Which Prescription Drugs Are Most Effective for Neuropathic Pain?
Neuropathy is a medical term used to describe pain and related symptoms caused by nerve damage. If the condition is generalized, it is usually diagnosed as “peripheral neuropathy,” though many other types of neuropathy exist. Some of the specific neuropathic conditions with more precise diagnoses include:
- Diabetic neuropathy (neuropathy resulting from diabetes mellitus)
- Mononeuropathy (neuropathy affecting only one nerve)
- Polyneuropathy (neuropathy affecting multiple nerve pathways)
- Automatic neuropathy (neuropathy affecting nerves which are not under the patient’s voluntary control)
While the various subtypes of neuropathy have specific symptoms, there are some things which all forms of neuropathy have in common. The pain tends to come with tingling or burning sensations, and numbness, weakness and a diminished sense of touch tend to occur in affected areas. Doctors treat these symptoms with a range of medications, some of which tend to be more effective than others.
Neuropathy Medication: Which Ones Work Best?
Over-the-counter pain relievers may suffice to treat mild flare-ups of neuropathy pain, but most people with some form of nerve pain require prescription drugs to keep their symptoms under control. Here is an overview of the most commonly prescribed types of medication for neuropathic pain:
- Topical anesthetics. One of the most common treatments for neuropathic pain is the lidocaine patch. Lidocaine is a topical anesthetic which can be externally applied to painful areas of the body. Some patients use up to four lidocaine patches a day, and it can be a very effective way to numb and relieve localized neuropathic pain.
- Anti-seizure medications. Drugs which are normally used to treat epilepsy are often prescribed to patients with neuropathic pain. They work because anti-seizure medications are designed to have a calming effect on the nervous system, which helps inhibit the generation and passage of pain signals. This is one of the most widely used long-term solutions for people suffering from peripheral neuropathy and related conditions.
- Antidepressants. Along with anti-seizure medications, antidepressants are among the most widely used drugs for neuropathic pain. The chemical action that causes pain relief is complex, but in a nutshell, antidepressants work by altering the neurochemical processes that cause you to sense pain. In particular, venlafaxine, tricyclic antidepressants, and serotonin and norepinephrine reuptake inhibitors have proven effective in the treatment of neuropathic pain.
Note that narcotic painkillers, such as tramadol and hydrocodone, are not often prescribed to patients suffering from neuropathic pain. This is because nerve pain is a long-term condition, and taking these drugs for extended periods of time creates a risk of dependence and addiction. Doctors will generally only prescribe them to help patients get acute, intense episodes of nerve pain under control.
One final class of drugs is useful in the treatment of certain forms of neuropathy. Immunosuppressants, which are drugs that alter the function of the immune system, may be prescribed if the pain has an autoimmune origin. However, these drugs must be used sparingly, as they can leave the patient vulnerable to opportunistic viral and bacterial infections.