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March 21, 1980

Diabetic Neuropathic Cachexia: Beneficial Response to Combination Therapy With Amitriptyline and Fluphenazine

Author Affiliations

From the Endocrine Service, Department of Medicine, Fitzsimmons Army Medical Center, Aurora, Colo. Dr Gade is currently with the Department of Medicine, St Luke's Hospital, Denver.

JAMA. 1980;243(11):1160-1161. doi:10.1001/jama.1980.03300370034023

DIABETIC neuropathic cachexia is a rare diabetic neuropathic syndrome. When it does occur, the painful component of the syndrome may be severely incapacitating and functionally compromising. The usual treatment regimens employed for diabetic peripheral neuropathies have been discouraging, and the management of the pain remains a difficult clinical problem. A recent report1 in The Journal regarding the successful use of amitriptyline hydrochloride and fluphenazine dihydrochloride in diabetic peripheral neuropathy prompted us to try these drugs in a patient with the unrelenting pain of diabetic neuropathic cachexia. His dramatic response to this therapeutic program was rapid and long-lasting.

Report of a Case  The patient was a 59-year-old man with diabetes of 12 years' duration, which had been controlled with diet and tolbutamide therapy. He was admitted to the hospital with a six-month history of bilateral aching in the anterior thigh muscles, most notable at night,