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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.
- 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.
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
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