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Option (Evidence Strength: Grades B, B, C, and B) Amitriptyline (Evidence Strength: Grade B ) One randomized controlled trial reported efficacy of oral amitriptyline (25 mg daily titrated over several weeks to 100 mg daily if tolerated) to be superior to placebo (63% of treatment group clinically significantly improved compared to 4% of placebo group) at four months

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The rigidity of the silica gel particle is higher than that for precipitated silica and thus better resists the shear forces arising during the manufacture and application of the paint

doi: 10.1186/s40348-019-0091-z 102

Research is ongoing to better understand how oral delivery compares to other forms