• Jayantee Kalita, Satish Chandra, and Usha Kant Misra.
• Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
• Neurol India. 2017 May 1; 65 (3): 506-511.

BackgroundComparative study of Class I drugs in central poststroke pain (CPSP) is lacking.ObjectiveTo evaluate the safety and efficacy of pregabalin and lamotrigine in patients with CPSP.SettingTertiary care teaching referral hospital.MethodsWe included consecutive patients with CPSP having ≥50 mm score on Visual Analog Scale (VAS) and randomized them to receive either oral pregabalin or oral lamotrigine. Their clinical findings, serum chemistry, and cranial magnetic resonance imaging findings were noted. The severity of CPSP was assessed by VAS while the allodynia was assessed on a 0-10 scale. The hospital anxiety and depression (HAD) score was also recorded. The primary outcome was> 50% reduction in the VAS score while the secondary outcome was> 50% reduction in the severity of allodynia and improvement in HAD score at 3 months. Adverse reactions were noted in both the groups.ResultsThere were 30 patients with CPSP with a median age of 54.5 years (Male:Female = 36:4). While both pregabalin (P < 0.0001) and lamotrigine (P < 0.0001) resulted in significant improvement in the VAS score (63.3% vs. 53.3%), allodynia (66.7% vs. 75%), and HAD score (80% vs. 81.8%) compared to the baseline, the was no significant intergroup difference. Lamotrigine had to be withdrawn in three patients due to skin rash.ConclusionsBoth pregabalin and lamotrigine are equally effective in CPSP, but significant side effects leading to drug withdrawal occured with lamotrigine administration.

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