Several small case series are reported in which most of the second and third generation antiepileptic drugs have been used in various chronic pain conditions, usually neuropathic pain and/or headache. The results are mostly disappointing and the few that claim efficacy are far from convincing. Some clearly negative results from large trials involving antiepileptic drugs remain unpublished. The clinician should therefore resist the temptation to try just another drug from this class when others have failed; many old and new AEDs require good understanding of their pharmacological properties and attention to detail if they are to be used safely.
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