Background: Neuropathic pain is a persistent and clinically challenging condition arising from damage or dysfunction of the somatosensory nervous system. Effective pharmacological management is essential for improving patients' quality of life. Gabapentinoids (Pregabalin and Gabapentin) and Serotonin–Norepinephrine Reuptake Inhibitors (SNRIs), particularly Duloxetine, are widely used first-line agents; however, robust head-to-head comparative evidence remains limited.

Objectives: The primary aim of this study was to evaluate and compare the efficacy of Gabapentinoids and SNRIs in reducing pain intensity among patients diagnosed with neuropathic pain, using the PainDETECT Questionnaire (PD-Q).

Methods: A prospective, observational, comparative study was conducted at Sri Naveen Advanced Neuro Center and Mahatma Gandhi Memorial Hospital, Warangal. A total of 350 adult patients with neuropathic pain were enrolled. Pain intensity scores were recorded at baseline, mid-treatment, and at the end of the study period. Data were analyzed using unpaired t-tests and one-way ANOVA to determine statistical significance.

Results: Of the 350 patients who completed the study, 272 received Gabapentinoids and 78 received Duloxetine. Both treatment groups demonstrated substantial reductions in pain scores. The mean reduction was 5.01 points in the Gabapentinoid group and 4.73 points in the SNRI group. Statistical analysis revealed no significant difference between the two groups (p > 0.05), indicating comparable efficacy.