| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
| Neurology supplements are not peer-reviewed. Information contained in Neurology supplements represent the opinions of the authors and are not endorsed by nor do they reflect the views of the American Academy of Neurology, Editor-in-Chief, or Associate Editors of Neurology. |
From the Department of Neurology, University of Wisconsin Hospital and Clinics, Madison, Wisconsin.
Address correspondence and reprint requests to Dr. Misha-Miroslav Backonja, University of Wisconsin Hospital and Clinics, Department of Neurology, Room H6/574, 600 Highland Avenue, Madison, WI 53792-5132; e-mail: backonja{at}neurology.wisc.edu
Emerging evidence from animal models of neuropathic pain suggests that many pathophysiologic and biochemical changes occur in the peripheral and central nervous system. Similarities between the pathophysiologic phenomena observed in some epilepsy models and in neuropathic pain models justify the use of anticonvulsants in the symptomatic management of neuropathic pain. Positive results from laboratory and clinical trials further support such use. Carbamazepine was the first of this class of drugs to be studied in clinical trials and has been longest in use for treatment of neuropathic pain. Clinical trial data support its use in treating trigeminal neuralgia, but data for treatment of painful diabetic neuropathy are less convincing. Use of newer anticonvulsants has marked a new era in the treatment of neuropathic pain. Gabapentin has demonstrated efficacy, specifically in painful diabetic neuropathy and postherpetic neuralgia. Lamotrigine has been reported to be effective in relieving pain from trigeminal neuralgia refractory to other treatments, HIV neuropathy, and central post-stroke pain. Results from clinical trials of phenytoin are equivocal. Zonisamide’s mechanisms of action suggest that it would be effective in controlling neuropathic pain symptoms. Other anticonvulsants, including lorazepam, valproate, topiramate, and tiagabine, have also been under investigation. Anecdotal experience provides support for studies with oxcarbazepine and levetiracetam for treating neuropathic pain. Evidence supporting the efficacy of anticonvulsants in treatment of such pain is evolving. Additional clinical trials should provide information that will better define their role in neuropathic pain.
This article has been cited by other articles:
|
|
 |
|
  M. U. Farooq, A. Bhatt, A. Majid, R. Gupta, A. Khasnis, and M. Y. Kassab Levetiracetam for managing neurologic and psychiatric disorders Am. J. Health Syst. Pharm., March 15, 2009; 66(6): 541 - 561. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Christiansen, A.-K. Meinild, A. A. Jensen, and H. Brauner-Osborne Cloning and Characterization of a Functional Human {gamma}-Aminobutyric Acid (GABA) Transporter, Human GAT-2 J. Biol. Chem., July 6, 2007; 282(27): 19331 - 19341. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Kanai, A. Suzuki, M. Kobayashi, and S. Hoka Intranasal lidocaine 8% spray for second-division trigeminal neuralgia Br. J. Anaesth., October 1, 2006; 97(4): 559 - 563. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Vissers and T. Meert A Behavioral and Pharmacological Validation of the Acetone Spray Test in Gerbils with a Chronic Constriction Injury Anesth. Analg., August 1, 2005; 101(2): 457 - 464. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. SARLANI, E. G. GRACE, B. A. BALCIUNAS, and A. H. SCHWARTZ Trigeminal neuralgia in a patient with multiple sclerosis and chronic inflammatory demyelinating polyneuropathy J Am Dent Assoc, April 1, 2005; 136(4): 469 - 476. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S.-A. Ryder and C. F Stannard Treatment of chronic pain: antidepressant, antiepileptic and antiarrhythmic drugs CEACCP, February 1, 2005; 5(1): 18 - 21. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Scott and M. J. Kothari Evaluating the Patient with Peripheral Nervous System Complaints J Am Osteopath Assoc, February 1, 2005; 105(2): 71 - 83. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Chen, T. J. Lamer, R. H. Rho, K. A. Marshall, B. T. Sitzman, S. M. Ghazi, and R. P. Brewer Contemporary Management of Neuropathic Pain for the Primary Care Physician Mayo Clin. Proc., December 1, 2004; 79(12): 1533 - 1545. [Abstract] [PDF]
|
|
|
|
 |
|
 L. J. Hirsch, D. Weintraub, Y. Du, R. Buchsbaum, H. T. Spencer, M. Hager, T. Straka, C. W. Bazil, D. J. Adams, S. R. Resor Jr., et al. Correlating lamotrigine serum concentrations with tolerability in patients with epilepsy Neurology, September 28, 2004; 63(6): 1022 - 1026. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Lussier, A. G. Huskey, and R. K. Portenoy Adjuvant Analgesics in Cancer Pain Management Oncologist, September 1, 2004; 9(5): 571 - 591. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S F McDouall and R C Tasker Are anticonvulsants a satisfactory alternative to opiate analgesia in patients experiencing pain with Guillain-Barre syndrome? Arch. Dis. Child., July 1, 2004; 89(7): 686 - 687. [Full Text]
|
|
|
|
 |
|
 G. Villetti, M. Bergamaschi, F. Bassani, P. T. Bolzoni, M. Maiorino, C. Pietra, I. Rondelli, P. Chamiot-Clerc, M. Simonato, and M. Barbieri Antinociceptive Activity of the N-Methyl-D-aspartate Receptor Antagonist N-(2-Indanyl)-glycinamide Hydrochloride (CHF3381) in Experimental Models of Inflammatory and Neuropathic Pain J. Pharmacol. Exp. Ther., August 1, 2003; 306(2): 804 - 814. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
