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Consumer Reports warns that off-label use of anticonvulsants may not be the best initial treatment and is expensive.
A new report from Consumer Reports Best Buy Drugs warns patients that, although antiepileptics are routinely prescribed for off-label uses, they may not always be the best initial treatment and can be quite expensive. The report provides evidence showing efficacy in treating conditions such as neuralgia, bipolar disorder, and fibromyalgia-including several drugs that are already approved for those indications. However, it also cautions that other treatments may be more efficacious or be a better initial choice of treatment. When taking cost, evidence of efficacy, adverse effects, and dosing convenience into consideration, the report recommended carbamazepine, valproic acid, gabapentin, lamotrigine, and pregabalin (Lyrica, Pfizer) as Best Buys. The full report is available free-of-charge on-line at