Question: I take Zoloft, 100 milligrams, for neuropathy, and Xanax, 1 milligram. They work fine, but completely ruin your sex life. I don't like taking drugs all the time. I am an otherwise a healthy 67-year-old. Are there any alternatives that I could try? I have tried melatonin, but it didn’t do much.

Dr. Hibberd's Answer:

Neuropathy, a condition in which the nerve function is disturbed, gives rise to many symptoms that each often need to be addressed according to the most aggravating symptom(s) the neuropathy may be causing.
Unusual sensory signals may generate tingling through significant levels of perceived pain, and your treatment needs to be tailored to the problem.

Unfortunately, correcting the cause of the neuropathy does not lead to immediate relief either due to nerve damage or due to an accumulation of byproducts within the nerve itself that may take months or years to clear up even in the face of correction of the underlying disorder. This is the reason there is such a wide range of treatment options for patients suffering from neuropathy.

Common medications used to treat neuropathy include anti-convulsants, anti-depressants, anxiety and hypnotic medications, pain relievers (both non-narcotic and narcotic), and anti-inflammatory medications. Occasionally, circulatory medications and (rarely) chelator agents are useful depending upon the cause of the neuropathy.

Physical and occupational therapy is often useful, together with various local treatments that include ultrasound, diathermy (heat), and pulsed low dose laser treatments. Much of the time, combinations of multiple low-dose medications are more effective than high doses of any single drug group.

Melatonin will not affect neuropathy, and try to avoid the temptation to self medicate without the knowledge of your doctor. Do be sure your condition has been properly identified and any documented deficiencies corrected.