Safety Comparison between Amitriptyline versus Gabapentin on Neuropathic Pain Therapy in Geriatric with Type II Diabetes Mellitus

Background: Neuropathy in diabetes mellitus is a disorder that occurs in the peripheral nervous system. Diabetic neuropathy is more prevalent in elderly (44%) compared to adult (24%). The most commonly used agent in diabetic neuropathy are Amitriptyline and Gabapentin, mostly to treat the neuropathic pain. However, there were variations in the results of the studies that have been done related to safety between both drugs. Thus, further research is needed to confirm the safety of both drugs in diabetic neuropathy treatment especially in geriatrics patients. Objective: The aim of this study was to compare the safety of Amitriptyline versus Gabapentin administration for diabetic neuropathic pain in geriatric. Methods: A prospective cohort study involving 70 elderly were observed during 4 weeks. The outcome targets were incidence of side effect and comparison incidence of side effect between both drugs. Non-parametric Mann Whitney U, Chi-Square, and Fisher’s Exact test were used to analyze the outcome. Result: Most side effects have appeared in the group Amitriptyline is a dry mouth followed by sedation / drowsiness, fatigue, dizziness, and constipation. In the group of Gabapentin the incidence of adverse events that most often arises is sedation (sleepiness) followed by dizziness, dry mouth, and fatigue. Low doses administration showed that Amitriptyline has significantly greater adverse effects (p < 0.05) compared with Gabapentin. However, no significant differences were found in therapeutic dose (p > 0.05). Conclusion: The incidence of adverse events was more common in geriatric patients receiving Amitriptyline compared to Gabapentin.