Anticonvulsants for pain - professional information
NICE have produced guidance on drug treatment of neuropathic pain (CG96). While much of this concurs with the guidelines we have formulated locally in Gloucestershire, and has been incorporated into these guidelines, the guidelines focus heavily on pregabalin rather than gabapentin. We feel (in keeping with many localites in the UK) that this is illogical and that greater flexibility in this offers a very substantial saving in prescribing costs. We have therefore positioned pregabalin as third line after gabapentin in the Gloucestershire guidelines.
We have also drafted advice on review and possible down-titration of pregabalin. This guidance is currently being trialled and is posted here.
Links
Bandolier review of anticonvulsants in chronic pain, and Bandolier review of pregabalin (2010)
Pain Service Website, Gloucestershire Hospitals NHS Foundation Trust
Webmaster Dr J G de Courcy, Consultant in Pain Medicine and Anaesthesia
email: pain.webmaster[at]glos.nhs.uk