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- Anti-seizure medications: Relief from nerve pain
Anti-seizure medications: Relief from nerve pain
Newer anti-seizure drugs may have fewer side effects
More recent research supports the use of the anticonvulsants gabapentin (Neurontin) or pregabalin (Lyrica) to help relieve pain caused by damaged nerves.
Both gabapentin and pregabalin are particularly effective in the treatment of postherpetic neuralgia, diabetic neuropathy and pain caused by a spinal cord injury. Pregabalin also may be used to treat fibromyalgia.
Because these drugs have few side effects and are usually well tolerated, they are often the first medications to try for neuropathic pain. You may experience side effects, such as drowsiness, dizziness, confusion or swelling in the feet and legs. These side effects are limited by starting with a low dosage and slowly increasing it.
Medications from other drug classes with distinct mechanisms of pain relief (such as antidepressants) may be used in combination with anti-seizure class medications if anti-seizure medications fail to control your pain.
Side effects limit use of older anticonvulsants
Anti-seizure drugs have been used to treat nerve pain for many years, but their use was limited by the severity of side effects they produce.
Older anti-seizure drugs include:
- Carbamazepine (Carbatrol, Tegretol)
- Oxcarbazepine (Trileptal)
- Phenytoin (Dilantin)
- Valproic acid (Depakene)
Side effects may include:
- Liver damage
- Double vision
- Loss of coordination
If you take an older anticonvulsant, you generally need regular follow-up visits so that your doctor can monitor for side effects. These older drugs often have more side effects than do the newer anticonvulsants, and the evidence supporting use of the older anticonvulsants for neuropathic pain is sparse at times. As a result, older drugs may be recommended only when the newer medications prove ineffective.
As scientists learn more about the way anti-seizure drugs work, this information will be useful in determining which drugs may work best for different types of nerve pain. Pain caused by nerve damage can be disabling, but anti-seizure drugs sometimes provide relief.Previous page
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- Bajwa ZH, et al. Overview of the treatment of chronic pain. http://www.uptodate.com/home. Accessed June 13, 2013.
- Daroff RB, et al. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4377-0434-1..00051-7--s0085&isbn=978-1-4377-0434-1&sid=1449455838&uniqId=413635127-3#4-u1.0-B978-1-4377-0434-1..00051-7--s0085. Accessed June 13, 2013.
- Lynch ME. The pharmacotherapy of chronic pain. Rheumatic Disease Clinics of North America. 2008;34:369.
- Jongen JL, et al. Neuropathic pain and pharmacological treatment. Pain Practice. In press. Accessed June 12, 2013.
- Diabetic neuropathies: The nerve damage of diabetes. National Diabetes Information Clearinghouse. http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/index.aspx. Accessed June 13, 2013.
- Shingles: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/shingles/detail_shingles.htm. Accessed June 13, 2013.
- Facing forward: Life after cancer treatment. National Cancer Institute. http://www.cancer.gov/cancertopics/coping/life-after-treatment/. Accessed June 13, 2013.
- Low back pain fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm. Accessed June 13, 2013.
- Fibromyalgia: Questions and answers about fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/health_info/fibromyalgia/. Accessed June 13, 2013.
- Suicidal behavior and ideation and antiepileptic drugs. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm100190.htm. Accessed June 13, 2013.
- NINDS trigeminal neuralgia information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/trigeminal_neuralgia/trigeminal_neuralgia.htm. Accessed June 13, 2013.
- Watson JC (expert opinion). Mayo Clinic, Rochester, Minn. June 27, 2013.