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Prescription Drugs for Diabetes Nerve Pain

Many people need to turn to prescription medication to find relief for diabetes nerve pain. Your choices include:

NSAIDs. Although some nonsteroidal anti-inflammatory drugs are available over the counter, your doctor may suggest higher doses, or different NSAIDs, that require a prescription. There are many prescription NSAIDs to choose from including, Celebrex, Lodine, and Relafen. People with diabetes are more at risk of kidney damage that can occur with NSAIDs. In addition, people with diabetes are at high risk of heart disease, and prescription NSAIDs may raise the risk of heart problems.

Antidepressants. Although antidepressants were developed for depression, these drugs have also become important in relieving chronic pain - whether the person is depressed or not. Antidepressants used to treat pain include:

  • Tricyclic antidepressants (TCAs) primarily affect the levels of the brain chemicals norepinephrine and serotonin. TCAs are the most commonly used antidepressant and, according to experts, the best studied, and the most effective of the antidepressants used for pain.

Of the TCAs, Elavil has been a very good option for pain, yet it has troublesome side effects, including drowsiness, weight gain, dry mouth, and dry eyes. For people with peripheral neuropathy, there can be additional side effects. Many people also develop blood pressure and heart rate problems and get dizziness when taking Elavil.

A newer drug in this class, Pamelor, is  effective and has fewer side effects, so it is better tolerated. Norpramin is also considered good and has the least side effects of all.

  • Selective serotonin reuptake inhibitors (SSRIs) are a newer form of antidepressant. These drugs work by altering the amount of the brain chemical serotonin. SSRIs are very effective for depression, the experts say, but less effective for pain. Some studies have shown them to be beneficial, but they're still less effective than TCAs for pain.

  • Serotonin and norepinephrine reuptake inhibitors (SNRIs) are another newer form of antidepressant medicine. They treat depression by increasing availability of the brain chemicals serotonin and norepinephrine.

    Effexor and Cymbalta are quite effective for pain and have fewer side effects than the SSRIs or TCAs. Cymbalta is FDA-approved for painful neuropathy; Effexor is not.

Antiseizure drugs. Drugs that prevent epileptic seizures can also relieve certain pain conditions, including neuropathy. The drugs work by controlling the abnormal firing of nerve cells in the brain and other parts of the body, such as legs and arms.

  • Neurontin is the antiseizure drug most commonly used for nerve pain from peripheral neuropathy.  While it's effective at treating painful neuropathy, it tend to cause sedation or dizziness at higher doses. But if the dosage is increased slowly, it is well tolerated.
  • Lyrica is a seizure medication that is FDA-approved for painful neuropathy. The most common side effects are dizziness and sleepiness. 

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