NEVRAPLUS

Effect of a-lipoic acid on symptoms and quality of life in patients with painful diabetic neuropathy

Agathos E. et al.

Objective: To examine the effect of a-lipoic acid on neuropathic symptoms in patients with

diabetic neuropathy (DN).

Methods: Patients with painful DN were treated with 600 mg/day a-lipoic acid, orally,

for 40 days. Neuropathy Symptom Score (NSS), Subjective Peripheral Neuropathy Screen

Questionnaire (SPNSQ) and douleur neuropathique (DN)4 questionnaire scores were

assessed at baseline and day 40. Quality-of-life treatment effects were assessed by Brief

Pain Inventory (BPI), Neuropathic Pain Symptom Inventory (NPSI) and Sheehan Disability Scale

(SDS). Changes in body weight, arterial blood pressure, fasting serum glucose and lipids were also assessed.

Results: Out of 72 patients included, significant reductions in neuropathic symptoms were

shown by reduced NSS, SPNSQ and DN4 scores at day 40 versus baseline. BPI, NPSI, and

SDS in terms of work disability, social life disability, and family life disability scores were also

significantly reduced. Moreover, 50% of patients rated their health condition as ‘very much better’ or ‘much better’ following a-lipoic acid administration. Fasting triglyceride levels were reduced, but no difference was found in body weight, blood pressure, fasting glucose, or other lipids at day 40 versus baseline.

Conclusions: A-lipoic acid administration was associated with reduced neuropathic symptoms and triglycerides, and improved quality of life.

J Int Med Res. 2018 May;46(5):1779-1790. doi: 10.1177/0300060518756540. Epub 2018 Mar 8. PMID: 29517942; PMCID: PMC5991249. https://pubmed.ncbi.nlm.nih.gov/29517942/

Treatment of carpal tunnel syndrome with alpha-lipoic acid

Geronimo et al.

Abstract. – Carpal Tunnel Syndrome (CTS) is the most common peripheral mononeuropathy;

its symptoms and functional limitations significantly penalize the daily activities and quality of life of many people. While surgery is reserved to most severe cases, the earlier stages of disease may be controlled by a pharmacological treatment aimed to “neuroprotection”, i.e. to limiting and correcting the nerve damage. Our study was aimed to compare the efficacy of a fixed association of α-lipoic acid (ALA) 600 mg/die and γ-linolenic acid (GLA) 360 mg/die, and a multivitamin B preparation (Vit B6 150 mg, Vit B1 100 mg, Vit B12 500 μg daily) for 90 days in 112 subjects with moderately severe CTS. Demographic, case-history and treatment efficacy data were collected; the Boston questionnaire was administered and the patients were evaluated by Hi-Ob scale and electro-myography. A significant reduction in both symptoms scores and functional impairment (Bostonques-tionnaire) was observed in ALA/GLA group, while the multivitamin group experienced a slight improvement of symptoms and a deterioration of functional scores. Electromyography showed a statistically significant improvement with ALA/GLA, but not with the multivitamin product. The Hi-Ob scale showed significant efficacy of ALA/GLA in improving symptoms and functional impairment, while in the multivitamin group the improvement was significant, but less marked than in the ALA/GLA group.

In conclusion, the fixed association of ALA and GLA proved to be a useful tool and may be proposed for controlling symptoms and improving the evolution of CTS, especially in the earlier stages of disease.

Eur Rev Med Pharmacol Sci. 2009 Mar-Apr;13(2):133-9. PMID: 19499849. https://pubmed.ncbi.nlm.nih.gov/19499849/

Efficacy of combined topiramate/thioctic acid therapy in migraine prophylaxis

Ali et al.

Abstract

Migraine cannot be cured and the aim, shared with the patient, is to minimise the impact

of the illness on the patient’s life and lifestyle. The aim of prophylaxis is to reduce the number of migraine attacks. Prophylaxis should be considered when appropriately used acute management gives inadequate control of symptoms. The efficacy and safety of topiramate 50 mg/d and thioctic acid (a-lipoic acid) 300 mg/d either as monotherapy or in combination were investigated as migraine prophylactic agents. Forty secondary school migraineur girls were enrolled in the study. The study was conducted in two phases, a prospective baseline phase and 1-month treatment phase. Combined topiramate/thioctic acid therapy was more effective than either topiramate or thioctic acid monotherapy as a migraine-preventive treatment. Combined topiramate/thioctic acid therapy decreased the mean monthly migraine frequency from 5.86 ± 1.2 to 2.6 ± 0.98 (p 6 0.05), topiramate (50 mg/d) from 5.71 ± 1.4 to 4.75 ± 1.5 and thioctic acid (300 mg/d) from 5.68 ± 1.6 to 5.22 ± 1.8. Reduction in mean monthly migraine days was also significantly greater in the group receiving combined topiramate/thioctic acid (from 12.32 ± 1.85 to 5.74 ± 1.1) compared to those receiving either topiramate 50 mg/d (from 12.7 ± 1.34 to 11.85 ± 1.35) or thioctic acid 300 mg/d (from 12.5 ± 1.72 to 11.65 ± 1.44). The responder rate (% of patients showing P50% reduction in monthly migraine frequency) was 85% in patients receiving combined topiramate/thioctic acid therapy compared to 30% and 20% in patients receiving either topiramate or thioctic acid, respectively. The incidence of adverse events was higher in patients receiving topiramate (50 mg/d) monotherapy. The most common adverse events were nausea, fatigue, paraesthesia and taste perversion

Saudi Pharmaceutical Journal (2010) 18, 239–243 doi:10.1016/j.jsps.2010.07.006

B Vitamins for Neuropathy and Neuropathic Pain

Mauro Geller et al.

Abstract

Vitamins B1, B6 and B12 are members of a group of water-soluble organic vitamins with important structural and functional roles in the human body. This updated literature review examines the physiological and biochemical properties of these B vitamins.

Geller M, Oliveira L, Nigri R, Mezitis SG, Ribeiro MG, et al. (2017) B Vitamins for Neuropathy and Neuropathic Pain. Vitam Miner 6: 161. doi:10.4172/2376-1318.1000161