Table 3: Drugs for pain control in small fiber neuropathy.

DrugDosage (per day)Common side effects

AntidepressantsSedation, weight gain, anticholinergic effects, sexual dysfunction, arrhythmia (side effects most prominent Sedation, weight gain, anticholinergic effects, sexual dysfunction, arrhythmia (side effects most prominent with amitriptyline)
 Amitriptyline (Elavil)20–150 mg
 Nortriptyline (Aventyl)20–150 mg
 Desipramine (Norpramin)20–200 mg
 Duloxetine (Cymbalta)60–120 mg
Anticonvulsants
 Gabapentin (Neurontin)600–3,600 mgSedation, dizziness, peripheral edema, weight gain
 Pregabalin (Lyrica)150–600 mgSimilar to gabapentin
 Topiramate (Topamax)25–400 mgWeight loss, sedation, cognitive slowing, renal stones, paresthesias
 Lamotrigine (Lamictal)25–400 mgStevens-Johnson syndrome, rash, dizziness, nausea, sedation
 Carbamazepine (Tegretol)200–1,200 mgDizziness, sedation, ataxia, aplastic anemia, liver enzyme elevation
 Oxcarbazepine (Trileptal)600–2,400 mgDizziness, nausea, fatigue, leukopenia
Topical anesthetics
 5% Lidocaine patch (Lidoderm)Every 12 hoursLocal edema, burning, erythema
 0.075% Capsaicin patchThree or four times a dayBurning
Opioids, opioid agonists
 Tramadol (Ultram)100–400 mgSedation, dizziness, seizures, nausea, constipation
 Oxycodone (Oxycontin)10–100 mgSedation, constipation, nausea; potential for addiction and abuse