Table 3.
Drugs for pain control in small fiber neuropathy.
| Drug | Dosage (per day) | Common side effects |
|---|---|---|
| Antidepressants | Sedation, weight gain, anticholinergic effects, sexual dysfunction, arrhythmia (side effects most prominent Sedation, weight gain, anticholinergic effects, sexual dysfunction, arrhythmia (side effects most prominent with amitriptyline) | |
| Amitriptyline (Elavil) | 20–150 mg | |
| Nortriptyline (Aventyl) | 20–150 mg | |
| Desipramine (Norpramin) | 20–200 mg | |
| Duloxetine (Cymbalta) | 60–120 mg | |
| Anticonvulsants | ||
| Gabapentin (Neurontin) | 600–3,600 mg | Sedation, dizziness, peripheral edema, weight gain |
| Pregabalin (Lyrica) | 150–600 mg | Similar to gabapentin |
| Topiramate (Topamax) | 25–400 mg | Weight loss, sedation, cognitive slowing, renal stones, paresthesias |
| Lamotrigine (Lamictal) | 25–400 mg | Stevens-Johnson syndrome, rash, dizziness, nausea, sedation |
| Carbamazepine (Tegretol) | 200–1,200 mg | Dizziness, sedation, ataxia, aplastic anemia, liver enzyme elevation |
| Oxcarbazepine (Trileptal) | 600–2,400 mg | Dizziness, nausea, fatigue, leukopenia |
| Topical anesthetics | ||
| 5% Lidocaine patch (Lidoderm) | Every 12 hours | Local edema, burning, erythema |
| 0.075% Capsaicin patch | Three or four times a day | Burning |
| Opioids, opioid agonists | ||
| Tramadol (Ultram) | 100–400 mg | Sedation, dizziness, seizures, nausea, constipation |
| Oxycodone (Oxycontin) | 10–100 mg | Sedation, constipation, nausea; potential for addiction and abuse |