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Prescription medications and treatments for nerve pain

Nerve pain, also called neuropathic pain, from complications of conditions such as diabetes, cancer, HIV or shingles can be long-term and feel like burning, stabbing, shooting, aching or throbbing pain.

Several types of medication are available for nerve pain. Doctors will make recommendations based on individual symptoms and circumstances.

Anticonvulsants: The name might sound alarming, but some of these medicines can help people with nerve pain. In fact, they're often considered a first choice. These medicines were originally developed for people with epilepsy to control seizures. It turned out that their effects on the nervous system could also help dull pain. Side effects include drowsiness, dizziness and nausea.

Keep in mind that not all anticonvulsants will help. Your doctor will choose medicines that have been shown in studies to work on nerve pain.

Antidepressants: Along with anticonvulsants, certain types of antidepressants can be the first choice for treating neuropathic pain. Nerve pain specialists often recommend two major types.

  • Tricyclic antidepressants have been used for decades. While they're not used to treat  depression as often now, they can play an important role in controlling nerve pain symptoms. Many studies have shown that they can help. These medications can cause side effects, like dizziness, constipation, blurred vision and upset stomach. They might not be safe for people with certain conditions, like heart problems.
  • SNRIs (serotonin and noradrenaline reuptake inhibitors) are a newer type of antidepressant that seem to help with nerve pain. In general, these medicines have fewer side effects than tricyclic antidepressants. They might be safer for some, especially older people with heart problems. However, they might not be as effective as tricyclics in tackling nerve pain.

Using antidepressants for nerve pain can have an added benefit, considering that chronic pain often coincides with depression. Chronic pain can make a person depressed, and depression can often make the experience of chronic pain seem worse. So these medicines might help improve your mood as well as ease your discomfort.

Of course, some people don't like the idea of taking antidepressants for their nerve pain because they worry taking antidepressants implies that the pain is just "in their heads". This is not the case at all. It just happens that these medicines work for both conditions.

Painkillers: For severe nerve pain, powerful opioid painkillers can help. Studies have found that for many types of nerve pain, they are as effective as anticonvulsants or antidepressants. Unlike other treatments for nerve pain, they also work very quickly.

However, because of their side effects, many doctors only turn to these medications when other treatments haven't worked. Opioid painkillers can cause constipation, stomach upset and sedation. They also pose some risk of addiction and abuse, so it's important to use them exactly as your doctor recommends.

Other painkillers - like prescription doses of NSAIDs (non-steroidal anti-inflammatory drugs) - might be helpful. But on the whole, those medications don't seem to work well with nerve pain. 

  • Topical treatments: Painkiller gels and anaesthetic patches are another effective approach and can be applied to a particularly painful area of skin. These work best with small, localised spots of pain. The side effects are minor and include skin irritation.
  • Combination treatments: Your doctor might recommend that you use one or two of these treatments together, an approach called combination therapy. Many studies have shown that combining certain medications (often an anticonvulsant and an antidepressant) can have a better effect on nerve pain than either medication alone.

 

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