Medications for peripheral neuropathy treat the pain rather than the nerve damage. First-line options include certain anti-seizure drugs and specific antidepressants, with topical agents for localised areas. Treating the underlying cause is what affects progression. Nothing on the list repairs nerves, so treating the underlying cause sits alongside pain treatment rather than after it.
Medications for peripheral neuropathy treat the pain rather than the nerve damage. First-line options include certain anti-seizure drugs and specific antidepressants, with topical agents for localised areas. Treating the underlying cause is what affects progression. Nothing on the list repairs nerves, so treating the underlying cause sits alongside pain treatment rather than after it.
Nothing in this list repairs nerves. Pain medication makes symptoms tolerable; treating the underlying cause is what slows or halts progression. Both matter, and confusing them leads to years of escalating analgesia while a treatable driver goes unaddressed. So glucose control, correcting vitamin B12 deficiency, treating thyroid disease, stopping alcohol and reviewing culprit medications sit alongside the pain treatment rather than after it.
Certain anti-seizure medications, notably gabapentin and pregabalin, and specific antidepressants including duloxetine and the older tricyclics such as amitriptyline, are the established first-line options. Each is started low and increased gradually, since starting high produces side effects that end the trial early. Response varies considerably between individuals, so trying more than one is normal rather than a failure. Topical agents including lidocaine and capsaicin suit localised areas.
Ordinary painkillers work poorly here, which surprises people and is worth knowing before months are spent on them. Gabapentinoids cause drowsiness and unsteadiness, matter more in kidney impairment, and interact with opioids in ways that increase risk. Tricyclics cause dry mouth, constipation and can affect the heart, and are used cautiously in older adults because of anticholinergic effects. Ask what to do about a missed dose, and do not stop these abruptly.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.