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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 and more rigorous research supports the use of the following newer anticonvulsants to help relieve pain caused by damaged nerves.
- Gabapentin (Neurontin)
- Pregabalin (Lyrica)
- Lamotrigine (Lamictal)
Gabapentin and pregabalin
Both gabapentin and pregabalin are particularly effective in the treatment of postherpetic neuralgia, diabetic neuropathy and pain caused by a spinal cord injury. Pregabalin may also help fibromyalgia. Because these drugs have few side effects — typically, drowsiness and dizziness — and are usually well tolerated, they are often the first medications to try for neuropathic pain.
Lamotrigine has proved effective in treating trigeminal neuralgia, nerve pain experienced after a stroke and HIV neuropathy (particularly in people with HIV taking antiretroviral therapy). It may also be helpful for diabetic neuropathy. If you develop a rash while taking lamotrigine, see your doctor right away because it may indicate a severe skin reaction that requires emergency treatment, such as Stevens-Johnson syndrome.
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 typically need regular follow-up visits so your doctor can monitor for side effects. Because these older drugs generally 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, they often are 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/index.html. Accessed Sept. 9, 2010.
- Diabetic neuropathies: The nerve damage of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/neuropathies/index.htm. Accessed Sept. 9, 2010.
- Shingles: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/shingles/detail_shingles.htm. Accessed Sept. 9, 2010.
- Pain control: Support for people with cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/paincontrol.pdf. Accessed Sept. 9, 2010.
- Low back pain fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm. Accessed Sept. 9, 2010.
- Barkin RL, et al. Pharmacotherapeutic management of acute and chronic pain: Anticonvulsants. In: Rakel RE, et al. Textbook of Family Medicine. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/104961741-4/0/1481/214.html?tocnode=53392677&fromURL=214.html#4-u1.0-B978-1-4160-2467-5..50023-3--cesec73_891. Accessed Sept. 9, 2010.
- Trigeminal neuralgia fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/trigeminal_neuralgia/detail_trigeminal_neuralgia.htm. Accessed Sept. 9, 2010.
- Goodyear-Smith F, et al. Anticonvulsants for neuropathic pain: Gaps in evidence. Clinical Journal of Pain. 2009;25:528.
- Dworkin RH, et al. Recommendations for the pharmacological management of neuropathic pain: An overview and literature update. Mayo Clinic Proceedings. 2010;85:S3.
- Lamotrigine. Micromedex Healthcare Series. http://www.micromedex.com. Accessed Sept. 13, 2010.
- Suicidal behavior and ideation and antiepileptic drugs. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm100190.htm. Accessed Sept. 13, 2010.
- Hereditary neuropathies information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/neuropathy_hereditary/neuropathy_hereditary.htm. Accessed Sept. 14, 2010.