The Aword

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Antiepileptic drugs (AEDs) have been widely studied and prescribed for the relief of pain, especially neuropathic pain. Similarities between epilepsy and neuropathic pain have been observed for over 100 years (Trousseau described trigeminal neuralgia as "epileptiform" in 1885).

It followed that using drugs that treat epileptic seizures might be of benefit in relieving neuropathic pain; in 1942, phenytoin was used to treat facial neuralgia([i]) and in 1962([ii]), carbamazepine came into use and has subsequently remained the most widely used AED to combat neuropathic pain, until the recent introduction of gabapentin, which is currently very popular with pain specialists.

Like antidepressants, anticonvulsants have NNT (Number needed to treat) of between 2 and 3 (i.e. 2 or 3 patients will need to be treated for every 1 successful outcome). This indicates that they are very effective.

[i] Bergouignan M Rev Laryngol Otol Rhinol 1942;63:34-41 Cures heureuses de nevralgies faciales essentielles par le diphenylhydantoinate de soude.

[ii] Blom S Lancet 1962 Trigeminal neuralgia; its treatment with a new anticonvulsant drug(G32883)