Oral medications such as antidepressants and anticonvulsants are recommended as first-line options for treating peripheral neuropathic pain. In this review, authors Sommer and Cruccu evaluate the literature to compare these oral medications with topical therapies, typically reserved for second- or third-line therapy. They found that utilizing a capsaicin 8% patch is not clinically worse when compared to pregabalin for a number of pain etiologies and may offer a safer and more tolerable option for select patients. Lidocaine 5% patch offered good relief for symptomatic herpes zoster, but was not equivalent to Pregabalin for other neuropathic pain conditions.
Link to Journal of Pain and Symptom Management: Topical Treatment of Peripheral Neuropathic Pain article (3/2017)