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September 16, 1983

Treatment of Painful Diabetic Neuropathy With Trazodone

Author Affiliations

University of Pittsburgh Khurana Clinic Pittsburgh

JAMA. 1983;250(11):1392. doi:10.1001/jama.1983.03340110016015

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To the Editor.—  Since the first report of treatment of painful diabetic neuropathy with amitriptyline hydrochloride and fluphenazine hydrochloride in seven patients by Davis et al in The Journal (1977;238:2291), the use of tricyclic antidepressants with or without combination with phenothiazines has become widespread and is effective in most patients. The pain relief is thought to be caused by increased cortical inhibition of sensory input rather than mood alteration because of small dosages and rapid onset of action. In our practice, the effect has been most prominent when both drugs were used in combination.We have recently noticed a dramatic relief in pain and numbness of diabetic neuropathy in five of six patients by the use of trazodone hydrochloride (Desyrel) given alone in a dosage of 100 mg/day in divided doses. In the sixth patient, fluphenazine had to be added to the program. Trazodone is an antidepressant chemically unrelated to