Neuropathy Drug Treatment - An Assessment (2012)

Today's post comes from drmarcspitz.com (see link below), who regular readers of this blog may be familiar with. He is a podiatrist from California who always talks sense about neuropathy and gives a totally unbiased and non-commercial view of the topic at hand. This article sums up the current main drug-treatment approaches to neuropathy and is a good guide to how and why these drugs are used. His advice to talk any treatment over with your doctor is very important - these drugs are not M & M's.

Treating Neuropathy with Neurontin, Lyrica or Cymbalta-the Pros and Cons

This entry was posted on Sunday, May 13th, 2012

Read any medical journal or peruse any medical friendly websites, it seems that the three most consistently recommended medications for the treatment peripheral neuropathy are Neurontin, Lyrica or Cymbalata. You would think these drugs are the wonder drugs for neuropathy-this not quite accurate. Actually there are many drawback to these medications-let’s take a closer look.

Neurontin-The #1 prescribed medication for neuropathy

Neurontin is commonly prescribed medication for neuropathy pain-that is neuropathy in the feet.
Neurontin (generic name is gabapentin) is an oral medication approved by the FDA for the treatment of seizure for patients who have epilepsy. Gabapentin is classified as an anticovulsant medication. It is also indicated to help relive nerve pain associated with shingles (also called postherpetic neuralgia). While this medication is one of the most prescribed, it was a not developed as a primary treatment for any type of peripheral neuropathy.
There are many side effects associated with the drug with most being, drowsiness, memory problems, lethargy and a sensation of fogginess.” There are many other side effects as well including, allergic reaction, dizziness, headache to name just a few. Is it effective in reducing neuropathy pain?-the verdict is not out. There are wide variety of reported results-however in some studies Neurontin has been reported to be effective less than 50% of the time.

Lyrica-The New Neurontin

Lyrica is chemically related to Neurontin.. It also has been approved by the FDA for diabetic neuropathy-any of use of Lyrica to reduce neuropathy pain other than diabetes is called “off-label.” It is also prescribed for other conditions including pain form shingles (postherpetic neuralgia), fibromyalgia and as adjunctive therapy (meaning working in combination with other medications). It will not restore feeling in the foot nor will it restore damaged nerves.

Cymbalta- #3 but closing fast

Cymbalta is an antideoressant medication. It is used to treat major depressive disorders and general anxiety disorder. It is in the category of antidepressants called selective serotonin and norepinephrine reuptake inhibitors—SSNRI’s. Cymbalta has also been approved by the FDA to manage pain associated with diabetic peripheral neuropathy. It is used “off label” to treat other types of neuropathy pain.
Like the other medications mentioned, Cymbalta will not reverse damage but may reduce neuropathy pain. It will not restore feeling in the foot.
Cymbalta will not reverse damage but may reduce pain caused by diabetic peripheral neuropathy. Side effects include drowsiness, weight gain, nausea constipation or diarrhea, dry mouth sleep disturbances among many others.

Should I take any of these drugs for my neuropathy?
Great question and there is no right answer. You have to weigh the benefits versus side effects. Some of my patients relate that the adverse effects of these drugs are actually as a bad or worse than the neuropathy pain. Talk to your physician before starting any of these medications and express your concerns. A word of caution-do not stop taking any of these medications without informing your doctor as sudden withdrawal can lead to seizures.

http://drmarcspitz.com/blog/2012/05/13/treating-neuropathy-with-neurontin-lyrica-or-cymbalta-the-pros-and-cons/