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The use of pregabalin analgesia for patients with chronic prostatitis/chronic pelvic pain syndrome

It has been suggested that chronic prostatitis/chronic pelvic pain syndrome is due to pain caused by the nerves in or around the prostate. Pregabalin is a pain killer that is specific for nerve pain. Therefore we conducted a search of the literature to evaluate the use of pregabalin for this ailment and whether or not it was better than placebo.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Pregabalin for acute and chronic pain in adults

Pregabalin relieves pain caused by damage to nerves, either from injury or disease. Antiepileptics (such as pregabalin) are medicines used for treating epilepsy, but are also effective for treating pain. The type of pain that responds well to pregabalin treatment is neuropathic pain (pain caused by damage to nerves). This includes postherpetic neuralgia (persistent pain in an area previously affected by shingles) and painful complications of diabetes, as well as fibromyalgia. Only a minority of patients with these types of pain will have a substantial benefit, and somewhat more will have moderate benefit. With pregabalin daily doses of 300 mg to 600 mg, the patient global impression of change rating of much or very much improved was about 35% in postherpetic neuralgia, 50% in painful diabetic neuropathy, and 40% in fibromyalgia. There is no evidence that pregabalin is effective in acute conditions where pain is already established, and in chronic conditions in which nerve damage is not the prime source of the pain, such as arthritis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Gabapentin or pregabalin for preventing migraine attacks in adults

Various medicines, collectively termed 'antiepileptics', are used to treat epilepsy. For several years, some of these drugs have also been used for preventing migraine attacks. For the present review, researchers in The Cochrane Collaboration reviewed the evidence about the effects of gabapentin and two related drugs (pregabalin and gabapentin enacarbil) in adult patients (≥ 16 years of age) with 'episodic' migraine (headache on < 15 days per month). They examined research published up to 15 January 2013, along with three unpublished and previously confidential drug company research reports, and found six relevant studies, five of gabapentin and one of gabapentin enacarbil, both over a wide dose range. The studies showed that neither gabapentin nor gabapentin enacarbil was more effective than placebo at reducing the frequency of migraine headaches. Gabapentin commonly caused side effects, especially dizziness and somnolence (sleepiness). No studies of pregabalin were identified, and research on this drug is desirable.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Pregabalin add‐on for drug‐resistant partial epilepsy

Use of pregabalin in combination with other antiepileptic drugs can reduce the frequency of seizures, but has some adverse effects. The overall evidence for reducing seizures was rated as moderate in quality.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Antiepileptics other than gabapentin, pregabalin, topiramate, and valproate for preventing migraine attacks in adults

Various medicines, collectively termed 'antiepileptics', are used to treat epilepsy. For several years, three antiepileptics have also been recommended as drugs of first choice (topiramate and valproate) or third choice (gabapentin) for preventing migraine attacks. These three drugs, along with one other (pregabalin), are the subject of separate Cochrane reviews. For the present review, researchers in The Cochrane Collaboration reviewed the evidence about the effect of other antiepileptics in adult patients (≥ 16 years of age) with 'episodic' migraine (headache on < 15 days per month). They examined research published up to 15 January 2013 and found 10 studies of nine different antiepileptics. The majority of these drugs were no better than placebo for migraine prophylaxis (acetazolamide, carisbamate, clonazepam, lamotrigine, oxcarbazepine, and vigabatrin). In one study each, carbamazepine and levetiracetam were better than placebo, and there was no significant difference between zonisamide and topiramate (a drug proven to be effective for migraine prophylaxis). None of these studies was of high methodological quality. The quantity and quality of the evidence were such that no firm conclusions could be drawn about the effect or lack of effect of any of the antiepileptics studied.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Pregabalin monotherapy for epilepsy

