Anticonvulsants for neuropathic pain: gaps in the evidence

To summarize the available evidence on the use of anticonvulsant drugs for the treatment of various conditions of neuropathic pain.

This is a systematic review on quantity and quality of evidence for using anticonvulsants in the management of neuropathic pain. Medical Subject Heading terms searched were "anticonvulsants" and "pain." Data sources used were the Cochrane Controlled Trials Register, Cochrane Database of Systematic Reviews, Medline 1966 to May 2006, Embase 1980 to May 2006, and CINAHL 1982 to May 2006. Additional studies were identified by hand searching the reference lists of retrieved papers and by autoalerts subsequent to May 2006. Randomized controlled trials, systematic reviews, and meta-analyses included. Non-English papers excluded. Evidence and evidence gaps with regard to specific conditions and drugs identified.

Concise summary of all existing evidence or lack thereof was produced. A succinct table is presented of the efficacy of specific drugs for specific conditions and the nature and quality of evidence. The paper outlines the incidence of specific neuropathic pain conditions within various population groups and assesses the quantity of available evidence in regard to the frequency that those conditions are likely to occur.

Gaps in the evidence are striking. Recommendations directly supported by the evidence by drug and by condition are made.