5 doctors weighed in:

If carbamazepine isn't working to treat my trigeminal neuralgia, what is a good drug to try next?

5 doctors weighed in
Dr. Paul Grin
Pain Management

In brief: Trileptal

is reported to be effective for trigeminal neuralgia.
Some clinicians now prefer to use oxcarbazepine (Trileptal) as their first line drug for trigeminal neuralgia because of its reduced side effect profile. Unfortunately, about half of TN sufferers eventually become dissatisfied with medical therapy, explore surgical options.

In brief: Trileptal

is reported to be effective for trigeminal neuralgia.
Some clinicians now prefer to use oxcarbazepine (Trileptal) as their first line drug for trigeminal neuralgia because of its reduced side effect profile. Unfortunately, about half of TN sufferers eventually become dissatisfied with medical therapy, explore surgical options.
Dr. Paul Grin
Dr. Paul Grin
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Dr. Jeffrey Cohen
Neurology

In brief: Several

Drugs with best success rates: Carbamazepine and oxcarbazepine.
Next level: gabapentin, pregabalin. Another effective drug: baclofen. Further down the line: lacosamide, topiramate, lamotrigine, levetiracetam. Some add on treatments: topical or nasal lidocaine. The list goes on... Sometimes it isn't that the drug doesn't work, but it may not be used in the best manner.

In brief: Several

Drugs with best success rates: Carbamazepine and oxcarbazepine.
Next level: gabapentin, pregabalin. Another effective drug: baclofen. Further down the line: lacosamide, topiramate, lamotrigine, levetiracetam. Some add on treatments: topical or nasal lidocaine. The list goes on... Sometimes it isn't that the drug doesn't work, but it may not be used in the best manner.
Dr. Jeffrey Cohen
Dr. Jeffrey Cohen
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Dr. Alfredo Nieves
Gynecology

In brief: Trigeminal neuralgia

Gabapentin, lyrica, (pregabalin) elavil, Gabitril could be medications that you may want to ask your doctor about.

In brief: Trigeminal neuralgia

Gabapentin, lyrica, (pregabalin) elavil, Gabitril could be medications that you may want to ask your doctor about.
Dr. Alfredo Nieves
Dr. Alfredo Nieves
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1 comment
Dr. Stephen Rodrigues
Add in ... One can began Myofascial Release Therapy (see prior posts) early because it is already in use today in regular physical therapy, massage therapy, sports medicine and in chiropractic medicine. Self-care is a mandatory part of the therapy, so stretching, yoga Pilates, soaking and exercise are vital. For chronic pain suffers a Wellness Program of Vitamins and minerals (esp. Magnesium glycinate) sleep hygiene, exercise, self Massage, yoga, heat, Epsom tub soaking, stretching all are needed.
Dr. Sassan Hassassian
Anesthesiology

In brief: Varies

Carbamazepine used to be the main agent in treatment of trigeminal neuralgia years ago.
We now have a multitude of anti-neuropathic agents with better side effect profile. To list a few, we have lyrica, (pregabalin) neurontin, topamax, etc. The choice is based on coexisting medical issues and other medications on which patient is placed. The physician can make this determination on a case by case basis.

In brief: Varies

Carbamazepine used to be the main agent in treatment of trigeminal neuralgia years ago.
We now have a multitude of anti-neuropathic agents with better side effect profile. To list a few, we have lyrica, (pregabalin) neurontin, topamax, etc. The choice is based on coexisting medical issues and other medications on which patient is placed. The physician can make this determination on a case by case basis.
Dr. Sassan Hassassian
Dr. Sassan Hassassian
Thank
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