ABSTRACT
While the most common treatments for nociceptive pain include anti-inflammatory and opioid medications, anticonvulsant medications (ACM) are first-line drugs for neuropathic pain. Both older and newer ACMs may be used in patients with neuropathic pain, migraine, essential tremor, spasticity, restless legs syndrome, and several psychiatric disorders including bipolar disorder and schizophrenia. Anticonvulsants are useful for trigeminal neuralgia, postherpetic neuralgia, diabetic neuropathy, as well as central pain. Chemically, anticonvulsants are a diverse group of drugs, are typically highly protein bound, and undergo extensive hepatic metabolism. Gabapentin is a popular anticonvulsant for neuropathic pain. Gabapentin was approved for use in the United States in 1993, as an adjunctive treatment of adults with partial epilepsy. Almost immediately after its release, physicians began to use gabapentin for various neuropathic pain disorders, such as diabetic peripheral neuropathy and postherpetic neuralgia.
