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,
Gade GN, Hofeldt FD, Treece GL. Diabetic Neuropathic Cachexia: Beneficial Response to Combination Therapy With Amitriptyline and Fluphenazine. JAMA. 1980;243(11):1160–1161. doi:10.1001/jama.1980.03300370034023
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