Aaron Filler, MD, PhD

Trulli Trulli

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Centrally Acting Non-narcotic Pain Medications

Table 4 - Centrally Acting Non-narcotic Pain Medications

ClassNameChemical nameRisks
Compounded Over-the-Counter   
 Fioricettylenol, caffeine, butalbitalDI, A1
Anti-Seizure Medications for Pain Relief for Nerve Injury   
 TegretolcarbamazepineDR, LT
 DilantinphenytoinDR, DI, CE
 TopamaxtopiramateMC, DI
 LamotriginelamictalDR, SA
 KeppralevitiracetamDI, WI
Anti-depressants for pain relief   
 ElavilamitryptilineDI, MC, WI
Centrally acting analgesic   
 UltramtramadolA1, MC, WI

Table 4 – Medications that act in the brain or spinal cord to block or slow the transmission of pain information through the nervous system to the brain.

All pain medications listed in the text and table of this site have side effects. In addition to those listed as special risks for each of these medications, there are serious but unusual side effects that occur rarely such as decreased production of blood cells by the body. All medications are risky for anyone who may be pregnant or who is breast feeding and require special attention before prescribing. With the exception of over-the-counter drugs, all of these medications should only be taken with a prescription for the patient and under the direction of a physician. Liver toxicity and kidney toxicity usually do not occur, but routine blood tests for signs of these problem are essential if they are taken on an ongoing basis.


(A1) – some addiction potential; (CE) – cardiac effects; (DI) – dizziness; (DR) – drowsiness;  (LT) – liver toxicity; (MC) – mental clouding; (SA) – severe allergic reactions; (WI) – withdrawal risk

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