Vitamin B12 may be more effective than nortriptyline in improving painful diabetic neuropathy

Introduction Despite many therapeutic options, painful diabetic neuropathy is still a common and challenging complication of diabetes mellitus and is often resistant to treatment with current modalities. Methods In this randomized, single-blind clinical trial we compared the efficacy of parenteral vitamin B12 and nortriptyline, for symptomatic improvement of pain, paresthesia, burning, freezing, stabbing and electrical sensation. Changes in nerve conduction parameters of amplitude, duration and latency were also compared. Results One hundred patients (50 in each group) completed the study. After treatment, the pain score based on a visual analogue scale decreased 3.66 units in the vitamin B12 group and 0.84 units in the nortriptyline group (P