Overall, the evidence supporting the use of anticonvulsants by people with one (or more) of the three conditions is mixed. Other treatment options exist for all three which may work better than an anticonvulsant. Some anticonvulsants have been linked to clear clinical benefits, however, and several have been approved by the Food and Drug Administration (FDA) for use by people with bipolar disorder, nerve pain, or fibromyalgia.
The anticonvulsants are generally safe, but in rare cases can cause serious side effects. Newer anticonvulsants marketed since the late 1990s have sometimes been put forth as safer and posing less risk of adverse effects than older ones. Studies do not support this conclusion.
Taking cost, dosing convenience, and the evidence for effectiveness, safety, and adverse effects into consideration, we have chosen the following as Consumer Reports Best Buy Drugs if your doctor and you have decided to try an anticonvulsant:
- Generic carbamazepine – for treating the mania phase of bipolar disorder or trigeminal neuralgia, a type of nerve pain that affects facial nerves
- Generic valproic acid – for treating the mania phase of bipolar disorder
- Lamotrigine (Lamictal) – for treating both the mania and depressive phases of bipolar disorder
- Generic gabapentin – for treating the nerve pain associated with diabetes or herpes zoster infection (shingles)
- Pregabalin (Lyrica) – for treating the nerve pain associated with diabetes or herpes zoster infection (shingles)
Lamictal, Lyrica and higher doses of both generic gabapentin and generic valproic acid are relatively costly medicines. But the evidence for their effectiveness, for the indications given, justify their selection as Best Buys providing good value for the money.
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| Recommendations: Anticonvulsants Drugs | ||||||
| CR Best Buy | Generic Name and Dose | Brand Name (or Generic)2 | Number of Pills Per Day2 | Total Daily Dose3 | Average Monthly Cost4 | Compare Prices |
| Carbamazepine 200mg tablet | Epitol | Two-Five | 400-1,000mg | $14-$35 |  |
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| Carbamazepine 200mg tablet | Tegretol | Two-Five | 400-1,000mg | $58-$145 | |
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Carbamazepine 200mg tablet | Generic | Two-Five | 400-1,000mg | $6-$15 | |
| Carbamazepine 100mg chewable tablet | Tegretol | Two-Six | 200-600mg | $36-$108 | |
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Carbamazepine 100mg chewable tablet | Generic | Two-Six | 200-600mg | $16-$48 | |
| Carbamazepine 100mg SR tablet5 | Carbatrol | Two-Four | 200-400mg | $98-$196 | |
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| Carbamazepine 200mg SR tablet | Carbatrol | Two-Four | 400-800mg | $90-$180 | |
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| Carbamazepine 300mg SR tablet | Carbatrol | Two-Three | 600-900mg | $92-$138 | |
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| Carbamazepine 100mg SR tablet | Tegretol XR | Two-Four | 200-400mg | $36-$72 | |
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| Carbamazepine 200mg SR tablet | Tegretol XR | Two-Four | 400-800mg | $64-$128 | |
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| Carbamazepine 400mg SR tablet | Tegretol XR | Two-Four | 400-1,600mg | $120-$240 | |
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| Carbamazepine 100mg SR tablet | Equetro | Two-Four | 200-400mg | $100-$200 | |
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| Carbamazepine 200mg SR tablet | Equetro | Two-Four | 400-800mg | $106-$212 | |
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| Carbamazepine 300mg SR tablet | Equetro | Two-Four | 600-1,200mg | $96-$192 | |
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| Divalproex 125mg tablet | Depakote | Two-Four | 250-500mg | $66-$132 | |
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| Divalproex 125mg | DepakoteSprinkle | Two-Four | 250-500mg | $62-$124 | |
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| Divalproex 250mg tablet | Depakote | Two-Four | 500-1,000mg | $114-$228 | |
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| Divalproex 500mg tablet | Depakote | Two-Four | 1,000-2,000mg | $202-$404 | |
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| Divalproex 250mg SR tablet | Depakote ER | One-Four | 250-1,000mg | $57-$228 | |
