A variety of drugs can be added to conventional pain relievers to reduce nerve pain. Adding one of these nerve pain medications won’t completely take the pain away, but it may help.
Anticonvulsants: These medications were developed to control seizures, but they also help to blunt pain signals in the nerves. Several are in wide use for chronic pain (see “Medications for nerve pain”).
It takes about three to four weeks for the full effect to kick in. Your doctor will usually start you on a low dose and gradually increase it. That reduces side effects.
Antidepressants: Certain types of antidepressants also help to control nerve pain. They may have a synergistic effect in people who experience depression along with chronic pain. Chronic pain often causes depression, and depression can intensify a person’s sensitivity to pain; some antidepressants address both. There are three options:
- Tricyclic antidepressants, such as amitriptyline (Elavil), doxepin (Sinequan), and nortriptyline (Pamelor). These drugs are prescribed for pain at doses lower than are effective for depression.
- Serotonin–norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta) and venlafaxine (Effexor). SNRIs have fewer side effects than tricyclics, although some research suggests they may be less effective.
- Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), are the most commonly prescribed medications for depression. Some doctors may try these for treating nerve pain, too, but the evidence for effective pain relief is mixed.