Anticonvulsants Seem to Be Ineffective for Low Back Pain
THURSDAY, July 5, 2018 -- Anticonvulsant drugs are ineffective for chronic low back pain and can cause harm, despite a recent increase in prescribing, according to a review published online July 3 in CMAJ, the journal of the Canadian Medical Association.
Oliver Enke, M.B.B.S., from the University of Sydney, and colleagues conducted a literature review to identify studies comparing an anticonvulsant (topiramate, gabapentin, or pregabalin) to placebo in patients with non-specific low back pain, sciatica, or neurogenic claudication.
Based on nine studies (859 unique participants), the researchers found that in 14 out of 15 comparisons, anticonvulsants were not effective for reducing pain or disability in low back pain or lumbar radicular pain. Specifically, there was high-quality evidence of no effect of gabapentinoids versus placebo on chronic low back pain in the short term (pooled mean difference [MD], 0.0) or for lumbar radicular pain in the immediate term (pooled MD, 0.1). However, there was a high level of evidence of increased risk of adverse events from use of gabapentinoids.
"We have shown, with mostly high- and moderate-quality evidence, that common anticonvulsants are ineffective for chronic low back pain and lumbar radicular pain, and are accompanied by increased risk of adverse events," the authors write.
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Posted: July 2018