R-ALA, Why do neurologists not prescribe this medication/supplement?

Just my non-medical opinion but R-ALA is a supplement and unless you have some sort of vitamin deficiency that shows up in testing and R-ALA would help to eliminate the deficiency, I doubt that any medical doctor or neurologist would recommend it unless maybe they've done some research or testing to show that it helps. The Foundation for Peripheral Neuropathy states it in easy to understand words here:

"Pain Management & Treatments for PN
It is common for people with peripheral neuropathy to experience different degrees of pain. It’s important to identify the type of pain medication that will work best for managing painful peripheral neuropathy symptoms, that also works with your body chemistry, and complements other treatments."
- https://www.foundationforpn.org/treatments/

It is complex, medication or not medication. Since I am not in pain and having read extensively about peripheral neuropathy, I am on neurotherapy, checking my levels of vitamins, especially some of the the B group. I have refused several medications suggested by my primary doctor and my neurologist. I am taking 2 capsules of Alpha Lipolic Acid a day because it is generally recommended . I am 80 years old.
Good luck to you.

My GP recommended it to me a few years ago, and it does seem to help.

@bigjohnscho my guess, and it’s only a guess, is either they don’t know about how much it helps or the pharmaceutical companies are promoting drugs.

As always, follow the money trail…

It works very well for me!

I researched this and put myself on it. We'll see if it helps.

I took alpha lipoic acid for over a year with no improvement. I stopped when I read that it can interfere with those taking thyroid medication, which I do. There isn’t a cure ( yet ) , but I have found the more active I keep my body and brain and try to eat healthy , the less I’m feeling the discomfort. The times it bothers me the most is sitting alone reading or watching TV. I put my feet on a heated massager or vibration plate on the floor, also bought an electrical pulsating plate which they all help in distracting from the discomfort. I set the timer on my phone every half hour and get up and walk . I also lay on my back facing the headboard on my bed with my feet in the air resting against the headboard for about 20 minutes, reversing blood flow. I walk around my neighborhood in the morning and at night. It is a full time job taking care of your health when you have neuropathy, but I know there are far worse problem to have to endure. Both of my sisters, my mother and my husband all battled cancer. I think with the benefit of AI that a understanding of this condition will come at a much faster rate, hopefully.