First Line Treatment

Protective clothing to prevent UV light exposure, cooling compounds (wet towel, ice packs)

Oral antihistamines (hydroxyzine, loratadine, cetirizine)

Topical local anesthetics agents (capsaicin)

Oral anti-depressants (amitriptyline, doxepin, fluoxetine)

Oral anti-convulsants (pregabalin, gabapentin)

Second Line Treatment

Oral antipsychotics (risperidone, pimozide, chlorpromazine)

Combination therapy (amitriptyline-ketamine cream, amitriptyline-ketamine-lidocaine cream)

NK-1 antagonists (aprepitant)

Alternative therapies: botulinum A toxin

Surgical interventions (cervical spine manipulation, discectomy)

Table 1 First and Second Line Therapy in the Treatment of BRP [2,5,6].