Use of anticonvulsants drugs for neuropathic painful conditions

[Guest guest]

J Pak Med Assoc. 2008 Dec;58(12):690-6.

Use of anticonvulsants drugs for neuropathic painful conditions.

Hussain AM, Afshan G.

Department of Anaesthesia, Aga Khan University Hospital, Karachi,

Pakistan.

Neuropathic pain, a form of chronic pain initiated and sustained by

an insult to the peripheral or central nervous system, is a challenge

to clinicians as it does not respond well to traditional pain

therapies. However exact pathophysiology is not known but considering

similarities between epilepsy models and in neuropathic pain models

justify the rationale for use of anticonvulsant drugs in the

symptomatic management of neuropathic pain disorders.

The role of anticonvulsant drugs in the treatment of neuropathic pain

is evolving and various clinical trials have used these

anticonvulsants and shown positive results in the treatment of

trigeminal neuralgia, painful diabetic neuropathy and postherpetic

neuralgia. The availability of newer anticonvulsants tested in higher

quality clinical trials has marked a new era in the treatment of

neuropathic pain.

Gabapentin has the most clearly demonstrated analgesic effect for the

treatment of neuropathic pain, specifically for treatment of painful

diabetic neuropathy and postherpetic neuralgia. Pregablin is a newer

drug and will soon gain popularity in clinical practice. There is a

need for further advances in our understanding of the neuropathic

pain syndromes to establish the role of anticonvulsants in the

treatment of neuropathic pain.