ABSTRACT
OBJECTIVE: To review the use of dextromethorphan for the treatment of painful diabetic neuropathy. DATA SOURCES: MEDLINE and EMBASE searches for studies using dextromethorphan to manage diabetic neuropathy were conducted from 1966 to 1999 and 1980 to 1999, respectively. DATA SYNTHESIS: Peripheral neuropathy is a common manifestation of diabetic patients. Many classes of medications have been investigated to treat this condition, including N-methyl-D-aspartate inhibitors. A review of studies using dextromethorphan to manage diabetic neuropathy was performed. CONCLUSIONS: There are insufficient safety and efficacy data to justify the use of dextromethorphan for treating painful diabetic neuropathy. Further clinical trials are needed.
Subject(s)
Dextromethorphan/therapeutic use , Diabetic Neuropathies/drug therapy , Excitatory Amino Acid Antagonists/therapeutic use , Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors , Dextromethorphan/adverse effects , Excitatory Amino Acid Antagonists/adverse effects , Humans , Randomized Controlled Trials as TopicABSTRACT
Thirty-six cases of hepatic toxicity associated with felbamate therapy have been collected by the Food and Drug Administration. Five patients died. We describe a case of massive acute hepatic necrosis and death within 40 days of initiation of felbamate therapy for a generalized tonic-clonic seizure disorder. We describe the clinical and histopathologic features.