A number of people continue to have seizures and many experience adverse effects, despite current antiepileptic treatments. As a result, there is increasing interest in new pharmacological treatment options such as pregabalin. This systematic review evaluated the efficacy and tolerability of pregabalin in people with epilepsy. The review authors only included two, short‐term randomised controlled trials involving 753 participants treated with pregabalin monotherapy for epilepsy. Studies included in this review suggested that pregabalin was inferior to lamotrigine but was better than gabapentin, but we found some limitations in the study design which may have had a great influence on the results. There is no strong evidence to support its monotherapy as a treatment for epilepsy. Long‐term trials and high quality randomised clinical trials are needed to evaluate the efficacy and safety of pregabalin monotherapy for treating epilepsy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Comparing Fibromyalgia Drugs

How do drugs for fibromyalgia compare in improving symptoms?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: June 12, 2011

Comparing Antiepileptics for Bipolar Disorder, Migraines, Fibromyalgia, and Chronic Pain

How do antiepileptics compare in treating bipolar disorder?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: October 1, 2010

Options for Treating Restless Legs Syndrome: A Review of the Research for Adults

This summary will cover: What RLS is Treatment options for RLS What researchers have found about RLS treatments

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: August 30, 2013

Anticonvulsants for fibromyalgia

Researchers in The Cochrane Collaboration conducted a review of research about the effects of anticonvulsants (antiepileptic drugs) on fibromyalgia (FM). After searching for all relevant studies, they found eight studies with up to 3579 people. The anticonvulsants that they studied were gabapentin, lacosamide, levetiracetam and pregabalin. They found reliable conclusions for pregabalin only.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Antiepileptic drugs to treat neuropathic pain or fibromyalgia‐ an overview of Cochrane reviews

Neuropathic pain is pain coming from damaged nerves. It is different from pain messages carried along healthy nerves from damaged tissue (eg a fall, cut, or arthritic knee). Neuropathic pain is treated by different medicines than pain from damaged tissue. Medicines such as paracetamol or ibuprofen are probably not effective in neuropathic pain, while medicines that are sometimes used to treat depression or epilepsy can be very effective in some people with neuropathic pain. Our understanding of fibromyalgia (a condition of persistent, widespread pain and tenderness, sleep problems, and fatigue) is lacking, but fibromyalgia can respond to the same medicines as neuropathic pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Systemic drugs for the prevention of chronic pain after surgery

Pain associated with surgery generally resolves within one to two weeks, however in some situations surgical patients are left with longstanding pain for months or even years after the surgical procedure. Researchers have studied the ability of various drug treatments to prevent the development of chronic pain after surgery and this systematic review evaluated published studies in this field. Available studies suggest a modest effect of ketamine, compared to placebo, for prevention of chronic pain after surgery, however small study size could lead to an overestimation of this effect. Studies of other drugs such as gabapentin and pregabalin did not suggest the same preventative effect. Additional large studies using improved research methods are necessary to more clearly identify treatments that are beneficial for preventing chronic postsurgical pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Anticonvulsant drugs for migraine prophylaxis

1. Topiramate for the prophylaxis of episodic migraine in adults. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD010610. DOI: 10.1002/14651858.CD010610.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Phenytoin for neuropathic pain and fibromyalgia in adults

Nerves which have been damaged by injury or disease can continue to produce pain. This type of pain is called neuropathic pain. Some antiepileptic medications can help neuropathic pain. Phenytoin is an antiepileptic medication, and the aim of this review was to assess how effective phenytoin is for neuropathic pain and fibromyalgia. We identified no good quality studies of phenytoin used in this situation. When used to treat epilepsy, phenytoin can cause potentially troublesome adverse events, affecting nervous tissue, the blood, and unborn children. Based on current evidence, phenytoin cannot be recommended for treating neuropathic pain. Other antiepileptic drugs such as pregabalin, gabapentin, and carbamazepine have been shown to be of value in neuropathic pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Antiepileptic drugs for treating seizures in adults with brain tumours

Seizures are a common symptom of both primary and secondary brain tumours and can cause significant morbidity. The mainstay of treatment for seizures in adults with brain tumours is medical therapy with antiepileptic drugs. This review appraises the evidence for a range of commonly used antiepileptic drugs for the treatment of seizures in adults with brain tumours.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Clonazepam for neuropathic pain and fibromyalgia in adults

