Trigeminal Neuralgia
Medications
A trial of medication is almost always warranted for patients with trigeminal neuralgia before considering more invasive treatments such as surgery. In fact, patients with newly diagnosed TN tend to consistently obtain pain relief with carbamazepine (Tegretol), at least for a while. This response to Tegretol can be a powerful and reliable indicator that the patient does indeed have TN, and not some other type of pain problem. There are some patients however, who have do have typical TN, for whom Tegretol does not provide any benefit.
Carbamazepine (Tegretol) is the primary drug that has been and continues to be used for the medical treatment of TN. This medication (as well as most of the medications used for TN) belong to the class of drugs known as anti-convulsants or anti-epileptic drugs (AED), that is, drugs that are typically used to treat seizures. These drugs are believed to be effective because it thought that the abnormal electrical impulses that produce pain in TN are similar to the electrical abnormalities in patients with epilepsy.
Tegretol should be started at a low dose, perhaps 100mg once or twice daily. Patients who start out at too high of a dose will commonly develop side effects that cause them to stop the medication. Many of these side effects can be avoided simply by beginning at a small dose and gradually increasing the amount of medicine every few days. Some patients will obtain pain relief with a small dose of medication while others may require higher doses in order to achieve a positive effect. Generally, the upper dose limit is around 1200mg per day although some patients do take higher daily doses without problems. The most common side effects of Tegretol include drowsiness, dizziness, nausea, and mental dullness. These side effects can be particularly troublesome in elderly patients. Patients taking Tegretol should have their blood count and liver function monitored every few months.
Although Tegretol is probably the most common medication for TN, a number of other medications have been and are currently used. Below is a list of these medications.
Carbamazepine (Tegretol)
Oxcarbazepine (Trileptal)
Gabapentin (Neurontin)
Phenytoin (Dilantin)
Valproic acid (Depakote)
Lamotrigene (Lamictal)
Topamax (Topirimate)
Keppra (Levateracitam)
Lyrica (Pregabalin)
Amitriptyline (Elavil)
Nortriptyline (Pamelor)
Desipramine
Baclofen
Clonazepam (Klonopin)
Carbamazepine (Tegretol) is the primary drug that has been and continues to be used for the medical treatment of TN. This medication (as well as most of the medications used for TN) belong to the class of drugs known as anti-convulsants or anti-epileptic drugs (AED), that is, drugs that are typically used to treat seizures. These drugs are believed to be effective because it thought that the abnormal electrical impulses that produce pain in TN are similar to the electrical abnormalities in patients with epilepsy.
Tegretol should be started at a low dose, perhaps 100mg once or twice daily. Patients who start out at too high of a dose will commonly develop side effects that cause them to stop the medication. Many of these side effects can be avoided simply by beginning at a small dose and gradually increasing the amount of medicine every few days. Some patients will obtain pain relief with a small dose of medication while others may require higher doses in order to achieve a positive effect. Generally, the upper dose limit is around 1200mg per day although some patients do take higher daily doses without problems. The most common side effects of Tegretol include drowsiness, dizziness, nausea, and mental dullness. These side effects can be particularly troublesome in elderly patients. Patients taking Tegretol should have their blood count and liver function monitored every few months.
Although Tegretol is probably the most common medication for TN, a number of other medications have been and are currently used. Below is a list of these medications.
Anti-Convulsant Medications
Carbamazepine (Tegretol)
Oxcarbazepine (Trileptal)
Gabapentin (Neurontin)
Phenytoin (Dilantin)
Valproic acid (Depakote)
Lamotrigene (Lamictal)
Topamax (Topirimate)
Keppra (Levateracitam)
Lyrica (Pregabalin)
Anti-Depressant Medications
Amitriptyline (Elavil)
Nortriptyline (Pamelor)
Desipramine
Other Medications
Baclofen
Clonazepam (Klonopin)