Anti-convulsant Drugs: Differential Indications – Neuropathic Pain and Migraine

Baron, R.; Sachau, J.

doi:10.1007/978-3-319-56015-1_379-1

R. Baron⁶ &
J. Sachau⁶

214 Accesses
1 Citations

Abstract

Neuropathic pain and migraine are highly prevalent in the population. However, treatment of these chronic pain conditions still remains challenging. Anti-convulsant drugs are one therapeutic option for both neuropathic pain and migraine acting via inhibition of neuronal hyperexcitability. The following chapter presents a summary of available anti-convulsants in the treatment of neuropathic pain and in migraine prophylaxis. We focus on the underlying pathophysiological mechanisms targeted by anti-convulsants, current recommendations in guidelines, and common adverse events. We also show results of current studies, providing new approaches considering the use of anti-convulsants in personalized treatment of neuropathic pain and migraine.

Neuropathic pain and migraine are common causes for chronic pain in clinical practice and are often experienced as being very exhausting by affected patients. Although neuropathic pain and migraine are different diseases in general, they might share some common pathophysiological mechanisms, i.e., hyperexcitability and sensitization ((Vécsei, Majláth, Balog, Tajti, CNS Neurol Disord Drug Targets 14:664–676, 2015)), underpinned by allodynia of the skin. Since epilepsy is also known to arise as a consequence of neuronal hyperexcitability, it is rational to believe that anti-convulsants might be effective in the treatment of both, neuropathic pain and migraine. In the following paragraphs, the specific molecular changes in the nociceptive system which are targeted by anti-convulsants and the role of these drugs in the treatment armamentarium of neuropathic pain and migraine are summarized.

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Division of Neurological Pain Research and Therapy, University Hopsital Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
R. Baron & J. Sachau

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Dept Psychiatry , Psychosomatics & Psychotherapy, University of Würzburg, Medical School Clinical Neurochemistry, Würzburg, Germany
Peter Riederer
Inst für Psychologische Medizin, Haag, Bayern, Germany
Gerd Laux
Department of Psychiatry, University of Toronto Department of Psychiatry, Toronto, ON, Canada
Benoit Mulsant
Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China
Weidong Le
Fujita Health University School Medicine, Toyoake, Aichi, Japan
Toshiharu Nagatsu

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Beta Neurology – Competence Center for Epilepsy, Beta Klinik GmbH, Bonn, Germany
Christian E. Elger

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Baron, R., Sachau, J. (2020). Anti-convulsant Drugs: Differential Indications – Neuropathic Pain and Migraine. In: Riederer, P., Laux, G., Mulsant, B., Le, W., Nagatsu, T. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_379-1

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DOI: https://doi.org/10.1007/978-3-319-56015-1_379-1
Received: 12 June 2019
Accepted: 02 December 2019
Published: 18 February 2020
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-56015-1
Online ISBN: 978-3-319-56015-1
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