Long enough title for ya?!

There are a couple of articles for background info about Diabetes Type 2 Overview and What is Diabetic Peripheral Neuropathy?

Which brings us to -How to treat diabetic peripheral neuropathic pain…

Number 1 treatment:  Blood glucose control!  If the blood glucose levels are kept within range, neuropathy can be slowed and possibly reversed.

In addition, to help with pain…

1.  Antidepressants

• Cymbalta (duloxetine) -typical dosing for DPNP is 60mg once daily.  It is only available in brand only-pricey!
• Elavil (amitriptyline) or Pamelor (nortriptyline) -both come in generic and are well tolerated but can cause drowsiness and general dryness (dry mouth, eyes…)
• Effexor XR (venlafaxine ER) -dosing is usually 15-225mg daily.  Brand only so pretty pricey.
• Celexa (citalopram) and Paxil (paroxetine) -these aren’t used alone but can be added on to other therapy

2.  Anticonvulsants

• Neurontin (gabapentin) -this is the most popular drug to treat DPNP.    It is available in generic.  Gabapentin should be titrated slowly because of side effects like dizziness and sedation.
• Lyrica (pregabalin) -like gabapentin but more potent (and expensive)
• Tegretol (carbamazepine), Lamictal (lamotrigine) and Dilantin (phenytoin) -all can help but aren’t usually used because of the major side effects.

3.  Pain Drugs

• Ultram (tramadol) -works well for pain in general and DPNP -it has pain and antidepressent activity.  Inexpensive and well tolerated.
• OxyContin (oxycodone CR) -major pain medicine -lots of side effects and can lead to addiction but when the pain is bad -it works!

4.  Topical -Lidocaine patches -work well as an add on therapy.

5.  Natural Remedies

• Capsin (capsaicin) -topical cream that is made from chili peppers!  The big picture is, capsaicin causes enough irritation in the area that the pain receptors are overwhelmed and “shutdown”.
• alpha-Lipoic Acid -an anti-oxidant that helps decrease pain and numbness.  Typical dose is 600mg daily.
• Evening Primrose -500mg up to 8,000mg daily.  Helps nerves function better (more sensation; less pain)
• Borage Oil -1,000 -4,000mg daily.  Works similarly to Evening Primrose
• Acupuncture and Magnet Therapy

We would love to hear your personal experiences!  Please leave us a comment!

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