Neuropathy can be caused by many factors, such as diabetes, injuries, metabolic disorders, diet, toxins, autoimmune diseases or hormonal imbalance. The medicine used to treat neuropathy depends on the underlying cause and accompanying symptoms. Over-the-counter drugs are used in the early stages of neuropathy or for mild symptoms. Prescription medications are use to manage chronic symptoms and address the emotional, mental and psychological effects of a chronic long-term debilitating physical condition.
Over-the-Counter Medications
Several over-the-counter drugs are used to treat neuropathy. Acetaminophen is recommended for mild symptoms of pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to reduce swelling, inflammation, pain and stiffness. Common examples are aspirin, naproxen and ibuprofen. These drugs work to inhibit pain messages to the brain by producing a substance to block prostagladins in the blood. A newer type of NSAIDs are the COX2 inhibitors. Their mode of action is blocking the COX-2 enzyme and reducing inflammation. They cause less digestive problems and reduce the risks for gastrointestinal bleeding. Celecoxib and Rofecoxib are commonly prescribed COX-2 inhibitor drugs.
Narcotics and Opioids
Narcotics or opioids are prescription drugs used to treat chronic pain and are usually given when other drug treatments have failed. Common opioids used are oxycodone, hydrocodone, fentanyl and codeine. These drugs have high potential for dependency and addiction, unpleasant side effects and don't work as well over time if taken continuously. In 2008 Lori Whitten at the National Institute of Drug Abuse wrote of a new potentially promising drug, ibudilast, which was in preclinical trials at the time. Ibudilast can inhibit glial cell activity in the central nervous system to prevent or stop many types of neuropathy pain.
Topical Medications
There are several topical drugs that contain local anesthetic agents that can be used to give relief to neuropathic symptoms. They are available as lotions, creams or ointments. Capsaicin cream act as an analgesic and can help reduce pain by numbing the area. The effect usually lasts for several hours. Lidocaine patches are applied directly to the affected area on the skin and provide pain relief and reduce inflammation.
Antidepressants and Anticonvulsants
Antidepressant drugs are used to treat pain and accompanying depression, mental and psychological problems. Common drugs in this class are selective serotonin reuptake inhibitors (SSRIs), serotonin receptor modulators (SRMs), tricyclic antidepressants and norepinephrine reuptake inhibitors. Two drugs, Pregabalin, an anticonvulsant, and Duloxetine, an SSRI, have been approved by the FDA for treating severe peripheral neuropathic pain.
Autonomic Neuropathy Medicines
Autonomic neuropathy is a common type of neuropathy in diabetics patients. It can affect the circulatory system and internal organ systems such as the genitourinary, gastrointestinal, reproductive, cardiovascular and respiratory systems.
Treatment and therapy is tailored to address and manage specific complications as they arise. For example, Metoclopramide is used to decrease nausea. Sexual dysfunctions are treated with Cialis and Viagra. Anticholinergic drugs act as antispasmodics to reduce gastric juices and acid secretion in the stomach and treat other gastrointestinal problems.
References
- PubMed.gov: Effect of Etodolac, a COX-2 Inhibitor, on Neuropathic Pain
- National Institute of Drug Abuse: Basic Science Discoveries Yield Novel Approaches to Analgesia
- The University of Chicago Center for Peripheral Neuropathy: Treatment and Therapy--Pain Medication
- Pain.com: Pregabalin and Duloxetine for the Treatment of Neuropathic Pain Disorders
- MayoClinic.com: Autonomic Neuropathy
