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(anti-seizure medications) Summary of Anti-seizure medications Some of the more effective and commonly used medications for chronic pain are drugs that were developed to control other conditions. Anti-seizure (anticonvulsant) medications were developed primarily to reduce or control epileptic seizures, but they also help control stabbing or shooting pain from nerve damage. These drugs seem to work by quieting damaged nerves to slow or prevent uncontrolled pain signals. These medications can cause dizziness, drowsiness, nausea and lack of balance and coordination. But most people are bothered only minimally. More severe but less common side effects include blood and liver disorders. To reduce your risk of side effects, your doctor will likely start you off on a small amount of the drug and gradually increase the dose while monitoring you.
Gabapentin was initially synthesized to mimic the chemical structure of the neurotransmitter gamma-aminobutyric acid (GABA), but is not believed to act on the same brain receptors. Its exact mechanism of action is unknown, but its therapeutic action on neuropathic pain is thought to involve voltage-gated N-type calcium ion channels. It is thought to bind to the α2δ subunit of the voltage-dependent calcium channel in the central nervous system Gabapentin was originally approved in the U.S. by the Food and Drug Administration in 1994 for use as an adjunctive medication to control partial seizures (effective when added to other antiseizure drugs). In 2002, approval was added for treating postherpetic neuralgia (neuropathic pain following shingles, other painful neuropathies, and nerve related pain). Although not "indicated" (i.e., not FDA-approved), gabapentin has been found to be effective in prevention of frequent migraine headaches, neuropathic pain, and nystagmus. Gabapentin has also been found to help patients with post-operative chronic pain (usually caused by nerves that have been severed accidentally in an operation and when grown back, have reconnected incorrectly). Symptoms of this include a tingling sensation near or around the area where the operation was performed, sharp shooting pains, severe aches after much movement, constant 'low ache' all day and sometimes a general 'weak' feeling. These symptoms can appear many months after an operation, and therefore the condition can go unnoticed. Gabapentin's most common side effects in adult patients include dizziness, drowsiness, and peripheral edema (swelling of extremities); these mainly occur at higher doses, in the elderly. Children 3–12 years of age were also observed to be susceptible to mild-to-moderate mood swings, hostility, concentration problems, and hyperactivity. Though gabapentin is not a controlled substance, it does produce psychoactive effects that could lead to abuse of the drug. However, it is widely regarded as having little or no abuse potential. Pregabalin, a gabapentinoid with higher potency marketed for neuropathic pain, is a controlled substance, under the DEA Schedule V.
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