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Anticonvulsant drugs ineffective for back pain, study shows

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Back pain is a common problem and many people take pain-killing drugs to help provide short-term relief.

Clinical practice guidelines usually recommend staying active, doing exercises and stretches, and taking ibuprofen or other non-opioid pain relievers if necessary.

Despite limited supporting evidence, the use of anticonvulsant drugs like gabapentin, topiramate and pregabalin to treat chronic low back pain and lumbar radicular pain has significantly increased in recent years.

Now, a new study suggests they are ineffective and can have adverse side effects.

The systematic review of nine placebo-controlled randomised trials found moderate- to high-quality evidence that anticonvulsants were not effective in reducing pain or disability in patients with low back pain or lumbar radicular pain.

Moreover, the researchers found high-quality evidence that such drugs have a higher risk for adverse effects including drowsiness, dizziness and nausea.

“Clinically, GP prescription of medicines used to treat nerve pain, such as anticonvulsants, has increased by an astounding 535% in the last ten years,” said study author Associate Professor Christine Lin of the University of Sydney.

“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 such as drowsiness or dizziness.

“There are also reports of suicidal ideation and misuse of these drugs.”

The findings, published in the Canadian Medical Association Journal, support recent guidelines in the UK and the US that do not recommend the use of anticonvulsants for low back pain.