Pharmacotherapy for painful diabetic neuropathy: Relevant comorbidities for drug selection

Drug class	Comorbidities favoring use	Comorbidities favoring avoidance
Serotonin-norepinephrine reuptake inhibitors (SNRIs) Duloxetine* Venlafaxine	Depression Anxiety	Restless legs syndrome Sexual dysfunction (for venlafaxine) Angle-closure glaucoma
Tricyclic antidepressants (TCAs) Amitriptyline Nortriptyline Desipramine	Depression Anxiety Insomnia	Cardiac disease Prolonged QTc Orthostatic hypotension Sexual dysfunction Urinary retention Angle-closure glaucoma
Gabapentinoid antiseizure medications Pregabalin* Gabapentin	Restless legs syndrome Essential tremor Insomnia	Substance abuse Peripheral edema Chronic obstructive pulmonary disease

* Approved by the US Food and Drug Administration for diabetic neuropathy.

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