Among the main treatments for idiopathic neuropathy, nortriptyline and duloxetine outperform pregabalin when pain reduction and adverse effects are considered together, according to a study guided by patient engagement.

There have been no efficacy trials of drugs to treat patients with idiopathic neuropathy — also called cryptogenic sensory polyneuropathy (CSPN) or small fibre sensory peripheral neuropathy — so there is little information to guide drug choices for these patients, the US study authors say.