Comparison of Effectiveness of Carbamazepine Versus Topiramate for the Management of Trigeminal Neuralgia

Abstract

Objective: To compare the effectiveness of Carbamazepine versus Topiramate for the management of trigeminal neuralgia.
 Study Design: Comparative prospective study.
 Place and Duration of Study: Oral and Maxillofacial Surgery department, Allied Hospital, Faisalabad Pakistan, from Nov 2017 to Nov 2018.
 Methodology: A total of 60 patients (30 in each group) were included. Group A was treated with Carbamazepine 100mg TDS and group B with Topiramate 25mg TDS. Visual analogue scale was used to access pain and was calculated at 1st visit (baseline), at 7th day, at 14th day and at 28th day.
 Results: Out of 60 patients, mean of age was 54.78 ± 8.49 years. Right and left side of the face was involved in 41 (68.3%) and 19 (31.7%) patients respectively. Maxillary branch was involved in 24 (40%) and mandibular branch was involved in 36 (60%) patients. The mean of visual analogue scale after 7 days in group A was 4.53 ± 0.93 and in group B was 7.1 ± 1.07, after 14 days mean of visual analogue scale in group A was 3.7 ± 1.02 and in group B was 4.03 ± 1.27. Mean of visual analogue scale after 28 days in group A was 3.27 ± 1.01 3.93 ± 1.28. The results were statistically significant with p-value of 0.03.
 Conclusion: Topiramate has comparable efficacy as that of Carbamazepine at dose of 75-100mg with lesser side effects. So Topiramate can be used as first line of treatment in trigeminal neuralgia.

Compared to oxcarbazepine and carbamazepine, botulinum toxin type A is a useful therapeutic option for trigeminal neuralgia symptoms: A systematic review

“…Among the 29 selected articles, 11 studied the effects of CBZ and OXB on the improvement of TN (Ariyawardana et al, 2003 ; Campbell et al, 1966 ; Di Stefano et al, 2014 , 2021 ; Gomez‐Arguellese et al 2008 ; Lechin et al, 1989 ; Lemos et al, 2010 ; Puri et al, 2018 ; Shaikh et al, 2011 ; Tariq et al, 2021 ; Verma et al, 2014 ; Yadav et al, 2015 ). A total of 1029 patients had been studied.…”

“…A total of 1029 patients had been studied. The oldest article was related to 1966 (Campbell et al, 1966 ), and the latest was related to 2021 (Di Stefano et al, 2021 ; Tariq et al, 2021 ). The age range of patients was 20–84 years.…”

“…The minimum sample size included 21 (Shaikh et al, 2011 ), and the maximum included 354 patients (Di Stefano et al, 2021 ). The shortest follow‐up period was 1 month (Puri et al, 2018 ; Tariq et al, 2021 ), and the longest was 87.72 months (Di Stefano et al, 2014 ). The lowest dose of CBZ was 100 mg (Ariyawardana et al, 2003 ; Tariq et al, 2021 ), and the highest was 1200 mg (Di Stefano et al, 2014 , 2021 ; Lechin et al, 1989 ; Lemos et al, 2010 ; Tariq et al, 2021 ).…”

“…The shortest follow‐up period was 1 month (Puri et al, 2018 ; Tariq et al, 2021 ), and the longest was 87.72 months (Di Stefano et al, 2014 ). The lowest dose of CBZ was 100 mg (Ariyawardana et al, 2003 ; Tariq et al, 2021 ), and the highest was 1200 mg (Di Stefano et al, 2014 , 2021 ; Lechin et al, 1989 ; Lemos et al, 2010 ; Tariq et al, 2021 ). The lowest dose of OXB was 300 mg (Di Stefano et al, 2021 ), and the maximum dose was 1800 mg (Di Stefano et al, 2014 , 2021 ).…”

“…Additional studies also suggested that Gabapentin can be more effective (Baykal & Kaplan, 2010;Lemos et al, 2010;Puri et al, 2018). Other investigations showed that CBZ was more effective compared with pimozide (Lechin et al, 1989) while duloxetine and topiramate were comparable to CBZ in recovery with fewer side effects (Tariq et al, 2021;Verma et al, 2014).…”