Which medications in the drug class Anticonvulsants, Other are used in the treatment of Multiple Sclerosis?

Updated: Oct 08, 2019
  • Author: Christopher Luzzio, MD; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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Answer

Anticonvulsants, Other

Gabapentin is an anticonvulsant drug that is particularly useful in patients who experience spasticity and neuropathic pain. Anticonvulsants (eg, carbamazepine, phenytoin) can also be used for the treatment of secondary pain in MS. Topiramate (Topamax) is an anticonvulsant that can be used for MS patients with tremor or spasms and has also been used for paroxysmal symptoms.

Gabapentin (Neurontin, Gralise, Fanatrex FusePaq)

Gabapentin is a membrane stabilizer, a structural analogue of the inhibitory neurotransmitter GABA. Paradoxically, gabapentin is thought not to exert an effect on GABA receptors. It is used to manage pain and provide sedation in patients with neuropathic pain.

Carbamazepine (Tegretol, Tegretol XR, Epitol, Carbatrol)

Carbamazepine is a sodium channel blocker that typically provides substantial or complete relief of pain in 80% of individuals with MS within 24-48 hours. It reduces sustained high-frequency repetitive neural firing and is a potent enzyme inducer that can induce its own metabolism.

Pregabalin (Lyrica)

Pregabalin is a structural derivative of GABA with an unknown mechanism of action. It is used to relieve neuropathic pain.

Topiramate (Topamax, Qudexy, Trokendi)

The exact mechanism of topiramate's anticonvulsant effects is unknown. Topiramate's actions involve several mechanisms, including reduction of the duration of abnormal discharges and the number of action potentials within each discharge. This is probably secondary to its ability to block voltage-sensitive sodium channels. Topiramate also increases the frequency at which GABA activates GABA-A receptors. Finally, it inhibits excitatory transmission by antagonizing some types of glutamate receptors.


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