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SNRI Drugs and Diabetic Neuropathy

Last updated: September 2022

Diabetic neuropathy is nerve damage caused by diabetes that can lead to pain, ulcerations, and in some cases, amputation. A class of drugs known as serotonin and norepinephrine reuptake inhibitors, or SNRIs, can help manage pain in people with diabetic neuropathy.1

What is diabetic neuropathy?

The most common type of diabetic neuropathy is diabetic peripheral neuropathy (DPN), which affects the nerves in the legs, feet, and hands. About 50 percent of people with diabetes have DPN, and of those, 50 percent experience pain.1

What are the symptoms of neuropathy?

Some people with DPN may never have symptoms and are only diagnosed when they develop a foot ulcer. Others may experience:1

  • Throbbing
  • Tingling
  • Numbness
  • Burning
  • Sharp pain

The pain can be constant or occasional. For some people, the symptoms may eventually go away, and for others, the symptoms can continue and become chronic.

What is the role of SNRIs as treatment?

There are no treatments that can reverse the damage to the nerves. Most treatments address the symptoms only.1

This is where the SNRI class of drugs comes in. These drugs act on brain chemicals such as serotonin. SNRIs do not just treat DPN. Other uses for these drugs include treatment for:2

  • Depression
  • Anxiety
  • Fibromyalgia
  • Hot flashes

What are common SNRIs prescribed?

The most common SNRIs prescribed for DPN are:3

  • Duloxetine (Cymbalta)
  • Venlafaxine (Effexor)

If someone with DPN also has anxiety and depression, these drugs may be good options to treat both conditions.3

How well do SNRIs work?

A clinical trial found that people who took duloxetine at the 60 mg dose were more likely to have at least a 50 percent reduction in pain after 3 months compared to people who were given a sugar (or dummy) pill.3

As a pharmacist, I have seen that these drugs can help reduce some levels of pain for some people. It may take a few tries with different drugs to find one that works best. Some people notice an improvement in their symptoms during the first week of treatment.

How should these drugs be taken?

Like most drugs, these medicines should be started at the lowest dose and gradually increased as needed. These drugs are typically taken once daily. Unless your doctor recommends it, they should not be stopped abruptly due to the risk of withdrawal symptoms.3

What are the side effects of SNRIs?

Always check with your pharmacist or doctor about the full list of side effects before starting treatment. Commonly experienced side effects are drowsiness, constipation, and nausea.

Do you take an SNRI to help manage symptoms of diabetic peripheral neuropathy? Share your experiences below!

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