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Arthur Taub, MD, PhD
New Haven, Conn

JAMA. 1986;256(6):713.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Mendel et al¹ present a placebo-controlled, double-blind, crossover study of the effects of the treatment of pain with the combination of amitriptyline and fluphenazine in six patients with diabetic neuropathy, concluding that "a placebo response was seen, but no additional effect of amitriptyline and fluphenazine was seen." The study is studded with major flaws, to the extent that its conclusions are vitiated.

No objective assessment of the neuropathy was made. Since cutaneous hypersensitivity and evoked dysesthesia, characteristic of painful diabetic neuropathy,² were not described, the group of patients studied is not comparable with the population of individuals with the disorder. Furthermore, since "none of the patients in the study exhibited signs or symptoms of depression," atypicality is further ensured.

Previous studies^3-5 were concerned with patients refractory to other modes of treatment. Mendel et al¹ provide no information regarding prior response to any treatment. . . . [Full Text PDF of this Article]

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