Which medications in the drug class Anticonvulsants are used in the treatment of Chronic Pain Syndrome?

Updated: Jan 14, 2020
  • Author: Manish K Singh, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
  • Print
Answer

Anticonvulsants

Certain antiepileptic drugs (eg, the gamma-aminobutyric acid [GABA] analogue gabapentin and pregabalin [Lyrica]) have proven helpful in some cases of neuropathic pain. [15] For example, a randomized, double-blind, placebo-controlled study reported that twice-daily doses of gastric-retentive, extended-release gabapentin (gabapentin ER) provided safe and effective treatment for postherpetic neuralgia; nonplacebo patients in the study received 1800 mg of gabapentin per day. [16]

Pregabalin also demonstrated pain relief in diabetic peripheral neuropathy and postherpetic neuralgia. It may provide benefit in other neuropathic pain as well. [44]

A Cochrane Database of Systematic Reviews article that looked at 29 studies with a total of 3571 participants with chronic pain conditions concluded that gabapentin provided pain relief in about 30% of patients. Adverse events, although frequent, were mostly tolerable; they included dizziness, somnolence, peripheral edema, and gait disturbance. [45]

Other anticonvulsant agents (eg, clonazepam, topiramate, lamotrigine, zonisamide, tiagabine) also have been tried in chronic pain syndrome (CPS).

Gabapentin (Neurontin)

Gabapentin has anticonvulsant properties and antineuralgic effects; however, its exact mechanism of action is unknown. It is structurally related to GABA but does not interact with GABA receptors.

Pregabalin (Lyrica)

Pregabalin is a structural derivative of GABA; its mechanism of action unknown. Pregabalin binds with high affinity to the alpha2-delta site (a calcium channel subunit), and in vitro, pregabalin reduces the calcium-dependent release of several neurotransmitters, possibly by modulating calcium channel function. The US Food and Drug Administration (FDA) approved it for the treatment of neuropathic pain associated with diabetic peripheral neuropathy or postherpetic neuralgia and as adjunctive therapy in partial-onset seizures.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!