Gabapentin – Anti-epileptic drug.
- Used as an adjuvant in partial and secondarily generalised tonic-clonic seizures.
- Gabapentin and tricyclic antidepressants are efficacious in the treatment of painful diabetic neuropathy and postherpetic neuralgia.
- Approved for add-on therapy of focal seizures; increasingly used for the treatment of neuropathic pain.
Nortriptyline – Nortriptyline is a tricyclic antidepressant.
- Nortriptyline therapy may provide dual value for Parkinson’s Disease patients;
- it can both treat depressive symptoms and
- reduce alpha-synuclein accumulation, which may impact disease progression.
- Significantly reduces the accumulation of pathological α-synuclein which may impact disease progression.
- An active form of vitamin B12 is required for the integrity of myelin, neuronal function, proper red blood cell formation, and DNA synthesis.
- Helps in the synthesis of neuronal lipids, regeneration of axonal nerves and has neuroprotective activity, which promotes neurons to function properly.
Treating Diabetic Neuropathic Pain
- To decrease pain in patients suffering from diabetic neuropathy combined therapy with Gabapentin and Methylcobalamin can be more efficacious as compared to treatment with gabapentin alone.
- This combination is safe with minimal side effects.
Superior analgesic effect in painful neuropathic condition
- Combination therapy of gabapentin and nortriptyline offers a pivotal modality in the management of uncontrolled neuropathic pain.