Therapeutic role of pregabalin in diabetic neuropathic pain management

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Created On: 16/03/2026

Diabetic peripheral neuropathy (DPN), a common complication of diabetes, is marked by persistent neuropathic pain that substantially impairs quality of life.

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Key take away

Pregabalin demonstrates comparable or superior efficacy to several standard therapies for diabetic peripheral neuropathy pain with favorable tolerability.

Background

Diabetic peripheral neuropathy (DPN), a common complication of diabetes, is marked by persistent neuropathic pain that substantially impairs quality of life. Although various pharmacologic options, including antidepressants, anticonvulsants, and combination regimens, are routinely used in clinical practice, their comparative efficacy and tolerability profiles remain inconsistent.

Pregabalin, a widely prescribed anticonvulsant with established neuromodulatory properties, is a cornerstone therapy for neuropathic pain; however, its relative effectiveness compared with other standard and alternative treatments requires clearer delineation. In light of these considerations, the study aimed to systematically evaluate the efficacy and safety of pregabalin in mitigating DPN-related neuropathic pain, both as monotherapy and in comparison with commonly utilized pharmacologic and adjunctive therapies, to support more informed and individualized treatment decisions.

Method

A literature-based evaluation was conducted using studies identified through PubMed and Embase databases. Eligible studies assessing pregabalin in the management of DPN-related neuropathic pain were reviewed. Comparative analyses included pregabalin versus carbamazepine, amitriptyline, venlafaxine, duloxetine, and Xiaoketongbi Formula (XF), as well as pregabalin-based combination therapies. Outcomes assessed included pain reduction efficacy and adverse effect profiles.

Result

Pregabalin demonstrated comparable efficacy to amitriptyline, although longer treatment durations were suggested for more definitive comparisons. Duloxetine showed greater effectiveness at lower doses, whereas pregabalin exhibited superior efficacy at higher doses. Pregabalin outperformed venlafaxine and carbamazepine in pain reduction.

Notably, XF, an herbal treatment, demonstrated similar efficacy to pregabalin, suggesting a potential complementary role. Combination therapies did not show substantial advantage over pregabalin monotherapy. In terms of safety, pregabalin was generally well-tolerated, with predominantly mild adverse effects, and was considered to have a favorable tolerability profile relative to comparator treatments.

Conclusion

Pregabalin remained an effective and clinically reliable option for managing DPN pain. Its efficacy was comparable or superior to several established pharmacologic therapies, with a favorable tolerability profile. The absence of significant benefit from combination regimens further supported pregabalin’s utility as a standalone therapy.