Nerves which have been damaged by injury or disease can continue to produce pain. This type of pain is called neuropathic pain. Some antiepileptic medications can help neuropathic pain. Clonazepam is an antiepileptic medication, and the aim of this review was to assess how effective clonazepam is for neuropathic pain and fibromyalgia. We identified no good quality studies of clonazepam used in this situation. Dependence and tolerance may occur with prolonged use, although it is less of a problem with clonazepam than many other drugs from the same class (benzodiazepines), and behavioural disinhibition has been reported in a few patients with psychiatric problems. Based on current evidence, clonazepam cannot be recommended for treating neuropathic pain. Other antiepileptic drugs such as pregabalin, gabapentin, and carbamazepine have been shown to be of value in neuropathic pain.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Second‐generation antipsychotic drugs for anxiety disorders 

Anxiety disorders are a prevalent and disabling condition. Because of high rates of treatment resistance, there is interest in new pharmacological treatment options such as second‐generation antipsychotics. This systematic review evaluated the efficacy and tolerability of second‐generation antipsychotics in the treatment of anxiety disorders. We found eleven randomised placebo‐controlled trials, comparing quetiapine, olanzapine and risperidone with placebo and antidepressants. The vast majority of the available data was on quetiapine (> 3000 participants). Participants with generalised anxiety disorder responded significantly better to quetiapine than to placebo, measured as a reduction in the Hamilton Anxiety Scale (HAM‐A). Participants treated with quetiapine were more likely to drop out due to adverse events, to gain weight, to suffer from sedation or to suffer from extrapyramidal side effects. The evidence on the other second‐generation antipsychotics is currently too limited to draw any conclusions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Drug combinations for chronic neuropathic pain in adults

Neuropathic pain – due to nerve disease or damage – is often treated by pain medications which have limited effect and/or dose‐related side effects when given alone. Combinations of more than one drug are often used with the goal of achieving better pain relief or fewer side effects (if the pain relieving effects of the combined drugs are more additive than the side effects), or both. Despite evidence that over 45% of individuals suffering from neuropathic pain take two or more drugs for their pain, we could find only 21 high‐quality studies of various different systemic and topical drug combinations. Given the wide possible variety of different drug combinations and the small number of studies, results for neuropathic pain from this review are insufficient to suggest the value of any one specific drug combination. However, the publication of multiple high‐quality studies suggesting the superiority of some drug combinations, together with evidence that drug combinations are widely used in clinical practice, underline the importance of conducting more combination studies with improved methodology.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Duloxetine for treating painful neuropathy, chronic pain or fibromyalgia

Duloxetine is a drug used to treat depression and urinary urge incontinence (leakage of urine) and it can be also be useful for certain types of pain. Pain can arise spontaneously when there is damage to nerves that carry pain information to the brain (neuropathic pain). When this damage is to nerves outside the spinal cord it is called a peripheral neuropathy. Another type of pain, nociceptive pain, occurs when the nerves sense damage to another tissue (for example, a pinprick in the skin). Some pain is of unclear origin and occurs without apparent nerve or tissue damage. This sort of pain happens, for example, in fibromyalgia. The objective of this review was to assess the benefits and harms of duloxetine for treating painful neuropathy and chronic pain of all sorts.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Anticonvulsants for alcohol dependence

This review looked at evidence on the efficacy and acceptability of anticonvulsants alone or in combination with another medication or a psychosocial intervention for the treatment of alcohol dependence.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Medical Encyclopedia

  • Postherpetic neuralgia
    Postherpetic neuralgia is pain that lasts for more than a month after a shingles infection occurred. The pain may last for months or years.
  • Neuropathy secondary to drugs
    Neuropathy secondary to drugs is a loss of sensation or movement in a part of the body due to nerve damage from a certain medicine.
  • Metabolic neuropathies
    Metabolic neuropathies are nerve disorders that occur with diseases that disrupt the chemical processes in the body
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Systematic Reviews in PubMed

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