Hi Ingrid, many drugs are used for off label purposes, Meaning something they didn't recieve FDA aproval for. Only a couple of meds from the antidepressant class and anti seizure class have actually done the clinical trials to get FDA aproval for treatment of pain or nerve pain. However they have been used for years or decades for that very purpose. Antidepressants are used to treat pain, not just the depression associated with chronic pain, but because they reduce substance P, a potent neuro inflamatory agent that is found in high concetrations in CP patientsspinal fluid.

Anti seizure meds are also used to treat pain but are usually reserved specifically for neuropathic pain, They have used Neurontin to treat shingles for at least 15 years that I know of, even though it's never gone through the clinical trial process It's also used to treat many other types of nerve pain. If docs were restricted to using drugs only for their FDA aproved use, many meds that help thousands of people simply wouldn't be available.


Using a med for an off label use doesn't mean it's not effective, it simply means the company that invented the drug hasn't spent the milions of dollars and years of clinical trials to get FDA aproval to treat every other condition drugs in these classes have shown over the years to benefit. Often drugs are developed for one reason and found to help other problems. Just because it's not in the full prescribing info, doesn't mean it's not common practice among specific specialties to use meds for reasons other than their initial intended purpose. The info in the full prescribing instructions of each med is the info that was submitted to the FDA simply to get it on the market for one specific purpose.

Furtunately doctors are allowed to use meds for reasons other than what the drug was given FDA aproval for. If they were to prevent docs from using drugs for off label use, many drugs used to treat chronic pain and many other conditions simply wouldn't be available if a manufacturer was required to run a clinical trial on every possible use of a drug.

Neurontin and other drugs in the anti seizure class along with antidepressants have been used succesfully to treat different types of chronic pain for at least the 14 years I've been seeing PM docs and been involved in pain management. Prior to the invention of Oxycontin in 96 and the 180 degree shift in some docs thinking rergarding the use of opiates, These were the only meds aside from anti inflamatories and anti anxiety meds used to treat chronic pain.
You should also understand that just because one drug from that class doesn't help, it doesn't mean a different anti seizure med or different anti depressant won't benefit. Treating painis simply trial and error. Somepeople respond to nerotin, some do better with Toppamax or one of the dozen or more other anti seizure meds. Elevill was the first anti deprerssant used to treat chrioonic pain and reduce substance P. Since the 80's when Elevil was first used for CP, new clases and different types of anti depressants have been developed and they are now being used and have the same benfit. It's just a matter of finding what works best for you.
Good luck Dave