A Comparative Study between Oxcarbazepine and Gabapentin Regarding Therapeutic Efficiency and Tolerability in the treatment of Trigeminal Neuralgia

Debta, Fakir Mohan; Ghom, Anil; Shah, Jigna S; Debta, Priyanka

doi:10.5005/jp-journals-10011-1003

Cited by 3 publications

(2 citation statements)

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“…Debta et al found the efficacy of gabapentin alone in newly diagnosed trigeminal neuralgia patients to be 60–80%, but inferior to treatment with oxcarbazepine. 79 Lemos et al showed that patients receiving gabapentin in combination with ropivacaine block had a significantly lower number of pain days than with one of the treatments alone, p=0.003. 103 Cheshire et al examined 194 cases of TN, many of whom had paroxysmal facial pain resistant to previous surgical interventions or treatment with multiple medications.…”

Section: Medical Managementmentioning

confidence: 99%

“…Three randomized, double-blind controlled trials have compared oxcarbazepine to carbamazepine in TN patients. 71,72,[77][78][79][80] Both reduced the number of painful attacks and global pain assessments significantly. In a study of typical TN unresponsive to carbamazepine, oxcarbazepine monotherapy provided additional pain relief in 37.1% of the patients and reduced the number of pain days by at least 50% in 67.5% of them, suggesting that oxcarbazepine can be used as a salvage therapy for patients who fail carbamazepine.77…”

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confidence: 98%

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Trigeminal Neuralgia: Current Approaches and Emerging Interventions

Xu¹,

Xie²,

Jackson³

2021

JPR

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Section: Medical Managementmentioning

confidence: 99%

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confidence: 98%

Trigeminal Neuralgia: Current Approaches and Emerging Interventions

Xu¹,

Xie²,

Jackson³

2021

JPR

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Medication Management

Lake¹

2020

Trigeminal Nerve Pain

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First-Line Treatments (Table 8.1) CarbamazepineCarbamazepine was initially shown to be more effective than a placebo for treating trigeminal neuralgia in a randomized placebo-controlled trial published in 1966 [1]. At that time, doses from 100 mg three times per day to 200 mg four times per day were used. Patients using carbamazepine for 2 weeks had a 58% improvement in pain when compared to a 26% improvement in the placebo group, which was statistically significant. Carbamazepine also decreased the number of pain paroxysms by 68% and decreased triggers including eating (71%) and contact (82%). About 50% of patients on carbamazepine experience side effects, with the majority of those reporting giddiness (feeling unbalanced/lightheaded). This tended to improve the longer the patient was on the medication.In an analysis of four placebo-controlled trials of carbamazepine performed in the late 1960s, the number needed to treat was 1.7-1.8 and the medication decreased both frequency and intensity of pain attacks [2]. This analysis also found a number needed to harm of 3 for mild adverse events and 24 for serious events.Carbamazepine is an anticonvulsant medication that works as a sodium channel blocker. It stabilizes the neural membrane to decrease neural firing and propagation of synaptic signaling. It is metabolized primarily by CYP3A4, found in the liver and small intestine. Carbamazepine also induces CYP3A4; therefore, as patients

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Efficacy of gabapentin in the treatment of trigeminal neuralgia: A systematic review of randomized controlled trials

Dinh

Nguyen

et al. 2019

J of Invest & Clin Dent

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The aim of this systematic review was to determine the efficacy of gabapentin (GBP) in the treatment of pain of idiopathic trigeminal neuralgia (TN). A comprehensive literature search was conducted using the Cumulative Index of Nursing and Allied Health Literature (EBSCO Industries), Emcare (Ovid), Medline (Ovid), Medline (PubMed), Scopus (Elsevier) and Web of Science (Clarivate Analytics). The inclusion criteria comprised randomized controlled trials of GBP as a monotherapy in the treatment of idiopathic TN in adult participants and publications in English. All other study methodologies were excluded. The search yielded 1472 articles, and after exclusion, 11 full‐text articles were eligible for full‐text analysis. Only two studies met the inclusion criteria. There is insufficient evidence either to support or refute the efficacy of GBP in the management of idiopathic TN. Therefore, further well‐designed placebo‐controlled trials are required to confirm the efficacy of GBP in managing TN pain as a single therapy.

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A Comparative Study between Oxcarbazepine and Gabapentin Regarding Therapeutic Efficiency and Tolerability in the treatment of Trigeminal Neuralgia

Cited by 3 publications

References 18 publications

Trigeminal Neuralgia: Current Approaches and Emerging Interventions

Trigeminal Neuralgia: Current Approaches and Emerging Interventions

Medication Management

Efficacy of gabapentin in the treatment of trigeminal neuralgia: A systematic review of randomized controlled trials

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