THERAPEUTICS
Review: TCAs, anticonvulsants, opioids, and capsaicin cream are effective for diabetic neuropathy
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M C Wong
Mr M C Wong, United Christian Hospital, Hong Kong, China; wongmc0829@yahoo.com.hk
REVIEW PROCESS
in adults with diabetes, how effective are treatments for painful diabetic neuropathy?
Medline, EMBASE/Excerpta Medica, Evidence Based Medicine Reviews—ACP Journal Club, and Cochrane Central Register of Controlled Trials (to October 2006); and reference lists.
randomised, double-blind, placebo-controlled trials (RCTs) with sample size 
10, published in English as full articles, that evaluated the analgesic effects of oral or topical pain-relieving drugs (excluding Chinese herbal medicines) in adults with diabetic neuropathy. Quality assessment of individual trials was based on the 5-point Jadad score; trials with scores 
2 were excluded. 25 RCTs (n = 3290, range of mean ages 50–64 y) met the selection criteria; 17 RCTs assessed efficacy, and 21 RCTs assessed withdrawals for adverse events. Median duration of treatment was 6 weeks (range 2–16 wk).
50% or "moderate" reduction in pain and study withdrawal because of adverse
Mayo Clinic College of Medicine, Rochester, Minnesota, USA
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