Anticonvulsant medications like gabapentin and pregabalin don’t appear to improve low back pain, a meta-analysis in the Canadian Medical Association Journal finds.
Researchers examined nine studies of nearly 900 patients with chronic low back pain or lumbar radicular pain. Patients received either anticonvulsants (gabapentinoids or topiramate) or placebo. Gabapentinoids had no effect on low back pain or disability, but topiramate appeared to have a small effect on pain in the short term. No treatment affected lumbar radicular pain.
Gabapentinoids were associated with increased risk for adverse events relative to placebo, including drowsiness, dizziness, and nausea (pooled risk ratio, 1.4). Topiramate didn’t appear to carry increased risk.
The authors conclude: “Evidence to date does not support the use of anticonvulsants for chronic low back pain or lumbar radicular pain. This review found mostly moderate- to high-level quality of evidence suggesting no treatment benefit for pain and disability, and high-level evidence supporting the risk of harms.”