(FDA approved in bold)

• Partial-onset seizures (adjunctive for adults)
  
• Neuropathic pain associated with post-herpetic neuralgia
  
• Neuropathic pain associated with diabetic peripheral neuropathy
  
• Fibromyalgia
  
• Migraine prophylaxis
  
• Facial pain
  
• Panic disorder
  
• Mania or bipolar disorder
  
• Generalized anxiety disorder
  
• Alcohol/benzodiazepine withdrawal

• Structural analog of GABA that binds at the α₂δ subunit and reduces calcium influx. Changes calcium channel function but not a channel blocker
  
• Reduces release of excitatory neurotransmitters, such as glutamate, noradrenaline and substance P
  
• Inactive at GABA receptors and does not affect GABA uptake or degradation

• Seizures – 2 weeks
  
• Pain/anxiety – days-weeks
  
• Fibromyalgia – often in the first week

• Seizures – goal is the remission of seizures. Continue as long as effective and well-tolerated. Consider tapering and slowly stopping after 2 years without seizures, depending on the type of epilepsy
  
• Pain – goal is reduction of pain. Usually reduces but does not cure pain and there is recurrence off the medication. Consider tapering for conditions that may improve over time, i.e., post-herpetic neuralgia or fibromyalgia

• Epilepsy: consider changing to another agent, adding a second agent or referral for epilepsy surgery evaluation
  
• Pain: If not effective in 2 months, consider stopping or using another agent

• Epilepsy: No major drug interactions with other AEDs. Using in combination may worsen CNS side effects or weight gain
  
• Neuropathic pain: Can use with tricyclic antidepressants, SNRIs, other AEDs or opioids to augment treatment response. Proven to decrease opioid requirements in patients with post-herpetic neuralgia
  
• Anxiety: Usually used as an adjunctive agent with SSRIs, SNRIs, MAO inhibitors, or benzodiazepines

• No regular blood tests are recommended