Neuropathic pain management

Neurologists are not pain specialists, so we follow the NICE recommendations on the management of neuropathic pain.

• Neuropathic pain in adults: pharmacological management in non-specialist settings

If the patient cannot tolerate a therapeutic dose of gabapentin, pregabalin, amitriptyline or duloxetine, we will sometimes try other anti-depressants or antiseizure medications:

• Nortriptyline
• Imipramine
• Carbamazepine
• Lamotrigine
• Venlafaxine

If the pain is unmanageable, you can refer the patient to the Chronic Pain team at their local secondary care provider.