Background: Peripheral Neuropathy (PN) refers to broad range of disorders which cause damage and dysfunction of peripheral nerves in different patterns. Current pharmacotherapy includes antiepileptic drugs like pregabalin, gabapentin and antidepressants like duloxetine. Though several studies were published on pregabalin and duloxetine, the efficacy and tolerability between the drugs were still unclear. Hence, the present study aimed to compare the efficacy and safety of pregabalin plus methylcobalamin and duloxetine plus methylcobalamin in patients with peripheral neuropathy. Methods: Patients were recruited from out-patient department of Neurology. Baseline demographic details and baseline biochemical investigations among study groups were recorded and measured. At 0, 4, 8, 12 and 16 weeks, special investigators such as Semmes-Weinstein monofilament test for touch sensation, 128 Hz tuning fork test for vibration sensation, thermo tube test for temperature sensation and VAS for pain assessment were performed. Results: Duloxetine group showed higher efficacy over pregabalin at every consecutive follow up visit of all primary outcome measures such as Semmes-Weinstein monofilament test for touch sensation, 128 Hz tuning fork test for vibration sensation, thermo tube test for temperature sensation and VAS for pain assessment which were statistically significant (P<0.001). Conclusion: Combination of duloxetine and methylcobalamin proves to be better than combination of pregabalin and methylcobalamin increasing progression and pain in patients of painful diabetic neuropathy.

Duloxetine, Pregabalin, Methylcobalamin, Peripheral Neuropathy, Diabetic Neuropathy