Diabetic Painfull Peripheral Neuropathy:
new therapeutic approach
DOI:
https://doi.org/10.34024/rnc.2006.v14.8754Keywords:
Diabetic Neuropathies, Pain, Norepinephrine, Serotonin AntagonistsAbstract
The Diabetic Peripheral Neuropathy has a prevalence of 30% - 60% in diabetes patients type I and II. The extensive duration of the disease and an irregular glucose control increase the risks of its occurrence. Injuries to sensitive, anatomical and motor fibers may occur. The most common form is a distal symmetric polyneuropathy. The Diabetic Painful Peripheral Neuropathy, a modality of Neuropathic Pain, occurs in 10 . 20% of Diabetic Peripheral Neuropathy patients. The mechanism of Neuropathic Pain involves peripheral and central sensitization phenomena. For pain modulation, the Endogenous Analgesic System is of major importance, having the Endorphins, Serotonin and Noradrenalin, as neurotransmitters. Drugs potentializing the latter two are used as analgesic agents in Neuropathic Pain. Tricyclic antidepressants have that profile, although they occupy other receptors, which lend them a profile of undesirable side effects. A group of drugs selectively inhibiting Serotonin and Noradrenalin reuptake is a new option. Duloxetin belongs to this group, and is the first drug receiving FDA approval at the United States market for Diabetic Painful Peripheral Neuropathy. In this literature review article, the effectiveness and safety of this drug is evidenced.
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