Physical Medicine and Rehabilitation for Meralgia Paresthetica Medication

Updated: Apr 08, 2019
  • Author: Christopher Luzzio, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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Medication

Medication Summary

Medications for treatment of meralgia paresthetica (MP) discomfort include nonsteroidal anti-inflammatory drugs (NSAIDs), narcotics, and other agents, such as amitriptyline, Neurontin, and Tegretol. In general, avoid prolonged use of NSAIDs and narcotics if possible.

A TCA or anticonvulsant is started at a low dosage and titrated upward until symptoms resolve or side effects dictate otherwise. These drugs are discontinued if there is no relief with maximal quantities. A common error is stopping the medication before serum levels reach therapeutic ranges.

Suggestions for initiating chemical treatment for MP follow. The treatment of neuropathic pain varies significantly among physicians. Consult the Physicians' Desk Reference (PDR) for more detailed drug information on the following agents.

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Tricyclic antidepressants

Class Summary

Use for treatment of neuropathic symptoms; the exact mechanism is unknown.

Amitriptyline (Elavil)

Good medication for neuropathic pain, often discontinued because of somnolence and dry mouth.

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Anticonvulsants

Class Summary

For treatment of neuropathic symptoms; the exact mechanism is unknown. These agents are used to manage severe muscle spasms and to provide sedation in neuralgia.

Carbamazepine (Tegretol)

Because of adverse side effects and risks associated with carbamazepine, this compound is initiated judiciously; prolonged use is monitored carefully.

Gabapentin (Neurontin)

Has anticonvulsant properties and antineuralgic effects; however, exact mechanism of action is unknown. Structurally related to GABA but does not interact with GABA receptors. Titration to effect can take place over several days (300 mg on day 1, 300 mg bid on day 2, and 300 mg tid on day 3). Well-tolerated and safe medication that essentially is excreted 100%.

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