Home > Anticonvulsants for Chronic Pain
Experts do not know exactly how
anticonvulsants work to reduce
chronic pain. They may block the flow of pain signals
central nervous system.
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
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
trigeminal neuralgia (sudden facial pain). The best
evidence is for carbamazepine, but oxcarbazepine probably works well
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
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.)
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.
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)(What is a PDF document?) to help you understand this medication.
Wiffen PJ, et al. (2005). Gabapentin for acute and chronic pain. Cochrane Database of Systematic Reviews (3).
Wiffen PJ, et al. (2005). Carbamazepine for acute and chronic pain in adults. Cochrane Database of Systematic Reviews (3).
Moore RA, et al. (2009). Pregabalin for acute and chronic pain in adults. Cochrane Database of Systematic Reviews (3).
Fall M, et al. (2010). EAU guidelines on chronic pelvic pain. European Urology, 57(1): 35–48.
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.
January 20, 2011
Anne C. Poinier, MD - Internal Medicine & Nancy Greenwald, MD - Physical Medicine and Rehabilitation
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