Topical amitriptyline and ketamine for the treatment of neuropathic pain

Expert Rev Neurother. 2015;15(11):1249-53. doi: 10.1586/14737175.2015.1101347. Epub 2015 Oct 21.


A neuropathy is a disturbance of function or pathological change in nerves. In some cases, peripheral neuropathic pain may occur due to a lesion or disease of the peripheral somatosensory nervous system. Efficacy of different agents for peripheral neuropathic pain conditions is less than optimal. The administration of topical analgesics might be an option, due to the potential of reduced adverse effects and increased patient compliance. There is major interest in compounding topical analgesics for peripheral neuropathic pain, but several challenges remain for this approach. Topical analgesics have the potential to be a valuable additional approach for the management of peripheral neuropathic pain. Topical amitriptyline-ketamine combination (AK) is a promising agent for peripheral neuropathic pain conditions. Some studies have shown its efficacy in neuropathic pain conditions. However, this data was not uniformely obtained and its role remains still controversial. Efficacy may depend on many factors, including the choice of the vehicle, the concentration, the pain site, and specific diseases. More studies are necessary to support the use of AK in clinical practice.

Keywords: amitriptyline; ketamine; neuropathic pain; topical analgesics.

Publication types

  • Review

MeSH terms

  • Administration, Topical
  • Amitriptyline / administration & dosage
  • Amitriptyline / therapeutic use*
  • Analgesics / administration & dosage
  • Analgesics / therapeutic use
  • Humans
  • Ketamine / administration & dosage
  • Ketamine / therapeutic use*
  • Neuralgia / drug therapy*


  • Analgesics
  • Amitriptyline
  • Ketamine