From the Research
Lamotrigine is not recommended as a first-line treatment for post-stroke neuropathic pain due to lack of convincing evidence of its efficacy at doses of 200-400 mg daily, as shown in the most recent and highest quality study 1. The use of lamotrigine for post-stroke neuropathic pain has been studied in several trials, but the evidence is not strong enough to support its use as a first-line treatment.
- The study by 2 found that lamotrigine 200 mg/d reduced the median pain score in patients with central post-stroke pain, but this study is outdated and has been superseded by more recent and higher quality studies.
- The Cochrane review by 1 found no convincing evidence that lamotrigine is effective in treating neuropathic pain and fibromyalgia at doses of 200 mg to 400 mg daily, and highlighted the adverse effect profile of lamotrigine as a concern.
- Other studies, such as 3 and 4, also found limited evidence to support the use of lamotrigine for post-stroke neuropathic pain.
- The study by 5 reported a case of a patient with severe central post-stroke pain benefiting from a combination of Western multidisciplinary therapies and acupuncture, but this is a single case report and not a randomized controlled trial. Overall, the lack of convincing evidence of efficacy and the potential for adverse effects make lamotrigine a less desirable option for post-stroke neuropathic pain, and other treatments should be considered first.