and mean serum sodium level was 137.23 ± 2.41 nmol/L and hyponatremia was noted in 3.2% (n=12).

Conclusion: Duloxetine is found to be safe, well tolerate and effective in Diabetic Peripheral Neuropathic Pain (DPNP) and can be employed safely to relieve symptoms of DPNP. Efficacy was significantly associated with younger age groups, residential status, hypertension and obesity. Duloxetine induced hyponatremia was most prevalent side effect which was associated with female gender and older ages.