An updated practice guideline from the American Academy of Neurology (AAN) stated that gabapentinoids, serotonin norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, and sodium channel blockers had a higher likelihood, compared to placebo, of improving diabetic neuropathy pain.

The new guidance, published in Neurology, updated AANs 2011 guidance on treating painful diabetic neuropathy. Brian Callaghan, of University of Michigan, Ann Arbor, said that new studies on sodium channel blockers published since the last guideline have led to the recommendation of these drugs. They are considered as effective as other drug classes recommended in the guideline for pain relief.

The guideline recommends against the use of opioids to treat neuropathy, including SNRI/opioid dual mechanism agents, such as tramadol and tapentadol… (Medpage Today