Anticonvulsants for cancer pain

Examples

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Brand Name	Generic Name
Tegretol	carbamazepine

Brand Name	Generic Name
Neurontin	gabapentin

Brand Name	Generic Name
Keppra	levetiracetam

Brand Name	Generic Name
Trileptal	oxcarbazepine

Brand Name	Generic Name
Dilantin	phenytoin

Brand Name	Generic Name
Lyrica	pregabalin

Brand Name	Generic Name
Topamax	topiramate

Brand Name	Generic Name
Zonegran	zonisamide

How It Works

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Anticonvulsants control cancer pain by changing the way sodium and calcium travel across the surface of nerve cells in the brain. The nerve cells send fewer signals, and the brain senses less pain.

Why It Is Used

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Anticonvulsants help reduce pain related to the nervous system (neuropathic pain). Some have fewer side effects than tricyclic antidepressants.

How Well It Works

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Anticonvulsants help control cancer pain related to the nervous system (neuropathic pain).¹

Side Effects

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When anticonvulsants are used to control cancer pain, they may be given in small amounts to limit side effects. Tell your doctor if you experience any side effects, especially:

• Drowsiness.
• Restlessness and irritability.
• Confusion and dizziness.
• Nausea, vomiting, loss of appetite, and belly pain.
• Blurred vision or uncontrollable eye movements (nystagmus).
• Itching, fever, or a rash (sensitivity reaction).

People of Asian ancestry may be at a higher risk for skin problems from taking carbamazepine. These skin problems, which include Stevens-Johnson syndrome and toxic epidermal necrolysis, can be dangerous. The FDA recommends that people of Asian background be tested before they take carbamazepine.

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

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Drowsiness is the most common side effect of anticonvulsant drugs.

These drugs are started at low doses and gradually increased to achieve pain relief.

Carbamazepine can cause a decrease in the white blood cell count, or leukopenia. So it is not generally used to treat cancer pain.¹

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

References

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Citations

1. Foley KM (2005). Management of cancer pain. In VT DeVita Jr et al., eds., Cancer: Principles and Practice of Oncology, 7th ed., pp. 2615–2649. Philadelphia: Lippincott Williams and Wilkins.

Credits

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Author	Shannon Erstad, MBA/MPH
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer	Michael Seth Rabin, MD - Medical Oncology
Last Updated	October 30, 2007