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| Divalproex 500mg SR tablet | Depakote ER | One-Four | 500-2,000mg | $94-$376 | |
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| Ethotoin 250mg tablet | Peganone | Five-Ten | 1,250-2,500mg | $220-$440 | |
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| Gabapentin 100mg capsule | Neurontin | Two-Four | 200-400mg | $48-$96 | |
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| Gabapentin 300mg capsule | Neurontin | Two-Four | 600-1,200mg | $120-$240 | |
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| Gabapentin 400mg capsule | Neurontin | Two-Four | 800-1,600mg | $140-$280 | |
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| Gabapentin 600mg tablet | Neurontin | One-Three | 600-1,800mg | $109-$327 | |
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| Gabapentin 800mg tablet | Neurontin | One-Two | 800-1,600mg | $133-$266 | |
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Gabapentin 100mg tablet | Generic | Two-Four | 200-400mg | $38-$76 | |
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Gabapentin 300mg tablet | Generic | Two-Four | 600-1,200mg | $88-$176 | |
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Gabapentin 400mg tablet | Generic | Two-Four | 800-1,600mg | $92-$184 | |
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Gabapentin 600mg tablet | Generic | Two-Four | 1,200-2,400mg | $122-$244 | |
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Gabapentin 800mg tablet | Generic | Two-Three | 1,600-2400mg | $140-$210 | |
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Gabapentin 100mg capsule | Generic | Two-Four | 200-400mg | $32-$64 | |
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Gabapentin 300mg capsule | Generic | Two-Four | 600-1,200mg | $88-$176 | |
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Gabapentin 400mg capsule | Generic | Two-Four | 800-1,600mg | $80-$160 | |
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Lamotrigine 25mg tablet | Lamictal | One-Two | 25-50mg | $166-$332 | |
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Lamotrigine 100mg tablet | Lamictal | One-Two | 100-200mg | $170-$340 | |
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Lamotrigine 150mg tablet | Lamictal | One-Two | 150-300mg | $188-$376 | |
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Lamotrigine 200mg tablet | Lamictal | One-Two | 200-400mg | $198-$396 | |
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Lamotrigine 5mg dissolving tablet | Lamictal | One-Three | 5-15mg | $162-$486 | |
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Lamotrigine 5mg dissolving tablet | Generic | One-Three | 5-15mg | $123-$369 | |
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Lamotrigine 25mg dissolving tablet | Generic | One-Two | 25-50mg | $128-$256 | |
| Levetiracetam 250mg tablet | Keppra | Three-Six | 750-1,500mg | $285-$570 | |
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| Levetiracetam 500mg tablet | Keppra | Two-Six | 1,000-3,000mg | $220-$660 | |
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| Levetiracetam 750mg tablet | Keppra | Two-Four | 1,500-3,000mg | $308-$616 | |
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| Levetiracetam 1,000mg tablet | Keppra | One-Three | 1,000-3,000mg | $212-$636 | |
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| Oxcarbazepine 150mg tablet | Trileptal | Three-Five | 450-750mg | $189-$315 | |
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| Oxcarbazepine 300mg tablet | Trileptal | Two-Five | 600-1,500mg | $222-$555 | |
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| Oxcarbazepine 600mg tablet | Trileptal | Two-Four | 1,200-2,400mg | $394-$788 | |
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Pregabalin 25mg capsule | Lyrica | Two-Three | 50-75mg | $168-$252 | |
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Pregabalin 50mg capsule | Lyrica | Two-Three | 100-150mg | $162-$243 | |
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Pregabalin 75mg capsule | Lyrica | Two-Three | 150-225mg | $164-$246 | |
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Pregabalin 100mg capsule | Lyrica | Two-Three | 200-300mg | $162-$243 | |
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Pregabalin 150mg capsule | Lyrica | Two-Three | 300-450mg | $160-$240 | |
