How is painful diabetic neuropathy treated

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How is painful diabetic neuropathy treated? 

Food and Drug Administration-approved drugs such as pregabalin and duloxetine are often employed.

There are a large number of off-label anticonvulsants used including gabapentin, oxcarbazepine, valproate, or lacosamine.

Tramadol is also effective in some cases.

Tricyclic antidepressants can be employed, but the side effect profile is less favorable than that of duloxetine.

In more severe cases, an opioid may have to be added to the pharmacologic cocktail.

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