WITHDRAWN: Anticonvulsants for fibromyalgia.

Area of Science:

• Pharmacology
• Neurology
• Rheumatology

Background:

• Fibromyalgia (FM) is a chronic condition causing widespread pain, fatigue, and sleep disturbances, impacting quality of life.
• Anticonvulsants are frequently prescribed for chronic pain syndromes, including FM.

Purpose of the Study:

• To evaluate the efficacy and safety of anticonvulsant medications for treating fibromyalgia symptoms.
• To assess the benefits and harms of anticonvulsants in FM patients.

Main Methods:

• Systematic review of randomized controlled trials (RCTs) involving anticonvulsants for FM treatment.
• Searched multiple databases (CENTRAL, MEDLINE, PsycINFO, SCOPUS) and clinical trial registries for relevant studies.
• Included eight RCTs (pregabalin, gabapentin, lacosamide, levetiracetam) with 2480 participants in anticonvulsant groups and 1099 in placebo groups.

Main Results:

• Pregabalin showed a statistically significant benefit in reducing pain (NNTB=12) and improving overall patient-reported outcomes compared to placebo.
• Pregabalin did not substantially reduce fatigue (SMD -0.17) but offered a small benefit for sleep problems (SMD -0.35).
• Higher dropout rates due to adverse events (NNTH=13) were observed with pregabalin, with dizziness being a common side effect (NNTH=4).

Conclusions:

• Pregabalin provides a small benefit for fibromyalgia pain and sleep, but not fatigue.
• Increased adverse events, particularly dizziness, necessitate careful consideration of pregabalin's risk-benefit profile.
• Evidence for other anticonvulsants (gabapentin, lacosamide, levetiracetam) in FM is insufficient to draw definitive conclusions.