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Anticonvulsants for Chronic Pain


Examples

Generic NameBrand Name
carbamazepineTegretol, Neurontin, Trileptal, Lyrica, Topamax
gabapentinTegretol, Neurontin, Trileptal, Lyrica, Topamax
oxcarbazepineTegretol, Neurontin, Trileptal, Lyrica, Topamax
pregabalinTegretol, Neurontin, Trileptal, Lyrica, Topamax
topiramateTegretol, Neurontin, Trileptal, Lyrica, Topamax

How It Works

Experts do not know exactly how anticonvulsants work to reduce chronic pain. They may block the flow of pain signals from the central nervous system.

Why It Is Used

Anticonvulsant drugs typically are used to control seizures in people who have epilepsy. These drugs may also be used to treat other painful conditions, such as postherpetic neuralgia and fibromyalgia.

How Well It Works

Some anticonvulsant drugs may work better than others for certain conditions.

About 2 out of 3 people with nerve pain who take gabapentin or carbamazepine have some relief from their pain. Examples of nerve pain include postherpetic neuralgia and diabetic peripheral neuropathy.1, 2

Pregabalin helps with nerve pain, especially postherpetic neuralgia, diabetic peripheral neuropathy, and fibromyalgia.3

Gabapentin is sometimes used to treat chronic pelvic pain.4

Carbamazepine and oxcarbazepine are used to treat chronic pain from trigeminal neuralgia (sudden facial pain). The best evidence is for carbamazepine, but oxcarbazepine probably works well too.5

Side Effects

Common but temporary side effects may include dizziness, drowsiness, and fatigue. Tell your doctor if you think you are having side effects, which may include:

Do not suddenly stop taking an anticonvulsant. Your doctor will slowly reduce the dose of this medicine so that you won't have withdrawal symptoms such as anxiety, nausea, pain, sweating, and insomnia.

The FDA has issued a warning on anticonvulsants and the risk of suicide and suicidal thoughts. The FDA does not recommend that people stop using these medicines. Instead, people who take anticonvulsant medicine should be watched closely for warning signs of suicide. People who take anticonvulsant medicine and who are worried about this side effect should talk to a doctor.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Medicine will be started in low doses and then slowly increased until it effectively reduces your chronic pain.

Anticonvulsants are not safe for everyone. Be sure to tell your doctor about all medical conditions you have and other medicines you are taking to avoid side effects and complications.

Anticonvulsants may increase the chance of birth defects. If you are pregnant or thinking of getting pregnant, talk to your doctor before taking medicines.

Complete the new medication information form (PDF)Click here to view a form.(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Wiffen PJ, et al. (2005). Gabapentin for acute and chronic pain. Cochrane Database of Systematic Reviews (3).

  2. Wiffen PJ, et al. (2005). Carbamazepine for acute and chronic pain in adults. Cochrane Database of Systematic Reviews (3).

  3. Moore RA, et al. (2009). Pregabalin for acute and chronic pain in adults. Cochrane Database of Systematic Reviews (3).

  4. Fall M, et al. (2010). EAU guidelines on chronic pelvic pain. European Urology, 57(1): 35–48.

  5. Gronseth G, et al. (2008). Practice parameter: The diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies. Neurology, 71(15): 1183–1190.

Credits

ByHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Specialist Medical ReviewerNancy Greenwald, MD - Physical Medicine and Rehabilitation
Last RevisedJanuary 20, 2011

eMedicineHealth Medical Reference from Healthwise

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