Active substances: Gabapentin
We performed analysis using three tiers of evidence. We did not identify any additional studies. Participants were aged between 26 and 77 years.
There was no convincing evidence that lamotrigine is effective in treating neuropathic pain and fibromyalgia at doses of 200 mg to 400 mg daily.
Given the availability of more effective treatments including antiepileptics and antidepressant medicines, lamotrigine does not have a significant place in therapy based on the available evidence.
The adverse effect profile of lamotrigine is also of concern. It is different from pain messages carried along healthy nerves from damaged tissue a fall, or cut, or arthritic knee.
Neuropathic pain is treated by different medicines than pain from damaged tissue.
Medicines like paracetamol or ibuprofen are not effective in neuropathic pain, while medicines that are sometimes used to treat depression or epilepsy can be very effective in some people with neuropathic pain.
Our understanding of fibromyalgia a condition of persistent, widespread pain and tenderness, sleep problems, and fatigue is lacking, but fibromyalgia can respond to the same medicines as neuropathic pain. Lamotrigine is a medicine used to treat epilepsy, and so might be a useful medicine for neuropathic pain or fibromyalgia.
We found 12 studies of reasonable quality that tested lamotrigine against placebo for a number of weeks. Almost half of the 1511 people in the studies had painful limbs because of damaged nerves caused by diabetes, and seven different painful neuropathic conditions were examined.
No studies looked at fibromyalgia.
Lamotrigine did not help the pain, and was no different from placebo except in causing more side effects. This article has been cited by other articles in PMC.Philip J Wiffen, Email: ku. This article has been cited by other articles in PMC.
Abstract Background This review is an update of a review published in, itself a major update of previous reviews published in and, investigating the effects of gabapentin in chronic neuropathic pain pain due to nerve damage. Antiepileptic drugs are used to manage chronic neuropathic pain and fibromyalgia.
Objectives To assess the analgesic efficacy and adverse effects of gabapentin in chronic neuropathic pain and fibromyalgia. We obtained clinical trial reports and synopses of published and unpublished studies from Internet sources, and searched Clinicaltrials.
Participants were adults. We performed analysis using three tiers of evidence. For harm we calculated number needed to treat for harm NNH for adverse effects and withdrawal. Main results Seven new studies with 1919 participants were added.
Another report 147 participants provided results for a study already included, but which previously had no usable data.
A further report 170 participants used an experimental formulation of intrathecal gabapentin. There was no first tier evidence.