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Evidence summaries

Lamotrigine for Acute and Chronic Pain

Lamotrigine appears not to be beneficial in chronic pain conditions and neuropathic pain. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 12 studies with a total of 1 511 subjects, all with chronic neuropathic pain. The studies covered the following conditions: central post stroke pain (1), chemotherapy induced neuropathic pain (1), diabetic neuropathy (4), HIV related neuropathy (2), mixed neuropathic pain (2), spinal cord injury related pain (1) and trigeminal neuralgia (1); none investigated lamotrigine in acute pain. The studies included participants in the age range of 26 to 77 years. Study duration was 2 weeks in one study and at least 6 weeks in the remainder; eight were of eight week duration or longer. There is no convincing evidence that lamotrigine is effective in treating acute or chronic pain at doses of about 200-400 mg daily. Almost 10% of participants taking lamotrigine reported a skin rash.

Comment: The quality of evidence is downgraded by indirectness (differences in studied patients and conditions).

    References

    • Wiffen PJ, Derry S, Moore RA. Lamotrigine for chronic neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev 2013;12():CD006044. [PubMed]

Primary/Secondary Keywords