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Anticonvulsants for Chronic Low Back Pain

Examples

Generic Name Brand Name
carbamazepine Tegretol
gabapentin Neurontin
phenytoin Dilantin
pregabalin Lyrica
topiramate Topamax

How It Works

Anticonvulsants are used to help control or prevent abnormal increases in brain electrical activity.

Why It Is Used

Anticonvulsants can reduce some persistent low back pain.1

How Well It Works

Anticonvulsant medicine may relieve chronic pain for some people but not others.1 One type of anticonvulsant may work better for you than another. This type of medicine is not well studied as a chronic pain treatment but is considered a reasonable treatment option.

Side Effects

When prescribed for chronic pain control, anticonvulsants are used at doses low enough to avoid side effects, and the dosage is usually increased very gradually, if needed. Tell your doctor if you notice any of the following side effects:

  • Drowsiness
  • Restlessness and irritability
  • Confusion and dizziness
  • Nausea, vomiting, loss of appetite, and belly pain
  • Uncontrollable eye movements (nystagmus)
  • Gum disease (gingivitis)
  • Itching, fever, and a rash that looks like measles (sensitivity reaction)
  • Weight gain

Pregabalin can cause swelling in some people, including swelling of the face or lips. If swelling is bothering you, call your doctor. There may be another medicine you can try.

Topiramate can cause weight loss.

The U.S. Food and Drug Administration (FDA) has issued a warning on anticonvulsants and the risk of suicide and suicidal thoughts. The FDA does not recommend that people stop using these medicines. Instead, people who take anticonvulsant medicine should be watched closely for warning signs of suicide. People who take anticonvulsant medicine and who are worried about this side effect should talk to a doctor.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Anticonvulsants are not safe for everyone. To avoid side effects, be sure to tell your doctor about any medical conditions you have and any other medicines you are taking. You may already be taking one or more drugs to treat other problems, such as diabetes, arthritis, high cholesterol, heart disease, or high blood pressure. Be sure your doctor knows all the drugs you are taking.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Chou R, Huffman LH (2007). Medications for acute and chronic low back pain: A review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Annals of Internal Medicine, 147(7): 505–514.

Credits

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer Robert B. Keller, MD - Orthopedics
Last Revised December 14, 2011

Last Revised: December 14, 2011

Author: Healthwise Staff

Medical Review: William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Robert B. Keller, MD - Orthopedics

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