Medicines for neuropathic pain : University College London Hospitals NHS Foundation Trust

This page provides information about different medicines that might help to relieve
neuropathic pain. You may be experiencing pain because of your illness or the treatment you are having.

What is neuropathic pain?

Neuropathic, or nerve, pain is caused by nerve irritation or damage. It is often described as a shooting or burning pain.

There are different types of pain-relieving medicines and neuropathic pain does not always respond to the more common ones. Because of this, you may need to take several types of pain medicines before your doctor or nurse finds the right one for you.

Medicines that can help with neuropathic pain

Medicines for neuropathic pain were traditionally used for other problems, such as epilepsy and depression. This is because they work well within the nervous system and at lower doses they have been found to be effective for neuropathic pain too. These medicines can take a few weeks to build up in your body before they are effective. It’s important that you don’t stop taking them if you don’t feel they are working immediately.

Amitriptyline

Amitriptyline is best taken at night as it can make you feel drowsy or sleepy.

Traditionally, amitriptyline was used as an anti-depressant medication, but research has shown that at lower doses it can help to reduce neuropathic pain.

Gabapentin

Gabapentin is usually taken three times a day. It is sometimes used to treat people with seizures but can also help to reduce neuropathic pain.

Pregabalin

Pregabalin is sometimes used if amitriptyline or gabapentin has not helped. It is similar to gabapentin, but is usually taken twice a day.

Steroids

Steroids, such as dexamethasone, are sometimes used to help with neuropathic pain. They work by reducing inflammation around nerves. Steroids are prescribed for short periods only, and your doctor or nurse will monitor you for any side effects.

You will most likely start with a low dose of these medicines. Your doctor or nurse
may advise you to increase your dose over a few days or weeks to control your
pain as well as possible.

Side effects

The main side effect of medicines used to help with neuropathic pain is drowsiness.

For most people this side effect settles down after a week or two. If you drive or drink alcohol, it may be best to avoid doing so until you have got used to the medicine and drowsiness settles down.

Other side effects can include a dry mouth, constipation or dizziness.

If you have any questions about the medicine(s) you have been prescribed,
or if you think your medicines are not helping, please talk to your doctor or nurse,
or contact the Enhanced Supportive Care team.

Further information

Macmillan Support and Information Service

The Macmillan Support and Information Service is located on the ground floor of the University College Hospital Macmillan Cancer Centre. The support and information specialists based in the service provide emotional support, practical advice and information to anyone affected by cancer or a blood condition. The specialists are experienced healthcare professionals and they can see patients, their families and friends at any stage of their care.

You don’t need an appointment to visit the Macmillan Support and Information Service. The team will see you as quickly as possible.

Tel: 020 3447 8663

Email: uclh.supportandinformation@nhs.net