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Pregabalin 200mg capsule | Lyrica | Two | 400mg | $154 | |
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Pregabalin 225mg capsule | Lyrica | Two | 450mg | $154 | |
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Pregabalin 300mg capsule | Lyrica | Two | 600mg | $160 | |
| Phenytoin 50mg tablet | Dilantin | Three-Four | 150-200mg | $45-$60 | |
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| Phenytoin 50mg chewable tablet | Dilantin | Three-Four | 150-200mg | $51-$68 | |
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| Phenytoin 30mg ER capsule6 | Dilantin | One-Four | 30-120mg | $14-$56 | |
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| Phenytoin 100mg ER capsule | Dilantin | One-Four | 100-400mg | $13-$39 | |
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| Phenytoin 100mg tablet | Generic | Three-Four | 300-400mg | $36-$48 | |
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| Phenytoin 100mg ER capsule | Generic | One-Four | 100-400mg | $10-$40 | |
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| Phenytoin 200mg ER capsule | Dilantin | One-Three | 200-600mg | $27-$81 | |
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| Phenytoin 300mg ER capsule | Phenytek | One-Three | 300-900mg | $39-$117 | |
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| Tiagabine 2mg tablet | Gabitril | Two-Four | 4-8mg | $232-$464 | |
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| Tiagabine 4mg tablet | Gabitril | Two-Four | 8-16mg | $232-$464 | |
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| Tiagabine 12mg tablet | Gabitril | Two-Four | 24-48mg | $272-$544 | |
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| Tiagabine 16mg tablet | Gabitril | Two-Three | 32-48mg | $346-$519 | |
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| Topiramate 25mg tablet | Topamax | Two | 50mg | $164 | |
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| Topiramate 50mg tablet | Topamax | Two | 100mg | $316 | |
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| Topiramate 100mg tablet | Topamax | Two | 200mg | $426 | |
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| Topiramate 200mg tablet | Topamax | Two | 400mg | $494 | |
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| Topiramate 15mg capsule | Topamax | Two | 30mg | $176 | |
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| Topiramate 25mg capsule | Topamax | Two | 50mg | $220 | |
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| Valproic Acid 250mg capsule | Depakene | Two-Eight | 500-2,000mg | $184-$736 | |
|
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Valproic Acid 250mg tablet | Generic | Two-Eight | 500-2,000mg | $24-$96 | |
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Valproic Acid 250mg capsule | Generic | Two-Eight | 500-2,000mg | $15-$120 | |
| Zonisamide 25mg capsule | Zonegran | Two-Four | 50-100mg | $56-$112 | |
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| Zonisamide 50mg capsule | Zonegran | Two-Four | 100-200mg | $96-192 | |
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| Zonisamide 100 mg capsule | Zonegran | Two-Four | 200-400mg | $214-$428 | |
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| Zonisamide 25mg capsule | Generic | Two-Four | 50-100mg | $40-$80 | |
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| Zonisamide 50mg capsule | Generic | Two-Four | 100-200mg | $68-$136 | |
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| Zonisamide 100mg capsule | Generic | Two-Four | 200-400mg | $122-$244 | |
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1. "Generic" indicates that this is the generic version of this drug at the dose given.
2. Reflects typical or commonly recommended dosing. Many of the anticonvulsants are prescribed at widely varying doses that may be less than or greater than the range indicated in this table. With many drugs in this tablet, it is also common to start at a lower dose for two weeks or more and have the dose increased over the next few weeks. Many of the drugs are ineffective or only marginally effective at too low a dose.
3. See note 2.
4. Prices reflect nationwide retail averages for April 2007. They are rounded to the nearest dollar. Information derived by Consumer Reports Best Buy Drugs from data provided by Wolters Kluwer Health, Pharmaceutical Audit Suite.
5. SR=Sustained release
6. ER=Extended release
