Topical doxepin hydrochloride reduces neuropathic pain: a randomized, double-blind, placebo controlled study

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Abstract
Tricyclic antidepressants have a proven efficacy in neuropathic pain but their use is frequently complicated by side-effects. In a randomized, double-blind, placebo controlled study we compared the effect of twice daily application of doxepin hydrochloride 5% and placebo in forty patients with neuropathic pain. Results were obtained from 75% of those enrolled. There was a significant reduction in pain scores (linear visual analogue scores, 0-10) in those treated with topical doxepin hydrochloride when compared to placebo (mean fall in doxepin group 1.18, P < 0.01). minor side-effects were seen in 3 patients. there was no significant difference drowsiness levels in the two groups. We conclude that topical doxepin hydrochloride has an analgesic effect in neuropathic pain and its use is not commonly complicated by side-effects.