How Is Phantom Limb Pain Treated Medicinally?


Although no medications specifically for phantom pain exist, some drugs designed to treat other conditions have been helpful in relieving nerve pain. No single drug works for everyone, and not everyone benefits from medications. You may need to try different medications to find one that works for you.
Medications used in the treatment of phantom pain include:
 

Antidepressants. Tricyclic antidepressants often can relieve the pain caused by damaged nerves. Examples include amitriptyline and nortriptyline (Pamelor). These drugs work by modifying chemical messengers that relay pain signals. Antidepressants may also help you sleep, which can make you feel better. Possible side effects include sleepiness, dry mouth, blurred vision, weight gain, and a decrease in sexual performance or desire.
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Anticonvulsants. Epilepsy drugs — such as gabapentin (Gralise, Neurontin), pregabalin (Lyrica), and carbamazepine (Carbatrol, Tegretol) — are often used to treat nerve pain. They work by quieting damaged nerves to slow or prevent uncontrolled pain signals. Side effects may include depression, anxiety, suicidal thoughts, irritability, and allergic reactions such as hives, fever and swelling.
Narcotics. Opioid medications, such as codeine and morphine, may be an option for some people. Taken in appropriate doses under your doctor's direction, they may help control phantom pain. However, you may not be able to take them if you have a history of substance abuse. Even if you don't have a history of substance abuse, these drugs can cause many side effects, including constipation, nausea, vomiting or sedation.
 

Two drugs have shown promise in preventing phantom pain:
Calcitonin (Miacalcin). Researchers aren't sure why calcitonin — a hormone produced by the body that slows the rate at which your body breaks down bone — provides pain relief. You may receive this drug directly into a vein (intravenously) during the week after amputation. Possible side effects include nausea, vomiting and allergic reactions, including rashes, abdominal pain and swelling.
 

Ketamine (Ketalar). This anesthetic drug is sometimes given after surgery to help prevent phantom pain. Its side effects can include sedation, hallucinations and delirium.