Comparative Study to Evaluate Efficacy and Safety for Management of Neuropathic Pain with Gabapentin, Pregabalin, and Amitriptyline

Abstract

Background: Current treatments for neuropathic pain (NeP) are tricyclic antidepressants (TCA), such as pregabalin and gabapentin are first-line drugs for the management of NeP complaints. Current treatment for the management of neuropathic pain is often sub-standard. Methods: It's a three-arm, prospective, comparative, open-label study. A total of 270 patients with persistent lumbar radiculopathy were randomized into three groups based on clinical examination, symptoms, X-rays, and MRI scans of the lumbosacral spine. Patients in Groups A and B got Gabapentine 300 mg, Pregabaline 75 mg, and Amitriptyline 75 mg, respectively. Results: The mean NPRS score at two months was 3.72 ± 2.65 for Group A, 3.63 ± 2.65 for Group B, and 5.21 ± 2.65 for Group C. The F-value was 6.63, and the p-value was 0.001, which was statistically significant. As compared to the other two treatment groups, the subjects in Group 3 saw a significant difference. ‎ The adverse effects reported occurrence of dizziness was significantly more in group B with 21 patients (23.33%) as compared to group A with 11 patients (12.22%) and group C with 4 patients (4.44%), [p=0.041). The sedation occurred in 28 patients of group B (31.11%), which was significantly more than group A i,e, in 23 patients (25.55%) and group C, i.e., 22 patients (24.44%), [P=0.036]. Conclusions: In patients with NeP Thus, in conclusion, three groups Gabapentine, Pregabaline, and Amitriptyline, are equally efficacious in relieving pain in NeP. Pregabalin has advantages in terms of Numeric pain rating scale (NPRS) score over the Gabapentine and Amitriptyline. Gabapentine has fewer reported adverse effects and hence better patient compliance on long-term use. Keywords: Gabapentine, Amitriptyline, Pregabalin, Neuropathic pain