You may be feeling pain because of your illness or its treatment. This information explains different medicines that could help to ease a type of pain called neuropathic pain.
Neuropathic pain, also called nerve pain, happens when nerves are irritated or damaged. People often describe it as a shooting, burning or electric shock-like pain.
This kind of pain does not always respond well to usual painkillers like paracetamol or ibuprofen. Because of that, your doctor or nurse may try different types of medicines to find what works best for you.
Some medicines that help with nerve pain were originally used to treat other conditions, such as epilepsy or depression. Doctors discovered that these medicines can also help with nerve pain because they affect how the nervous system works.
These medicines can take a few weeks to start working, so it’s important to keep taking them even if you don’t feel relief right away.
Amitriptyline
- How to take it: Amitriptyline is often taken at night because it can make you feel drowsy or sleepy.
- Originally used for: Depression.
- How it works: At lower doses, it works on the nervous system to ease pain.
Gabapentin
- How to take it: Gabapentin is usually taken three times a day.
- Originally used for: Seizures.
Pregabalin
- How to take it: Pregabalin is usually taken two or three times a day.
- How it works: It’s similar to gabapentin.
- When it’s used: If amitriptyline or gabapentin do not work well for you, your doctor may recommend pregabalin instead.
Steroids (such as dexamethasone)
- How they work: Steroids can reduce inflammation around nerves, which may help to relive nerve pain. They don’t usually cause drowsiness.
- How they are used: They are usually prescribed for short periods, so withdrawal effects are unlikely. Your doctor or nurse will monitor you closely while you’re taking them.
You will usually start with a low dose of these medicines. Your doctor or nurse may gradually increase the dose over time. This helps them to find the amount that works best to manage your pain while keeping any side effects to a minimum.
The main side effect of these medicines is feeling drowsy or sleepy. For many people, this gets better after a week or two as your body adjusts to the medicine.
Alcohol can make you more drowsy when you are taking a medicine for nerve pain. It is best to avoid it until you have got used to the medicine and drowsiness settles down. If you feel drowsy, do not drive, use machinery, or do anything that needs you to be fully alert.
Other possible side effects include:
- dry mouth
- constipation
- feeling dizzy
If any side effects bother you or don’t improve, talk to your doctor or nurse. They can help you manage them or adjust your treatment if needed.
Important: Do not stop taking these medicines suddenly, especially if you’ve been using them for more than a few weeks. Stopping too quickly can cause withdrawal symptoms, such as:
- feeling anxious
- sweating
- feeling sick
- trouble sleeping
- your pain coming back
If you need to stop the medicine, your doctor or nurse will guide you on how to slowly reduce the dose over time. This helps your body adjust safely.
UCLH Macmillan Support and Information Service
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Email: uclh.
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University College London Hospitals NHS Foundation Trust cannot accept responsibility for information provided by external organisations.
If you have any questions about your medicine, or if it’s not helping with your pain, talk to your doctor, nurse, or the Enhanced Supportive Care team. They are there to help you feel as comfortable as possible.
Enhanced Supportive Care team
Tel: 020 3447 3412
Email: uclh.
Page last updated: 26 February 2026
Review due: 13 February 2028
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