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Anticonvulsants Drugs: Summary of Recommendations
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.
Anticonvulsant Drugs: Drug Comparison
Recommendations: Anticonvulsant Drugs
CR Best Buy Generic Name and Dose Brand Name (or Generic)2 Number of Pills Per Day2 Total Daily Dose3 Average Monthly Cost4 Compare
Prices
  Carbamazepine 200mg tablet Epitol Two-Five 400-1,000mg $4-$10
  Carbamazepine 200mg tablet Tegretol Two-Five 400-1,000mg $64-$160
best buy Carbamazepine 200mg tablet Generic Two-Five 400-1,000mg $16-$40
  Carbamazepine 100mg SR capsule Carbatrol Two-Four 200-400mg $106-$212
  Carbamazepine 100mg SR tablet Tegretol XR Two-Four 200-400mg $40-$80
  Divalproex 250mg tablet Depakote Two-Four 500-1,000mg $134-$268
  Divalproex 250mg SR tablet Depakote ER One-Four 250-1,000mg $61-$244
  Ethotoin 250mg tablet Peganone Five-Ten 1,250-2,500mg $405-$810
  Gabapentin 400mg capsule Neurontin Two-Four 800-1,600mg $160-$320
best buy Gabapentin 400mg tablet Generic Two-Four 800-1,600mg $92-$184
best buy Lamotrigine 100mg tablet Lamictal One-Two 100-200mg $186-$372
best buy Lamotrigine 5mg dissolving tablet Lamictal One-Three 5-15mg $171-$513
best buy Lamotrigine 5mg dissolving tablet Generic One-Three 5-15mg $118-$354
  Levetiracetam 500mg tablet Keppra Two-Six 1,000-3,000mg $228-$684
  Oxcarbazepine 300mg tablet Trileptal Two-Five 600-1,500mg $248-$620
best buy Pregabalin 100mg capsule Lyrica Two-Three 200-300mg $174-$261
  Phenytoin 100mg ER capsule Dilantin One-Four 100-400mg $14-$56
  Phenytoin 100mg ER capsule Generic One-Four 100-400mg $9-$36
  Tiagabine 4mg tablet Gabitril Two-Four 8-16mg $230-$460
  Topiramate 100mg tablet Topamax Two 200mg $442
  Topiramate 25mg capsule Topamax Two 50mg $220
  Valproic Acid 250mg capsule Depakene Two-Eight 500-2,000mg $180-$720
best buy Valproic Acid 250mg capsule Generic Two-Eight 500-2,000mg $18-$72
  Zonisamide 50mg capsule Zonegran Two-Four 100-200mg $668-$1,336
  Zonisamide 50mg capsule Generic Two-Four 100-200mg $60-$120

1. "Generic" indicates that this is the generic version of this drug at the dose given.

2. Reflects typical or commonly recommended dosing. Many of the anticonvulsants are prescribed at widely varying doses that may be less than or greater than the range indicated in this table. With many drugs in this tablet, it is also common to start at a lower dose for two weeks or more and have the dose increased over the next few weeks. Many of the drugs are ineffective or only marginally effective at too low a dose.

3. See note 2.

4. Prices reflect nationwide retail averages for April 2007. They are rounded to the nearest dollar. Information derived by Consumer Reports Best Buy Drugs from data provided by Wolters Kluwer Health, Pharmaceutical Audit Suite.
5. SR=Sustained release

6. ER=Extended release