Raskin and colleagues (2004) randomized patients with painful diabetic polyneuropathy to topiramate or placebo for a 12-week study period; patients were assessed on a visual analogue scale (VAS) for the responsiveness of pain to the treatment. VAS score among patients treated with topiramate decreased from 68 to 46; VAS score among patients treated with placebo decreased from 69 to 54. There was also a significant decrease in body weight among patients taking topiramate; topiramate had been previously found to be associated with weight loss. Patients receiving topiramate were more likely to reach a 30-50% reduction in pain intensity from baseline than were patients receiving placebo. Unfortunately, there was a 48% dropout rate in the topiramate group, potentially baising the resuls. These results suggest that topiramate is effective as symptomatic therapy for painful diabetic polyneuropathy.
Raskin P et al: Topiramate vs placebo in painful diabetic neuropathy: Analgesic and metabolic effects. Neurology 63:865, 2004