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Medications commonly used for painful diabetic neuropathy include: Gabapentinoids such as gabapentin and pregabalin, which calm overactive nerve signals Serotonin–noradrenaline reuptake inhibitors (SNRIs) such as duloxetine and venlafaxine, originally developed as antidepressants but also effective for nerve pain Tricyclic antidepressants such as amitriptyline or nortriptyline, used in lower doses than for depression Sodium channel blockers such as certain anti-seizure medications, in selected cases Topical treatments such as capsaicin cream or lidocaine patches for localised pain Opioid painkillers are generally avoided for long-term use in diabetic neuropathy because the benefits are limited and the risks — including dependence, constipation, and falls — are significant

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