| Amitriptyline‡ | 10 to 150 mg at bedtime | $12 (NA)§ | NNT = 1.3, NNH = 28 (major adverse events) |
| Nortriptyline‡ (Pamelor) | 25 to 150 mg at bedtime | $13 ($692)§ | NNH = 6 (minor adverse events)8 || |
| Desipramine‡ (Norpramin) | 25 to 150 mg at bedtime | $23 ($44) | |
| Pregabalin (Lyrica) | 150 to 600 mg per day, divided into two or three doses | NA ($168) | NNT = 3.3, NNH = 3.79 |
| 300 mg twice per day | NNT = 4.010 || |
| 100 mg three times per day | NNT = 6.010 || |
| 50 mg three times per day | NNT = 19.110 || |
| Gabapentin (Neurontin) | 300 to 1,200 mg three times per day | $60 ($182) | NNT = 4.3, NNH = 3.711 || |
| Carbamazepine (Tegretol) | 200 to 600 mg twice per day | $10 ($86)§ | NNT = 3.3, NNH = 1.99 || |
| NNT = 2.5, NNH = 3.712 |
| Venlafaxine, extended release (Effexor XR) | 150 to 225 mg per day | $142 ($150) | NNT = 3.1, NNH = 16.2 (major adverse effect) |
| NNH = 9.6 (minor adverse effect)8 |
| Duloxetine (Cymbalta) | 60 to 120 mg per day | NA ($154) | NNT = 5.1,5,13 NNH = 155 || |
| Morphine | 15 to 120 mg per day | $17 | Adverse effects and potential for addiction may limit use; decreased tolerated dose with similar effectiveness when used with gabapentin14,15 |
| Oxycodone, controlled release (Oxycontin) | 10 to 40 mg twice per day | $61 ($152) | NNT = 2.6 based on single small RCT16 |
| Another RCT showed benefit17|| |
| NNH = 816 (adverse effects led to withdrawal from study) |
| Tramadol (Ultram) | 200 to 400 mg per day | $64 ($246) | NNT = 3.8, NNH = 7.7 (adverse effects led to withdrawal from study)18 |
| Capsaicin cream (Zostrix) | 0.075% topical cream four times per day | NA ($22 per 57-g tube) | NNT = 5.7 (adverse effects make blinded trials difficult) |
| NNH = 2.5 (local adverse effect) |
| NNH = 9.8 (adverse effects led to withdrawal from study)19 |
| Lidocaine 5% patch (Lidoderm) | Up to three patches per day, each patch worn up to 12 hours; patches may be worn at the same time; a 12-hour drug-free interval is necessary | NA ($217 for one patch per day) | NNT = 4.4,20,21 NNH = 2920 |
| l-carnitine | 1,000 mg three times per day | $40 | Review of two RCTs showed improved pain and nerve fiber regeneration22 |
| Alpha-lipoic acid | 600 mg per day | $10 | Two RCTs showed conflicting results; long-term studies with oral formulation are needed23 |
| Acupuncture | Types variable | $60 to 120 per treatment | Small RCT and pilot study have shown benefit; a Cochrane review is underway 24–26 |
| Frequency-modulated electromagnetic neural stimulation | 30 minutes per day | Depends on cost of hardware | Two small studies showed benefits alone and in conjunction with amitriptyline27–29 |
