What is the Evidence For Pregabalin in the Treatment of Diabetic Neuropathy?
DOI: 10.3238/zfa.2019.0438-0441german translation / full article
Question In most guidelines pregabalin is considered a firstline therapy in the treatment of painful diabetic neuropathy. On the other hand there are rising concerns about its side effects and misuse. What is the best currently available evidence regarding risks and benefits of pregabalin in the treatment of diabetic neuropathy?AnswerThe effect of pregabalin is dose-dependent and starts at a daily dose of 300 mg. With increasing doses the risk for adverse events like dizziness and somnolence rises. Additionally, there is a considerable risk for misuse. A NNT of about 6 for a 50%-reduction of pain goes along with a NNH of 5–10 for dizziness and somnolence. Therefore, risks and benefits must be communicated to the patient before prescribing the drug to facilitate a shared decision making process. Prescriptions should be made with caution to reduce the risk of misuse, especially in patients with potential risks for drug dependency. Physicians should be aware of potential abuse.