16 Trigeminal Neuralgia Treatments: What Can Help Me?
Trigeminal neuralgia medications
Trigeminal neuralgia treatment guidelines with medication are much different from other pain condition guidelines. Because trigeminal neuralgia does not respond to anti-inflammatory medications (prescribed or over the counter) or opioids, your doctor will approach treatment with medication from a different angle.
Anticonvulsants are a first-line treatment option for trigeminal neuralgia. Common anticonvulsants include:
- Carbamazepine (e.g., Tegretol and Carbatrol)
- Oxcarbazepine (Trileptal)
- Lamotrigine (Lamictal)
- Phenytoin (Dilantin, Phenytek)
Anti-anxiety drugs such as clonazepam (Klonopin) and gabapentin (e.g., Neurontin and Gralise) may also be treatment options.
There can be serious side effects for anticonvulsant drugs, especially if they begin to lose effectiveness and are prescribed in higher doses. Side effects include dizziness, confusion, drowsiness, and nausea. For some patients, specifically of Asian descent, carbamazepine can cause a serious drug reaction. It is important to evaluate your tolerance for side effects before beginning anticonvulsant medications.
Even though pain is caused by issues in the trigeminal nerve, antispasmodic agents can work to counteract the effects of this nerve inflammation. Muscle relaxers can help ease tension in the musculature of the face and head. The most common antispasmodic medication used is baclofen (e.g., Gablofen and Lioresal), often in combination with carbamazepine. In addition to potential side effects of carbamazepine, muscle relaxants can also cause confusion, nausea, and drowsiness.
In some patients, the tricyclic antidepressant amitriptyline may help. There are plentiful adverse side effects, though, so few patients choose this therapy.