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Table 2 FDA approved neuropathic pain medications

From: Addressing chronic persistent headaches after MTBI as a neuropathic pain state

MedicationIndicationBeginning DosagesTitrationMaximum DosageDuration of Adequate Trial
GabapentinPostherpetic neuralgia100–300 mg every night or 100–300 mg 3×/dIncrease by 100–300 mg 3×/d every 1–7 d as tolerated3600 mg/d (1200 mg 3 ×/d); reduce if low creatinine clearance3–8 wk. for titration plus 1–2 wk. at maximum tolerated dosage
PregabalinDiabetic neuropathic pain50 mg three times a dayIncrease up to 100 mg three times a day600 mg a dayStart with 50 mg TID and increase up to 100 mg TID over 1 week
LamotriginePostherpetic neuralgia200–400 mg every night.Start with 25 to 50 mg every other day and increase by 25 mg every week.500 mg a day3 to 5 wk. for titration and 1–2 wk. at maximum tolerated dosage.
CarbamazepineTrigeminal neuralgia200 mg/d (100 mg bid)Add up to 200 mg/d in increments of 100 mg every 12 h1200 mg/d 
DuloxetineDiabetic neuropathic pain30 mg30 mg weekly120 mg2 wk.
5% lidocaine patchPostherpetic neuralgiaMaximum of 3 patches daily for a maximum of 12 h.None neededMaximum of 3 patches daily for a maximum of 12 h.2 wk.
 Opioid analgesics (in morphine equivalent dose)Moderate to severe pain5–15 mg every 4 h. as neededAfter 1–2 wk., convert total daily dosage to long-acting medication as neededNo maximum with careful titration; consider evaluation by pain specialist at dosages exceeding 120–180 mg/d4–6 wk.
Tramadol hydrochlorideModerate to moderately severe pain50 mg 1 or 2×/dIncreased by 50–100 mg/d in divided doses every 3–7 d as tolerated400 mg/d (100 mg 4×/d); in patients older than 75 yr., 300 mg/d in divided doses4 wk.
Tricyclic antidepressants (e.g., nortriptyline hydrochloride or desipramine hydrochloride)Chronic pain10–25 mg every nightIncrease by 10–25 mg/d every 3–7 d as tolerated75–150 mg/d; if blood level of active drug and its metabolite is < 100 ng/mL, continue titration with caution6–8 wk. with at least 1–2 wk. at maximum tolerated dosage
Duloxetine
Serotonin/norepinephrine
Reuptake inhibitor
Diabetic neuropathic pain30 mg bidIncrease by 60 to 60 bid. No further titration120 mg/d4 wk.
Fluoxetine
Serotonin/norepinephrine
Reuptake inhibitor
Diabetic neuropathic pain30 mg bidIncrease by 60 to 60 bid. No further titration120 mg/d4 wk.
Tapentadol ERDiabetic neuropathic pain50 mg bidIncrease by 50 mg/bid every 3 days as tolerated500 mg/d~
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