Our Recommendations — A Summary

Anticonvulsant drugs are prescribed widely to treat a range of medical conditions. Among those are bipolar disorder, fibromyalgia, and nerve pain (neuralgia) caused by injuries or diseases that adversely affect the nervous system.

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.

Taking cost, dosing convenience, and the evidence for effectiveness, safety, and adverse effects into consideration, we have chosen the following as Consumer Reports Best Buy Drugs if your doctor and you have decided to try an anticonvulsant:

• 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.

This information and our report were last updated in September 2007.