Table 1.

European Federation of Neurological Societies Recommended Treatment for Common Neuropathic Pain Conditions

Condition	First Line	Second or Third Line
Diabetic neuropathic pain	Duloxetine Gabapentin Pregabalin Tricyclic antidepressants Venlafaxine extended release	Opioids Tramadol†
Post-herpetic neuralgia	Gabapentin Pregabalin Tricyclic antidepressants Lidocaine plasters§	Capsaicin Opioids
Classical trigeminal neuralgia	Carbamazepine Oxcarbazepine	Surgery
Central pain	Gabapentin Pregabalin Tricyclic antidepressants	Cannabinoids (multiple sclerosis) Lamotrigine Opioids Tramadol (spinal cord injury)

Notes: Adapted with permission from Attal N, Cruccu G, Baron R, et al. European Federation of Neurological Societies. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2010;17(9):1113–e88.³² †Tramadol may be considered first line in patients with acute exacerbations of pain especially in combination with acetaminophen. ^§Lidocaine is recommended in elderly patients.