What is the strongest drug for nerve pain?

strongest drug for nerve pain
Medically reviewed by Dr. Ola Tarabzuni


Nerve pain, medically referred to as neuralgia or neuropathic pain, is often challenging to treat. Although treating nerve pain may prove to be difficult, fortunately, several effective nerve pain medications are available, including anticonvulsants, certain antidepressants, mild opioids, and some topical treatments. If you are searching for the strongest drug for nerve pain for your condition, this article is a must-read. 

What are good painkillers for nerve pain?

Nerve pain or neuralgia stems from a nervous system dysfunction and can be caused by several conditions. Sometimes, the exact cause cannot be identified, complicating the treatment. Common pain-relieving medicines such as paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), and opioid medicines (codeine or morphine) usually prove ineffective in treating nerve pain. Nerve pain medication usually acts on natural chemicals in the body’s nervous system and helps calm nerve activity, reducing hypersensitivity to pain.

Many pills for nerve pain are used to treat other conditions as well. Some of these include:

  • Antidepressant medicines: Amitriptyline and duloxetine may be prescribed as nerve medication, but the dosage prescribed is lower than that used to treat depression.
  • Anti-seizure medicines: Gabapentin and pregabalin are considered the best nerve pain medications due to their effectiveness. 

What is the best nerve pain medication for the elderly?

There are many options for nerve relief medicine. Knowing the cause can help in managing the pain. In many cases, prescription medication for nerve pain is the best option, as over-the-counter painkillers are not effective. Commonly prescribed meds for nerve pain include:

1. Antidepressants

Certain antidepressants can help alleviate nerve pain. These are particularly helpful in those with chronic pain and suffering from depression. Chronic pain often results in depression, which makes an individual sensitive to pain. In such cases, the best medication for nerve pain includes:

  • Tricyclic antidepressants: Amitriptyline (Elavil), nortriptyline (Pamelor), and doxepin (Sinequan) are some drugs for nerve pain. These drugs are prescribed at doses lower than the dosage prescribed to treat depression.
  • Serotonin–norepinephrine reuptake inhibitors (SNRIs): Duloxetine (Cymbalta) and Venlafaxine (Effexor) are other options as pain pills for nerve pain. SNRIs have the benefit of fewer side effects than TCAs, but they may be less effective, according to research. 
  • Selective serotonin reuptake inhibitors (SSRIs): The drug Fluoxetine (Prozac) is widely prescribed for depression but, in some cases, is used as a nerve pain medicine. However, the results are mixed, and it has been shown to be effective for some individuals. 
You can get your nerve pain medication refilled. Consult with one of our doctors.

2. Anticonvulsants

In many cases, the best pain reliever for nerve pain may be an anticonvulsant, and this claim is backed by research. Anticonvulsants are specifically prescribed to control seizures, but they also act as nerve-blocker pills. These are widely prescribed to manage chronic pain. However, it can take about three to four weeks to fully exhibit their effects. Initially, you may be put on a low dose, gradually increasing it until your best dose is determined. This helps reduce the possibility of side effects.

These first-line nerve blocker medications act on specific ion channels that regulate the movement of calcium ions. Gabapentin (Neurontin) and pregabalin (Lyrica) belong to the group of this strongest nerve pain medication.

3. Pain relievers

In milder cases of nerve pain, OTC pain relievers may help. These can be taken alongside other nerve pain pills.

However, these drugs are not effective for severe or persistent pain. These painkillers do not help treat electrical, stabbing, burning, or tingling pain. 

Some options for OTC pain relievers include :

4. Topical medications

Khorassani says Capsaicin is a potent “enzyme found in chili peppers.” It acts as a pain reliever. 

The enzyme disrupts pain signals to the brain. This ingredient is used in OTC creams and patches. The potency of capsaicin can vary in OTC formulations 1% is very low in treating severe neuropathy. However, 8% or higher is more effective at easing nerve pain, but higher concentrations are available through prescription.

Lidocaine is another typical pain reliever available as a cream or patch form that may help relieve nerve pain. The 5% Lidocaine patch blocks nerve discharge that temporarily or pain signal. 

Pills for nerve pain are not the only solution. Some alternate pain management strategies include:

  • regular exercise
  • cognitive behavioral therapy (CBT)
  • acupuncture
  • relaxation techniques
  • Meditation
  • Transcutaneous electrical nerve stimulation (TENS)
Do you need a prescription refill for nerve pain medication? Connect with our doctor.

How long does it take for nerve pain to calm down?

Depending on your condition, symptoms can take several weeks or months to improve. Some forms of mild neuropathic pain can be alleviated with painkillers, while others require multiple drugs and trials before the best option can be determined. For chronic conditions, anticonvulsants and antidepressants can be effective, but it may take a few weeks to register noticeable effects. A multidisciplinary approach may be adopted to deal with your condition and provide you with a customized treatment plan. 

What makes nerve pain worse?

Just like with any other pain, high levels of stress and anxiety can worsen neuropathic pain. Physical exertion may also amplify the nerve pain. Strenuous exercise and the following soreness can contribute to nerve pain, specifically at night.

Consult your doctor

There is a long list of medications that can help with nerve pain, but the best choice for you depends on both the underlying cause of your pain and the severity of your condition. Nerve pain can occur for many reasons, manifesting in different forms.

A combination of OTC, prescription medications, and nonpharmacological approaches may be required to deal with neuropathic pain. Commonly prescribed drugs for nerve pain include gabapentin, pregabalin, and duloxetine. However, these drugs can lead to side effects as well. Please consult our doctor at Your Doctors online to determine your best choice. 

FAQs about the strongest drug for nerve pain

Which is better for nerve pain Tylenol or ibuprofen?

In milder cases of nerve pain, OTC pain relievers such as Tylenol and ibuprofen may help. These can be taken alongside other nerve pain pills. However, these drugs are not effective for severe or persistent pain. These painkillers do not help treat electrical, stabbing, burning, or tingling pain. 

How long is too long for nerve pain?

Nerve pain can last for a long time. Depending on the underlying condition, it can last from days to weeks to months. If the pain persists and worsens, contacting the healthcare provider for a detailed evaluation is best. 

What is the most painful nerve condition?

Nerve pain is usually intense and can be felt as a shooting, stabbing, tingling, or shock-like pain. The pain can be excruciating or debilitating. Trigeminal neuralgia is one such condition that is classified as the most painful nerve condition.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Kalso, Eija, D. J. Aldington, and R. A. Moore. “Drugs for neuropathic pain.” Bmj 347 (2013).
  • Kalso, Eija, et al. “Systemic local‐anaesthetic‐type drugs in chronic pain: a systematic review.” European Journal of Pain 2.1 (1998): 3-14.
  • Finnerup, Nanna B., et al. “Algorithm for neuropathic pain treatment: an evidence based proposal.” Pain 118.3 (2005): 289-305.
  • Dworkin, Robert H., et al. “Advances in neuropathic pain: diagnosis, mechanisms, and treatment recommendations.” Archives of neurology 60.11 (2003): 1524-1534.

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