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Consumer Reports' Analysis: Drugs for Nerve Pain, Fibromyalgia Effective, But Not Always Best
Date:9/5/2007

d topiramate (Topamax).

Both the old and new anticonvulsants -- but especially the new ones -- gained traction through the 1990s in treating pain and mental disorders. They all affect the central nervous system. In particular, the drugs are now prescribed often to treat nerve pain, or neuralgia, caused by damage or trauma to the nerves or parts of the nervous system. Nerve pain occurs in many people who have diabetes, for example, which damages nerves and blood vessels. Cancer can also cause nerve pain, as can chemotherapy to treat cancer. Some infections can also cause nerve pain, including HIV. And shingles is a form of intense nerve pain caused by the herpes zoster virus -- affecting over a million people each year.

The report notes that the FDA has now approved several anticonvulsants to treat conditions other than seizures. Namely, divalproex, lamotrigine (Lamictal), and carbamazepine have been approved to treat the manic phases of bipolar disorder; carbamazepine, gabapentin (Neurontin), and pregabalin (Lyrica) have been approved to treat various forms of nerve pain; and pregabalin (Lyrica) was just recently (in June 2007) approved to treat fibromyalgia -- an often chronic condition characterized by muscle pain or soreness, joint tenderness or pain, fatigue, and a chronic, low-grade flu-like feeling.

The report presents evidence supporting those uses, but also cautions that other treatments may sometimes work better or be a better initial choice for some patients. In addition, it presents detailed information on the adverse side effects of the drugs, noting in particular that the newer drugs pose the same level of risk (albeit different risks) as the older drugs.

The report presents detailed cost information on the drugs as well, noting that the newer anticonvulsants can be quite expensive ($300 a month and up), and are generally more costly than the older drugs. However, some of the newer drugs (most notably gabapentin) are now avai
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SOURCE Consumer Reports Best Buy Drugs
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