Topical compounded formulations containing antidepressants or anticonvulsants can be effective alternatives to lidocaine for vulvodynia pain relief.

When lidocaine ointment is unavailable, compounded topical creams that include medications like amitriptyline, gabapentin, or ketamine offer nerve pain modulation directly at the vulvar site. These preparations have shown promise in reducing pain and improving quality of life, leveraging neuromodulatory effects without systemic side effects common to oral drugs.