Treating Peripheral Neuropathy

Many neuropathy sufferers are often looking for the “silver bullet”- that evasive medication or treatment that will relieve the terrible discomfort and numbness that is associated with the condition. Unfortunately this is not the case and in most instances treating neuropathy often requires a combination of treatments. The treatment list is long-ranging from prescription medication, laser therapy, nutritional supplements, acupuncture, hyberbaric oxygen, intravenous immunoglobulin therapy (IVIG), electrical spinal stimulation and even the use of morphine pumps for severe neuropathy pain. Since prescription was one of the first treatment approaches for neuropathy, this will be discussed in this article. The following are some of the more common medications used to ease neuropathy pain:

Gabapentin (Neurontin®)

Gabapentin is an oral medication approved by the FDA for the treatment of seizures for patients who have epilepsy. Gabapentin is classified as an anticonvulsant medication. While this medication is frequently prescribed, it was not developed as a primary treatment for any type of peripheral neuropathy. The mechanism of action of how gabapentin relieves nerve pain is not exactly known. Gabapentin is not intended to reverse nerve damage. Common side effects include drowsiness, headache, lethargy and dizziness. More serious side effects include allergic reaction, joint pain, blurred vision and seizures.

Pregabalin (Lyrica®)

About Lyrica Lyrica is an oral medication that is chemically related to Neurontin. It has been approved by the FDA only for the management of pain from diabetic neuropathy. It also has been approved by the FDA for other conditions including pain from shingles (postherpetic neuralgia) and fibromyalgia. Lyrica has not been approved by the FDA for the treatment of other kinds of peripheral neuropathy. It should be noted that the exact mechanism of how Lyrica works to relieve nerve pain is not entirely known. Side effects are similar to gabapentin, although many patients relate that they are more severe. Patients often relate that they experience extreme, fatigue, disorientation, and drowsiness to point that they have to discontinue taking Lyrica- for other side-effects-refer to those of gabapentin.

Duloxetine (Cymbalta®)

Cymbalta is an antidepressant medication. It is used to treat major depressive disorders and general anxiety disorder. Cymbalta has also been approved by the FDA to manage pain associated with diabetic neuropathy. As with the above two medication, Cymbalta can cause extreme drowsiness, fatigue, lethargy and confusion. Weight gain, tremors insomnia and sexual dysfunction are other side-effects. Other medications used for treating neuropathy pain Tricyclic Antidepressants including Tofranil, Elavil, Pamelor and Norpramin.

Pain Medications Over -the-counter medications

include asprin, Acetaminophen (Tylenol),and non-steroidal anti-inflammatories such as Aleave, Motrin and Advil

Prescription Pain Medications

These medications are generally used for people who have higher levels of symptoms, including more severe pain, tingling and burning. These “stronger” analgesics may be associated with more side effects. Medications in this category are called opoids and include codeine (including Tylenol with Codeine and Vicodin), Darvon, Darvocet-N, and oxycodone (OxyContin, Percocet and Percodan). The most potent opioids are morphine and methadone and should only be used in the most extreme cases.