Mr. A was a 57-year-old man who improved somewhat after treatment with 450 mg/day of nefazodone over 8 weeks for diabetic neuropathy. He obtained substantial further benefit with the addition of acupuncture: his self-ratings of pain, paresthesia, and numbness all fell from 50 to 5 on a visual analog scale. Physician ratings for paresthesia fell from 1.5 to 0; ratings for numbness decreased from 1.5 to 0.5. His baseline platelet 5-HT content was 40.1 ng/10⁸ platelets and increased to 73.7 by the end of 8 weeks of nefazodone treatment. During acupuncture treatment, it continued to rise to 95.1 and 102.4 before falling to 49.8 some time after completion of the series.

Mr. B was a 56-year-old man who also improved somewhat after treatment with 450 mg/day of nefazodone over 8 weeks for diabetic neuropathy. The addition of acupuncture to his nefazodone treatment produced additional improvement. His visual analog scale rating for pain fell from 55 to 25, and his rating for paresthesia fell from 80 to 55. Physician ratings for pain fell from 1.5 to 0.5, and ratings for paresthesia fell from 1.5 to 1.0. Mr. B’s baseline platelet 5-HT content was 44.7 and rose only to 47.6 during his initial nefazodone treatment. It increased to 110.9 and 124.4 when acupuncture treatment was added but fell to 51.0 after treatment.

Mr. C was a 61-year-old man who obtained minimal benefit from an initial course of nefazodone at a dose of 450 mg/day for diabetic neuropathy. During his acupuncture treatment, he obtained little added benefit. His visual analog scale ratings decreased only from 60 to 50 for pain, paresthesia, and numbness. Physician ratings for pain and paresthesia fell only from 1.5 to 1.0. Mr. C’s change in platelet 5-HT content was completely different from those of Mr. A and Mr. B. His baseline platelet 5-HT content was 28.3, at the end of the first 8 weeks of treatment it was 12.3, and during acupuncture treatment it was 11.9, 10.6, and 12.6.