The purpose of study is comparison of effectiveness of Amitriptyline and Topiramate in the treatment of painful diabetic neuropathy Inclusion criteria :From both genders selected who were between 18-80 years of age and were under anti hyperglycemic agents therapy with diabetic peripheral neuropathy syptoms in the form of pain and paresthesia in rest for at least 1 month. Exclusion criteria : persons with any important clinical disease, unstable clinical or psychologic disease , other neurupathic causes ,renal dysfunction ,liver disease , epilepsy ,psychiatric disease ,uncontroled HTN ,malignancy ,opiate addiction ,anti epileptic ,anti depressant , topical anti pain or opioid treatment,pregnant and lactating women and need to change treatment.
Target sample :patients with diabetic neuropathy
Sample size : 60
Single blind study
Time : one year
Primary outcomes : 1. Effectiveness of Amitriptyline in the treatment of Painful Diabetic neuropathy on VAS suggest
2. Effectiveness of Topiramate in the treatment of painful diabetic neuropathy on VAS suggest
3. Comparison of Effectiveness of Amitriptyline and Topiramate in the treatment of painful diabetic neuropathy
4. Comparison changes of fasting plasma sugar , glycosilated hemoglubolin ,total cholestrol ,triglyceride ,high density lipoprotein , creatinine between two groups
Patients divided into two groups ,control and interventional . Control group are teared with Amitriptyline and interventional group are treated with topiramate for up to three months and the results are compared .