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Evidence summaries

Anticonvulsant Drugs for Management of Cancer Pain

Anticonvulsants might possibly provide effective pain relief for the majority of patients with trigeminal neuralgia, diabetic neuropathy, and might possibly be effective for migraine prophylaxis, but the evidence for cancer pain is unclear. Adverse effects might possibly be common. Level of evidence: "D"

A systematic review 1 including 10 studies of carbamazepine, 1 of carbamazepine in combination with clomipramine, 5 of phenytoin, 2 of sodium valproate and 2 of clonazepam was abstracted in DARE.

For cancer pain, evidence of benefit was unclear.

Comment: The quality of evidence is downgraded by severe study limitations and indirectness (heterogeneity in interventions and outcomes). No details of the patients were given. The studies were combined by condition for meta-analysis, so that different studies evaluating different drugs were combined. Unpublished studies may have been missed, causing publication bias.

    References

    • McQuay H, Carroll D, Jadad AR, Wiffen P, Moore A. Anticonvulsant drugs for management of pain: a systematic review. BMJ 1995 Oct 21;311(7012):1047-52. [PubMed][DARE]

Primary/Secondary Keywords