Are his doctors open to prescribing real pain medications such as opiates? Generally with neuropathy pain, assuming that no underlying treatable cause had been found, they will start with Gabapentin, add an anti-depressant at low dose, and then add an opiate if necessary. High dose anti-depressants are by no means primary pain medications.

I have a long standing hereditary neuropathy with muscle wasting and severe pain. The pain is well controlled by 600 mg. x 3 of Gabapentin and 30 mg. x3 of MS Contin ( time release morphine) daily. I also take Baclofen for muscle spasms. I have been on this dosage for some time, but we did work up to it slowly, over several years. I do not have appreciable side effects from this combination beyond constipation and some afternoon drowsiness which may be from muscle fatigue or menopause as much as the morphine.

Pain management is a big challenge for neuropathy sufferers. Sometimes even strong pain meds do not touch neuropathic pain but in my opinion it is worth a try. I have never heard of simply increasing the dosage of an antidepressant as the solitary treatment.

Neurologists are often not comfortable providing pain management. They do not see the patient often enough for one thing. Could his PCP provide this?