Patients with nerve damage due to poor circulation, diabetes, HIV and herpes have pain that is difficult to manage. Many of these patients use narcotics that do not provide them with the relief they are seeking. There are other medications that have been shown to treat neuropathic pain better than narcotics.
Elavil
Elavil or amitriptyline is a tricyclic antidepressant that has been found to treat neuropathic pain well. Elavil comes in multiple dosages and is usually taken at bedtime. Dosing should be increased slowly, with increases occurring approximately every two weeks, in order to achieve maximum pain relief, according to Drugs.com. Because of its sedative effects, Elavil should be taken just before bedtime. Side effects of Elavil or amitriptyline include dry mouth, urinary retention and cardiac arrhythmias in the elderly. Elavil has a sister drug, nortriptyline or Pamelor, which is also effective and has fewer side effects. Tricyclic antidepressants are good choices for neuropathic pain because people with chronic pain are often depressed.
Gabapentin
According to the National Guideline Clearinghouse, gabapentin--also called Neurontin--is a seizure medication that has been found to be effective in the treatment of neuropathic pain. Neurontin has been used successfully to treat seizures for many years and has also been found to be effective in diabetic neuropathy. Gabapentin has been found to prevent hyperalgesia or exaggerated response to pain and the inflammatory response. Because Neurontin is excreted through the kidneys, patients with kidney disease will need to take less medication. Neurontin is associated with a number of side effects including dizziness, difficulty thinking, nausea and vomiting and weight gain. Suicidal thoughts were increased in patients taking gabapentin and it is advised that patients taking this medication be observed for mood changes or worsening depression.
Lyrica
Lyrica, or pregabalin, was developed specifically for neuropathic pain and is also used in generalized anxiety disorder according to Drugs.com. Lyrica is recommended as a first line therapy in neuropathic pain. Lyrica is excreted through the kidneys, and dosing must be adjusted in those with kidney insufficiency. Life-threatening side effects, including swelling of the face, throat, mouth and tongue, have been reported during initial and chronic therapy in some patients. Lyrica should be immediately discontinued if these symptoms should occur. Anti-epileptic drugs have been shown to increase suicidal thoughs in some patients. In clinical trials six percent of patients showed weight gain and peripheral edema or swelling of the lower extremities. The swelling went away when the drug was discontinued.
