Topiramate relieves refractory trigeminal neuralgia in MS patients

Medical management of trigeminal neuropathic pains

“…The DMKG group [79] evaluated misoprostol in 14 patients and showed benefit in the short term. Topiramate was found to be effective in six patients [80].…”

A Randomized Placebo-Controlled Trial of Duloxetine for Central Pain in Multiple Sclerosis

“…It is unknown whether differences in disease mechanism causing nerve pain alter the responsiveness to analgesia. 10 There have been few randomized controlled trials (RCTs) of pharmacotherapeutics for MS pain, and most of those studies have focused on treating trigeminal neuralgia in MS. [11][12][13][14][15] Three RCTs examined the use of cannabinoid derivatives (oral or oropharyngeal spray preparations) for MSrelated pain including dysesthetic limb pain and painful spasms. The studies found some evidence of effectiveness in pain relief, but the utility of these medications is limited by safety concerns, adverse effects, and their status with the Drug Enforcement Agency.…”

Newer antiepileptic drugs: Possible uses in the treatment of neuropathic pain and migraine

“…One case report of a patient with intercostal neuralgia cited some benefit, 113 and a small case series (N = 6) reported dramatic benefit in patients with trigeminal neuralgia. 114 However, a later placebo-controlled, crossover study in 3 patients with trigeminal neuralgia failed to show an advantage for topiramate relative to placebo. 91 …”