What is neuropathic pain? Neuropathic pain refers to pain emanating from a nerve or nerves. Compression, inflammation, trauma or chemical changes can cause a nerve to become painful. Patients often describe nerve pain as a shooting, stabbing, electrical, burning or having a numbing sensation.
Benefits of neuropathic pain medication? Using different mechanisms than anti-inflammatory medications or painkillers, neuropathic pain medication act more directly on the nerve. They can improve pain relief beyond what other medications may provide. Certain individuals may not tolerate anti-inflammatory medications or painkillers because of side effects. Oftentimes, anti-inflammatory medications or painkillers fail to relieve neuropathic pain. Neuropathic pain medications decrease pain, burning, and tingling, but do not bring back feeling if there is loss of sensation.
What are the different types of neuropathic pain medications? Neuropathic pain medications originate from 2 different families of medications, either anti-seizure medication or anti-depressant medication. Although these medications treat seizures or depression, they have been found to be effective when treating nerve pain because they target the nervous system. The selection of a particular medication is made according to your particular condition, medical history and past treatments.
| Anti-seizure medication | Anti-depressant medication |
| Neurontin (gabapentin) | Elavil (amitriptyline) |
| Lyrica (pregabalin) | Pamelor (nortriptyline) |
| Effexor (venlafaxine) | |
| Cymbalta (duloxetine) |
What is meant by off-label usage? Every prescription drug marketed in the United States carries an individual FDA approved label or insert specifying doses and uses of the medication. Once the FDA approves a drug, physicians may prescribe the drug for an unapproved use when they judge that it is medically appropriate for their patient. This practice is known as off label prescribing. Most neuropathic pain medications are often prescribed in off-label fashion. In fact, 20% of medications prescribed in the United States are off label.
Concerned about drug interactions? Your physician has carefully selected this medication after reviewing your medical history and list of medications to minimize the risk of side effects. Your doctor will start you on a smaller dose and gradually increase the dose if needed, by using the principle of “Start low, go slow.”
How and when to take the medication? How long should I take this medication? Anti-seizure medications can be taken every 8 hours if needed, and the effect is usually evident within several days. Anti-depressant medications are usually taken once a day, often at bedtime, and can take up to several weeks to begin working. Neuropathic pain medications can safely be taken for either short or long periods of time as needed.
How will I know if the medication is working? You will know the regimen is working if the pain severity diminishes and you are able to go about your day with less pain.
What are the side effects? Your doctor will discuss the side effect profile of the specific medication with you. Please call your doctor if you have any questions or concerns.