A systematic review of the utility of anticonvulsant pharmacotherapy in the treatment of vulvodynia pain

Introduction: Anticonvulsants have increasingly been invoked in the treatment of vulvodynia. However, the evidence supporting this treatment approach has not been systematically assessed. Aim: The study aims to evaluate the efficacy of anticonvulsant pharmacotherapy in the treatment of vulvodynia. Methods: A comprehensive search of the available literature was conducted. Main Outcome Measure: An assessment of the methodological quality of published reports addressing the utility of anticonvulsants in the treatment of vulvodynia was undertaken. Results: The search yielded nine published reports, i.e., one open-label trial, six nonexperimental studies, and two case reports. A number of methodological shortcomings were identified in several of the reports with respect to study design, including small sample sizes, lack of placebo or other comparison groups, inadequate outcome measures, among others. The vast majority of studies employed gabapentin. Evidence supporting the benefit of anticonvulsants studied to date was limited, i.e., based predominantly upon descriptive/observational reports. There were no systematic investigations into the comparative efficacy of different anticonvulsant agents in the treatment of vulvodynia. Conclusion: Although some vulvodynia-afflicted patients derive symptom relief from anticonvulsants, there is, as yet, insufficient evidence to support the recommendation of anticonvulsant pharmacotherapy in the treatment of vulvodynia. Additional investigations, employing randomized controlled trials, are warranted.