Effectivity comparison of amitriptyline versus gabapentin as neurophatic pain therapy in elderly with type ii diabetes mellitus

Background: Neuropathy in diabetes mellitus is a disorder that occurs in the peripheral nervous system. The incidence of diabetic neuropathy was found more prevalent in elderly (44%) compared to adult (24%). Amitriptyline and Gabapentin are widely used on treatment of neuropathic pain. There were variations in the results of the studies that have been done related to effectiveness between both drugs, causes the need further research, especially on geriatrics. Objective: The aim of this study was to compare the effectiveness of Amitriptyline versus Gabapentin for diabetic neuropathic pain in geriatric. Methods: A prospective cohort study involving 70 elderly were observed during 4 weeks. The outcome targets were neuropathy pain scale reduction (≥ 2 unit). Non-parametric Wilcoxon, Mann Whitney U, and Chi-Square test were used to analyze the outcome. Result: The whole subjects who got Amitriptyline or Gabapentin decreased pain scale ≥ 2 units compared to baseline. Comparison head to head at low doses, Amitriptyline showed reduce pain intensity greater than Gabapentin (p < 0.05), while on therapeutic doses show there was no difference in efficacy between two drugs (p > 0.05). Conclusion: Amitriptyline was found better in reducing diabetic neuropathic pain intensity compared to Gabapentin.