Review question

What are the benefits and harms of oxcarbazepine in the treatment of pain caused by nerve damage?

Background

Neuropathic pain is pain that arises from damage to the part of the nervous system that carries sensory information (e.g. pain) to the brain. It is difficult to treat because it tends to be severe, long-lasting and does not respond well to simple painkillers. Some studies have suggested that a medicine called oxcarbazepine, when given on its own, can relieve pain from nerve damage.

Study characteristics

We searched medical databases for clinical trials looking at the potential benefits and harms of oxcarbazepine in different types of neuropathic pain and found five trials. They involved 634 participants with painful diabetic neuropathy (nerve damage), 145 people with neuropathic pain due to radiculopathy (pain that arises at the point where nerves leave the spinal column), and 83 people with peripheral neuropathic pain of various causes (e.g. peripheral nerve injury (injury to nerves that connect the brain and spinal cord to the rest of the body), polyneuropathy (damage or disease affecting several peripheral nerves) and postherpetic neuralgia (pain that occurs after shingles)). The trials all compared oxcarbazepine with placebo (a pretend treatment). Four trials were funded by the manufacturer of oxcarbazepine.

Key results and quality of the evidence

This review found little evidence to support the effectiveness of oxcarbazepine in painful diabetic neuropathy, neuropathic pain from radiculopathy and mixed neuropathies of various causes. Oxcarbazepine may have some effect, but we cannot be confident that the results would be the same with further studies. Side effects, including those that were serious or made people stop taking the medicine were probably more common with oxcarbazepine than placebo. We know of trials that have not reported results, for example in a form of facial pain called trigeminal neuralgia, and some of the trials we found did not report data in a form that we could analyse. We need more well-designed studies of oxcarbazepine for various types of neuropathic pain, with large numbers of participants spread over different centres (e.g. difference hospitals and clinics), and all relevant data need to be published or presented.

This is the first update of a review published in 2013. Evidence is up to date to November 2016.