Treating the Chronic Pain Patient with Anticonvulsants
Treatment of chronic pain syndromes can be challenging, because long-term use of over-the-counter pain medications such as non-steroidal anti-inflammatory drugs is either ineffective or even dangerous if a person takes them for too long or in a higher dose than is recommended. It is better to see a doctor for more effective pain management options if you are suffering from severe or chronic pain. In addition, narcotic (opioid) pain medications are not the only option available for pain management. In some cases, these medications are not the best possible treatment for long-term pain management. Fortunately, there are other types of drugs which have been shown to be effective in managing chronic pain syndromes.Anticonvulsant medications, or anti-seizure drugs, are a class of medication that can be prescribed off-label for treating certain types of pain syndromes. Anticonvulsant medications have been shown to be particularly effective in treating neuropathic pain, or pain that originates from the nerves themselves, as opposed to the skin, muscles or internal organs of the body.
The conditions that have been studied that showed positive results with anticonvulsant treatment were peripheral neuropathy, postherpetic neuropathy, chronic migraine and trigeminal neuralgia. Peripheral neuropathy is nerve damage in the hands and feet that can be caused by certain health problems, such as diabetes. Postherpetic neuropathy is nerve pain that occurs after a person has had an outbreak of shingles, a herpes virus. Trigeminal neuralgia is severe nerve pain that occurs in a large nerve in the face, called the trigeminal nerve. Migraine headaches may also be helped by the use of anticonvulsant medications, in some cases. It is not unheard of for anticonvulsant medications to be tried as a treatment for other conditions, such as the neuromuscular chronic pain condition fibromyalgia and chronic pelvic pain.
The two most widely-prescribed anticonvulsant medications for treating chronic pain conditions are the medications that have been studied the most for pain treatment: gabapentin and carbamazepine. Gabapentin seems to work better on burning nerve pain, while carbamazepine is used for sharper, more intense nerve pain. Other anticonvulsants that may be prescribed are pregabalin and oxcarbazepine. The potential side effects of anticonvulsant medications include headache, gastrointestinal problems, weight changes, feet swelling and confusion. However, anticonvulsant medications must be stopped gradually. If they are stopped immediately, withdrawal symptoms may occur.
http://pain.com/library/2012/09/13-treating-chronic-pain-patient-anticonvulsants/
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