Some studies have suggested that other types of pain medication interventions be investigated before anti-seizure medication is prescribed for chronic pain treatment, while others say anticonvulsants are a mainstay and tend to have fewer long-term side effects. Studies are still being conducted on the effectiveness of anti-seizure medications for chronic pain.
Only a few anti-seizure medications are FDA approved for chronic pain treatment, including carbamazepine (for trigeminal neuralgia) and gabapentin (for postherpic neuralgia, or shingles pain). Use of anti-seizure medication for other types of chronic pain is considered “off-label use,” as there have been few studies to investigate their effectiveness in long-term chronic pain management.
Commonly Used Anti-Seizure Medications for Chronic Pain
- Gabapentin (Neurontin). Gabapentin is approved for the treatment of lasting postherpic neuralgia; however, it has also been effective at treating diabetic neuropathy.
- Carbamazepine (Tegretol). Carbamazepine was traditionally the mainstay anti-seizure medication for neuropathic pain, especially for treatment of trigeminal neuralgia (for which is it FDA approved). It is also effective for diabetic neuropathy pain and postherpic neuralgia.
- Pregabalin (Lyrica). Pregabalin is a newer anti-seizure medication for chronic pain, and is used for pain associated with postherpic neuralgia and diabetic neuropathy.
- Tiagabine (Gabitril). Tiagabine is an anti-seizure medication used in neuropathic pain associated with nerve injury, such as phantom limb pain.
- Topiramate (Topomax). Topiramate is an anti-seizure medication that is often used as a prophylactic migraine treatment. Prophylactics are taken to prevent pain rather than to control it once it starts.
- Valproic Acid (Depakote). Valproic acid is an anti-seizure medication that is used for migraine pain, and may be effective at treating other types of nerve pain.
- Lamotrigene (Lamictal). Lamotrigene can be used to treat pain associated with trigeminal neuralgia as well as central pain syndrome, or stroke pain.
Other Anti-Seizure Medications and Chronic Pain
Because of the way they work on the nervous system, the following anti-seizure medications may also be useful in the treatment of chronic pain. Their effectiveness in chronic pain management, however, has not been studied thoroughly:
Potential Side Effects of Anti-Seizure Medications
Anti-seizure medications have relatively few side effects when compared to other long-term pain medication use, though a few are worth mentioning. The main complaints include drowsiness, dizziness and fatigue. Anti-seizure medications may also cause the following:
- Confusion or trouble concentrating
- Loss of balance or trouble with coordination
- Double vision
- Slurred speech
- Loss of appetite
- Dry mouth
Remember: Medications affect everyone differently. Your experience will be unique. If you have any concerns about taking anti-seizure medications for chronic pain, talk to your healthcare provider as soon as possible.
American Chronic Pain Association. APCA Medications and Chronic Pain: Supplement 2007. Accessed 6/14/09. http://www.theacpa.org/documents/ACPA%20Meds%202007%20Final.pdf
Tremont-Lukats IW, Megeff C, and Backonja MM. Anticonvulsants for Neuropathic Pain Syndromes: Mechanisms of Action and Place in Therapy. Drugs. 2000 Nov;60(5):1029-52.
Wiffen PJ, Collins S, McQuay HJ, Carroll D, Jadad A, and Moore RA. Anticonvulsant Drugs for Acute and Chronic Pain. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD001133. DOI: 10.1002/14651858.CD001133.pub2.