Thanks for your question-
It would be useful to know what conventional treatments that you've tried for your patient-- peripheral neuropathy is certainly one of the more daunting complications that we deal with.
Firstly, it would be useful to know about which medications your patient is receiving-- stavudine and didanosine are both associated with increased incidence of neuropathy; dose reductions or treatment switches should be considered if other approaches have not helped.
We have had some luck with variety of "conventional" agents- such as tricyclic antidepressants or Neurontin. We occasionally see benefit from NSAIDS or even dronabinol (Marinol). Lastly, consider chronic pain management strategies with narcotic analgesics, including long acting morphine (MS Contin) or transdermal Fentanyl as adjuncts to shorter acting narcotics.
In the alternative medication category, I've heard occasional stories of benefit from vitamin B12, L-carnitine and accupuncture. When the above don't work, I've tried these.
Hope that this is a useful starting point. Thanks for writing, BY
