Table 2.

Classification of anticonvulsants used in neuropathic pain.

Anticonvulsant	Classification	Mechanism of Action	Recommended Doses in Monotherapy	Maximum Doses
Gabapentin Pregabalin	Ion channel modulators (reduce neuronal excitability)	Calcium ion channels. Decreasing the density of pre-synaptic voltage-gated calcium channels and subsequent release of excitatory neurotransmitter	300 mg/day 150 mg/day	3600 mg/day 600 mg/day
Topiramate	Multiple mechanisms of action. increasing GABA activity and inhibiting glutamate activity, topiramate blocks neuronal excitability	Canales de iones sódicos receptores GABAA, NMDA AMPA/kainato	100–200 mg/day	1000 mg/day
Carbamazepine Oxcarbazepine Lamotrigine Phenytoin	Ion channel modulators (reduce neuronal excitability)	Sodium ion channels Selectively binds and inhibits voltage-gated sodium channels, stabilizing presynaptic neuronal membranes and inhibiting presynaptic glutamate and aspartate release. Stabilizing the inactive state of the sodium channel and prolonging the neuronal refractory period	100–200 mg/day 600 mg/day 100–200 mg/day 200–400 mg/day	1200 mg/day 2400 mg/day 600–700 mg/day 500–600 mg/day
Levetiracetam	Modulators of the presynaptic junction	Modulation of synaptic neurotransmitter release through binding to the synaptic vesicle protein SV2A in the brain	250 mg/day	1500 mg/day
Clonazepam Diazepam	GABAergic transmission enhancers (potentiate inhibitory neurotransmission)	GABA-A receptors action.	0.5–1 mg/day 5–10 mg/day	2–4 mg/day 15–20 mg/day

GABA, gamma-aminobutyric acid; GABA-A, gamma-aminobutyric acid subunit A. AMPA, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid. NMDA, N-methyl-d-aspartate; Sv2A, synaptic vesicle glycoprotein 2A.