Advertisement

European Journal of Clinical Pharmacology

, Volume 37, Issue 2, pp 151–153 | Cite as

Imipramine treatment in diabetic neuropathy: relief of subjective symptoms without changes in peripheral and autonomic nerve function

  • S. H. Sindrup
  • B. Ejlertsen
  • A. Frøland
  • E. H. Sindrup
  • K. Brøsen
  • L. F. Gram
Originals

Summary

The effect of imipramine on symptomatic peripheral diabetic neuropathy in 9 patients was examined in a double-blind cross-over study against placebo. The dose of imipramine was adjusted to yield optimal plasma levels of imipramine plus desipramine of 300–750 nM.

Imipramine had a clear benificial effect on the symptoms of the neuropathy, whereas no changes in a range of neurophysiological measurements was detected.

Despite some adverse effects, especially of an anticholinergic nature, the patients generally preferred imipramine to placebo.

Key words

diabetic polyneuropathy imipramine adverse effects neurophysiological tests 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Davis JL, Lewis SB, Gerich JE, Kaplan RA, Schultz TA, Wallin JD (1977) Peripheral diabetic neuropathy treated with amitriptyline and fluphenazine. J Am Med Assoc 238: 2291–2292Google Scholar
  2. 2.
    Turkington RW (1980) Depression masquerading as diabetic neuropathy. J Am Med Assoc 243: 1147–1150Google Scholar
  3. 3.
    Kvinesdal B, Molin J, Frøland A, Gram LF (1984) Imipramine treatment of painful diabetic neuropathy. J Am Med Assoc 251: 1727–1730Google Scholar
  4. 4.
    Young RJ, Clarke BF (1985) Pain relief in diabetic neuropathy: The effectiveness of impiramine and related drugs. Diabetic Med 2: 363–366Google Scholar
  5. 5.
    Mendel CM, Klein RF, Chappell DA, Dere WH, Gertz BJ, Karam JH, Lavin TN, Grunfeld C (1986) A trial of amitriptyline and fluphenazine in the treatment of painful diabetic neuropathy. J Am Med Assoc 255: 637–639Google Scholar
  6. 6.
    Brøsen K, Klysner R, Gram LF, Otton SV, Bech P, Bertilsson L (1986) Steady-state concentrations of imipramine and its metabolites in relation to the sparteine/debrisoquine polymorphism. Eur J Clin Pharmacol 30: 679–684Google Scholar
  7. 7.
    Gram LF, Bjerre M, Kragh-Sørensen P, Kvinesdal B, Molin J, Pedersen OL, Reisby N (1983) Imipramine metabolites in the blood of patients during therapy and after overdose. Clin Pharmacol Ther 33: 335–342Google Scholar
  8. 8.
    Arezzo JC, Schaumburg HH, Laudadio C (1986) Thermal sensitivity tester. Device for quantitative assessment of thermal sense in diabetic neuropathy. Diabetes 35: 590–592Google Scholar
  9. 9.
    Niakan E, Harati Y, Comstock JP (1986) Diabetic autonomic neuropathy. Metabolism 35: 224–234Google Scholar
  10. 10.
    Gram LF (1983) Antidepressants: Receptors, pharmacokinetics and clinical effects. In: Burrows GD, Norman T, Davies B (eds) Antidepressants. Elsevier Science Publishers, Amsterdam, pp 81–96Google Scholar
  11. 11.
    Reisby N, Gram LF, Bech P, Nagy A, Petersen GO, Ortmann J, Ibsen I, Dencker SJ, Jacobsen O, Krautwald O, Søndergård I, Christiansen J (1977) Imipramine: Clinical effects and pharmacokinetic variability. Psychopharmacology 54: 263–272Google Scholar
  12. 12.
    Fields HL, Basbaum AI (1984) Endogenous pain control mechanisms. In: Wall PD, Melzach R (eds) Textbook of pain. Churchill Livingston, London, pp 142–152Google Scholar

Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • S. H. Sindrup
    • 1
  • B. Ejlertsen
    • 1
  • A. Frøland
    • 1
  • E. H. Sindrup
    • 2
  • K. Brøsen
    • 3
  • L. F. Gram
    • 3
  1. 1.Department of Internal MedicineFredericia HospitalFredericiaDenmark
  2. 2.Department of Clinical NeurophysiologyOdense UniversityOdenseDenmark
  3. 3.Department of Clinical PharmacologyOdense UniversityOdenseDenmark

Personalised recommendations