I think you may have to try a few things to find out what works best for you. Keep a journal recording pain levels, S/E, and other data so you can compare later (if needed).

I'm not as concerned (with my own PN) about the numbness & tingling as I am in the burning pain. I stopped the burning pain with R-Lipoic Acid & Pantothenic Acid. The numbness is still there, but to a lesser degree, and the tingling is greatly reduced. I tried Acetyl L-Carnitine for about a year, and haven't noticed any difference, so I'll be stopping it for (once current supply is used up) a while to see how that goes.

Gabapentin & Lyrica both work, but many people (self included) find that tolerance (need for increasing the dosage) to be a problem. Side effects are less for many people with Lyrica, but as it's still under patent (whereas gabapentin and topiramate are not) it's more pricey. Cymbalta (duloxetine) IS used for PN, and like others mentioned, individual results vary.

Amitriptyline has also helped, but I currently have no medical justification for asking for/taking it (it does make me a bit groggy, so I find taking it at night is best for PN).

HTH,

Doc