A Long‐term Low‐dosage Study of Carbamazepine in Trigeminal Neuralgia

Lloyd-Smith, Donald; Sachdev, Kuldip K.

doi:10.1111/j.1526-4610.1969.hed0901064.x

Cited by 12 publications

(10 citation statements)

References 1 publication

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“…However, there have been few reports of longterm treatment (Marotta, 1969;Lloyd-Smith and Sachdev, 1969;Petit and Christiaens, 1970;Bonduelle, 1976). The object of this paper is to report the results of long-term treatment with CBZ in the patients with TN, who have attended the Regional Department since 1962 when CBZ was first supplied in the U.K. as G32883.…”

Section: Introductionmentioning

confidence: 99%

Long-term treatment of trigeminal neuralgia with carbamazepine

Taylor

Brauer

Espir

1981

Postgraduate Medical Journal

224

119

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SummaryThe results of treating 143 patients with trigeminal neuralgia with carbamazepine (CBZ) over a 16-year period have been reviewed. The drug was effective initially with few mild side effects in 99 patients (69 %). Of these, 19 developed resistance later, i.e. between 2 months and 10 years after commencing treatment, and required alternative measures. Of the remaining 80 (56 %), the drug was effective in 49 for 1-4 years and in 31 for 5-16 years. Thirty-six patients (25%) failed to respond to CBZ initially and required alternative measures, as did 8 (6 %) who were intolerant of the drug. One patient developed CBZ-induced water intoxication with hyponatraemia. Subsequently hyponatraemia was excluded in 17 patients who had been taking CBZ for between 4 months and 7 years. This study has thus confirmed the efficacy of CBZ in the treatment of trigeminal neuralgia and shown that it may continue to be effective for many years.

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Section: Introductionmentioning

confidence: 99%

Long-term treatment of trigeminal neuralgia with carbamazepine

Taylor

Brauer

Espir

1981

Postgraduate Medical Journal

224

119

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“…However, it soon became apparent that carbamazepine, an anticonvulsant introduced in the clinic in 1959, was a more effective option for the treatment of TN [ 96 ]. This observation was supported by three placebo-controlled clinical trials [ 97 - 99 ], and since the early 1960s, carbamazepine continues to be the drug of choice for the treatment of TN [ 97 , 100 - 102 ]. However, as TN is a rare disease, the largest of these initial trials included 77 patients [ 97 ].…”

Section: Treatmentmentioning

confidence: 96%

Trigeminal Neuralgia: Basic and Clinical Aspects

et al. 2020

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The trigeminal nerve is the largest of all cranial nerves. It has three branches that provide the main sensory innervation of the anterior two-thirds of the head and face. Trigeminal neuralgia (TN) is characterized by sudden, severe, brief, and stabbing recurrent episodes of facial pain in one or more branches of the trigeminal nerve. Pain attacks can occur spontaneously or can be triggered by non-noxious stimuli, such as talking, eating, washing the face, brushing teeth, shaving, a light touch or even a cool breeze. In addition to pain attacks, a proportion of the patients also experience persistent background pain, which along with autonomic signs and prolonged disease duration, represent predictors of worse treatment outcomes. It is now widely accepted that the presence of a neurovascular compression at the trigeminal root entry zone is an anatomic abnormality with a high correlation with classical TN. However, TN may be related to other etiologies, thus presenting different and/or additional features. Since the 1960s, the anticonvulsant carbamazepine is the drug of choice for TN treatment. Although anti-epileptic drugs are commonly used to treat neuropathic pain in general, the efficacy of carbamazepine has been largely limited to TN. Carbamazepine, however, is associated with dose-limiting side-effects, particularly with prolonged usage. Thus, a better understanding and new treatment options are urgently warranted for this rare, but excruciating disease.

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“…There were 24 therapies assessed. Carbamazepine was the most common intervention examined across studies, with 19 observational studies 5,6,[20][21][22][27][28][29][30][31]33,35,[65][66][67][68][69][70][71] and 9 randomized controlled trials, 23,44,[47][48][49]58,59,62,63 followed by botulinum toxin A with 11 observational studies 8,[12][13][14][15][16][17][18][19]41,72 32 oxcarbazepine, 7,36,44 pregabalin, 39 valproic acid, 38 gabapentin, 6,21,73 lamotrigine 21,60,62,64 ), local anesthetics (lidocaine, 37,53,57,61,67 tocainide 48 ), selective serotonin receptor agonists (sumatriptan…”

Section: General Study Interventions and Outcome Measuresmentioning

confidence: 99%

“…There were 24 therapies assessed. Carbamazepine was the most common intervention examined across studies, with 19 observational studies 5,6,[20][21][22][27][28][29][30][31]33,35,[65][66][67][68][69][70][71] and 9 randomized controlled trials, 23,44,[47][48][49]58,59,62,63 followed by botulinum toxin A with 11 observational studies 8,[12][13][14][15][16][17][18][19]41,72 and 4 randomized controlled trials. 4,[50][51][52] Other pharmacologic interventions studied include antidepressants (amitriptyline, 2,11,42 duloxetine, 23,24 venlafaxine 3 ), anticonvulsants (clonazepam, 25,26,34 eslicarbazepine, ...…”

Section: General Study Interventions and Outcome Measuresmentioning

confidence: 99%

Neuromodulators for Atypical Facial Pain and Neuralgias: A Systematic Review and Meta‐Analysis

et al. 2020

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Objective: To evaluate the effectiveness of neuromodulating agents for the management of atypical facial pain and primary facial neuralgias.Methods: We searched MEDLINE, Embase, CINAHL, and ClinicalTrials.gov databases for original research articles that examine the effectiveness and adverse reactions of pharmacologic therapy for the treatment of trigeminal neuralgia and atypical facial pain. Studies that included surgical interventions for atypical facial pain or facial pain secondary to other causes were excluded. Meta-analysis was conducted for reductions in symptom scores and adverse effects.Results: Of 3,409 articles screened, 73 full-text articles were included, consisting of 45 observational studies and 29 randomized controlled trials. Twenty-four different pharmacological agents were assessed; carbamazepine was the most frequently studied while botulinum toxin A demonstrated the highest consistency in reduction of symptom scores. Pooled estimate of three randomized controlled trials revealed that patients with trigeminal neuralgia who received botulinum toxin A had higher odds (odds ratio 7.46; 95% CI 3.53-15.78) of achieving a ≥50% reduction in visual analogue scale scores compared to controls. Pooled estimate of 15 observational studies showed that three-fourths of patients with trigeminal neuralgia who received carbamazepine experienced clinically significant pain reduction (prevalence proportion 0.75; 95% CI 0.66-0.83).Conclusions: Patients receiving botulinum toxin A for trigeminal neuralgia had higher odds of achieving ≥50% reduction in pain scores. A significant proportion of patients with trigeminal neuralgia experienced positive response to carbamazepine. There was moderate evidence for amitriptyline in patients with atypical facial pain. Standardization of outcome reporting would facilitate future quantitative comparisons of therapeutic effectiveness.

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A Long‐term Low‐dosage Study of Carbamazepine in Trigeminal Neuralgia

Cited by 12 publications

References 1 publication

Long-term treatment of trigeminal neuralgia with carbamazepine

Long-term treatment of trigeminal neuralgia with carbamazepine

Trigeminal Neuralgia: Basic and Clinical Aspects

Neuromodulators for Atypical Facial Pain and Neuralgias: A Systematic Review and Meta‐Analysis

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