Effectiveness of oral clonidine and gabapentin on peripheral neuropathy in diabetic patients in southwestern Iran: a randomized clinical trial

Abstract

Background Peripheral neuropathy is not only the most prevalent consequence of diabetes but also the main reason for foot ulceration, disability, and amputation. Therefore, the current study aims to determine the effectiveness of oral clonidine and gabapentin on peripheral neuropathy in diabetic patients. Methods This 12-week, randomized, and parallel-group trial was conducted to compare the efficacy of oral clonidine and gabapentin with gabapentin alone in diabetic patients in southwest Iran during the first half of 2021. Thirty patients with type 2 diabetes with peripheral neuropathy as assessed by a visual analog scale (VAS) and divided into two groups of 15 patients, treated for up to three months. The data were analyzed using SPSS-21 software. In order to report the results, descriptive indices, independent t-test, one-way analysis of covariance (ANCOVA) and analysis of variance with repeated measures were used. Results The mean and standard deviation of the age of the participants in the clonidine + gabapentin group was equal to 50.20 ± 7.44, and in the gabapentin group was equal to 50.47 ± 7.57 (t = 0.10, P-value = 0.923). This research showed a significant difference between the clonidine + gabapentin group and with gabapentin group in terms of neuropathic pain and the severity of neuropathic pain (P < 0.001). Conclusions According to this research results, clonidine + gabapentin can reduce neuropathic pain and the severity of neuropathic pain in diabetic patients. Therefore, it is recommended that healthcare professionals with diabetes expertise prescribe these medications to reduce neuropathic pain and its severity. Trial registration This study was registered in the Iranian Clinical Trials System with the ID (IRCT20211106052983N1) on 14/01/2022.

Novel drug treatments for pain in advanced cancer and serious illness: a focus on neuropathic pain and chemotherapy-induced peripheral neuropathy

“…Clonidine (0.1 mg oral) has improved low-dose gabapentin analgesia in diabetic individuals with painful neuropathy. 166 Oral clonidine 0.1–0.2 mg by mouth has been compared to zolpidem in patients with chronic pain and secondary insomnia. Clonidine’s time to sleep onset was quicker ( p = 0.001), and pain was significantly improved relative to zolpidem.…”

“… 163 – 165 There is a growing body of literature that suggests that clonidine may be an effective analgesic for neuropathic pain. 166 – 169 There is extensive evidence that perioperative clonidine is an effective analgesic in children, is opioid-sparing, and is associated with reduced postoperative nausea and vomiting. 170 – 177 We will not review spinal clonidine, as it is a common practice in interventional pain management, but will limit discussions to parenteral, topical, oral, and transdermal clonidine, particularly for pain.…”