Analgesics are commonly used and may reduce the symptoms of pain in some but not all people with fibromyalgia. In fibromyalgia, there is no sign of inflammation, but anti-inflammatories may provide partial pain relief to some people with fibromyalgia. A controlled study of their use for fibromyalgia has shown them to be no more effective in reducing pain than a placebo. Prolonged use of anti-inflammatories may cause gastrointestinal bleeding. Anticonvulsants may provide effective pain relief for patients with chronic neuropathic pain, migraines, trigeminal neuralgia.
Anticonvulsants have an analgesic effect, although at similar risk of minor adverse effects.
Drowsiness, dizziness, and disturbance in gait were the common problems in controlled studies. Anticonvulsant drugs have been used in pain management since the 1960s, soon after they were first used to revolutionise the management of epilepsy. The clinical impression is that they are useful for neuropathic pain, especially when the pain is lancinating or burning. In controlled clinical trials, carbamazepine has been shown to be effective in the treatment of psychomotor and grand mal seizures, as well as trigeminal neuralgia. When anticonvulsants are used as adjuvant drugs in other pain syndromes valproate is often preferred to carbamazepine because it may be better tolerated.