Alcántara Montero A, Sánchez Carnerero C I
Unidad del Dolor, Hospital Don Benito-Villanueva de la Serena, Don Benito (Badajoz), España.
Servicio de Cirugía General y Digestiva, Hospital San Pedro de Alcántara, Cáceres, España.
Neurologia (Engl Ed). 2019 Jul-Aug;34(6):386-395. doi: 10.1016/j.nrl.2016.11.009. Epub 2017 Feb 16.
Eslicarbazepine acetate (ESL), together with carbamazepine and oxcarbazepine, belongs to the dibenzazepine family. According to the latest clinical practice guidelines, tricyclic antidepressants, dual antidepressants (venlafaxine, duloxetine), and some antiepileptics (gabapentin, pregabalin) are first-line drugs for neuropathic pain; tramadol, lidocaine 5% patches, and capsaicin 8% patches are considered second-line drugs; and strong opioids constitute a third line of treatment. Such other antiepileptics as lamotrigine and lacosamide are not authorised as treatments for neuropathic pain by the regulatory agencies, but are nonetheless prescribed off-label in routine clinical practice. Carbamazepine, on the other hand, is indicated for trigeminal and glossopharyngeal neuralgia.
We conducted a literature search to gather evidence on the use of ESL for neuropathic pain, headache, and cranial neuralgia.
Evidence is insufficient to recommend ESL for neuropathic pain, headache, and cranial neuralgia. Most of the available evidence comes from open and observational studies with small sample sizes and no control group; however, their favourable results call for further studies on the usefulness of ESL for neuropathic pain, headache, and cranial neuralgia.
醋酸艾司卡巴喷丁（ESL）与卡马西平和奥卡西平同属二苯并氮䓬类。根据最新临床实践指南，三环类抗抑郁药、双重作用抗抑郁药（文拉法辛、度洛西汀）以及一些抗癫痫药（加巴喷丁、普瑞巴林）是治疗神经性疼痛的一线药物；曲马多、5%利多卡因贴剂和8%辣椒素贴剂被视为二线药物；强效阿片类药物构成第三线治疗方案。其他抗癫痫药如拉莫三嗪和左乙拉西坦未获监管机构批准用于治疗神经性疼痛，但在常规临床实践中仍有超说明书用药的情况。另一方面，卡马西平适用于三叉神经痛和舌咽神经痛。
我们进行了文献检索，以收集有关ESL用于神经性疼痛、头痛和颅神经痛的证据。
证据不足，无法推荐ESL用于神经性疼痛、头痛和颅神经痛。现有证据大多来自样本量小且无对照组的开放性和观察性研究；然而，其良好结果表明需要进一步研究ESL用于神经性疼痛、头痛和颅神经痛的有效性。
