Charcot-Marie-Tooth and Other Hereditary Motor and Sensory Neuropathies Medication

Updated: May 22, 2018
  • Author: Timothy C Parsons, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
  • Print
Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and prevent complications.

Next:

Nonsteroidal anti-inflammatory drugs (NSAIDS)

Class Summary

These agents have analgesic, anti-inflammatory, and antipyretic activities. Their mechanism of action is not known, but they may inhibit cyclooxygenase activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell membrane functions.

Ibuprofen (Motrin, Ibuprin)

DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

Supplied OTC in 200-mg dosing or prescribed as 400-, 600-, and 800-mg tabs.

Naproxen (Aleve, Naprelan, Naprosyn, Anaprox)

For relief of mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing activity of cyclo-oxygenase, which results in a decrease of prostaglandin synthesis.

Previous
Next:

Antidepressants

Class Summary

These drugs increase the synaptic concentration of serotonin and/or norepinephrine in CNS by inhibiting their reuptake at the presynaptic neuronal membrane. These mechanisms may play a role in the analgesic effects of these medications.

Nortriptyline (Pamelor, Aventyl HCl)

Has demonstrated effectiveness in treatment of pain.

Amitriptyline (Elavil)

Has demonstrated effectiveness in treatment of pain.

Previous
Next:

Serotonin reuptake inhibitors

Class Summary

Serotoninergic antidepressants have had mixed reviews in the literature. Some of them have been reported to relieve painful sensory symptoms.

Paroxetine (Paxil)

Considered an alternative to TCAs, with fewer adverse anticholinergic and cardiovascular effects.

Previous
Next:

Anticonvulsants

Class Summary

These medications reduce neuronal excitability and prevent neuronal discharges associated with pain sensation.

Carbamazepine (Tegretol)

A sodium channel blocker that typically provides substantial or complete relief of pain in 80% of individuals with both idiopathic and MS-associated TN within 24-48 h. Adverse effect profile for older patients is more onerous than with newer anticonvulsants, thereby limiting usefulness in this group. As more published data on long-term efficacy of agents such as lamotrigine and gabapentin become available, these medications may soon become drugs of choice.

Gabapentin (Neurontin)

Uncontrolled studies have indicated possible effectiveness in patients whose pain has become refractory to carbamazepine. Often is tolerated better than carbamazepine by elderly patients. No placebo-controlled studies have been published.

Previous