Anticonvulsants for cancer pain

Examples

Brand Name	Generic Name	Chemical Name
Tegretol	carbamazepine
Neurontin	gabapentin
Keppra	levetiracetam
Trileptal	oxcarbazepine
Dilantin	phenytoin
Lyrica	pregabalin
Topamax	topiramate
Zonegran	zonisamide

How It Works

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

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

How Well It Works

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

Side Effects

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).

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

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.²

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

References

Citations

1. Foley KM, Abernathy A (2008). Management of cancer pain. In VT DeVita Jr et al., eds., DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology, 8th ed., vol. 2, pp. 2757–2790. Philadelphia: Lippincott Williams and Wilkins.

2. 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.

By:	Healthwise Staff	Last Revised: April 27, 2010
Medical Review:	E. Gregory Thompson, MD - Internal Medicine Michael Seth Rabin, MD - Medical Oncology
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