Lamotrigine for trigeminal neuralgia: Efficacy and safety in comparison with carbamazepine☆, ☆☆

Shaikh, Sameer; Yaacob, Hashim; Rahman, Rusdi Bin Abd

doi:10.1016/j.jcma.2011.04.002

Cited by 55 publications

(31 citation statements)

References 16 publications

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“…[ 24 ] 42 57 (30–88) BTX type A 75 U s.c. Placebo R, D-B, C 15/22 3/20 Short-term facial asymmetry (23 %) and transient oedema 12 weeks Shaikh et al. [ 14 ] 21 65 (32–84) Lamotrigine 400 mg CBZ 1200 mg R, N-B, C-O 13/21 19/21 Skin rash (LTG: 38 %, CBZ: 10 %), headache (LTG: 29 %, CBZ: 83 %), dizziness (LTG: 21 %, CBZ: 42 %); under 25 %: mental distress (both groups), altered taste sensation and pyretic feeling (LTG group), nausea (CBZ group) 83 days Kanai et al. [ 25 ] 24 63 (42–80) Sumatriptan 3 mg s.c. Placebo R, S-B, C-O 20/24 1/24 Fatigue (42 %) and nausea (17 %) 7 days Kanai et al.…”

Section: Resultsmentioning

confidence: 99%

Pharmaceutical Management of Trigeminal Neuralgia in the Elderly

Oomens

Forouzanfar

2015

Drugs Aging

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Classical trigeminal neuralgia (CTN) is a severe neuropathic pain in the distribution of one or more branches of the trigeminal nerve, which occurs in recurrent episodes, causing deterioration in quality of life, affecting everyday habits and inducing severe disability. The aim of this review is to give an overview of the current literature on pharmaceutical treatment options for CTN in the elderly. The first-line treatment for the management of CTN in adults is an antiepileptic—carbamazepine or oxcarbazepine. There is a lack of research on the use of antiepileptics in the elderly. This is a deficiency, as the use of antiepileptics raises a number of problems due to the polypharmacotherapy common in older patients. This can induce drug interactions due to co-morbidities and changes in pharmacokinetics and pharmacodynamics. Furthermore, the side effects of carbamazepine include central nervous system disturbances, such as a lack of balance, dizziness, somnolence, renal dysfunction and cardiac arrhythmias, which are poorly tolerated by the elderly. Unfortunately, the efficacy and safety of alternative treatment options have not been systematically evaluated. On the basis of the current literature, it is not possible to give an evidence-based recommendation for first-line pharmaceutical management of CTN specifically for the elderly.

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Section: Resultsmentioning

confidence: 99%

Pharmaceutical Management of Trigeminal Neuralgia in the Elderly

Oomens

Forouzanfar

2015

Drugs Aging

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“…The studies of carbamazepine's efficacy date back to the 1960s and are well summarized in the American Academy of Neurology's guidelines on the management of this condition. 33 There are some subsequent comparison studies described in this guideline and subsequently, 34 but the studies have small numbers of recruits. The NICE neuropathic pain guidelines made several suggestions for further research in this area to confirm the clinical suspicion that carbamazepine holds its place as first-line therapy.…”

Section: Carbamezapinementioning

confidence: 99%

Neuropathic pain: a pathway for care developed by the British Pain Society

Smith

Lee

Price³

et al. 2013

British Journal of Anaesthesia

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Neuropathic pain is a common chronic pain condition that can be challenging to treat, particularly for non-specialists. The development of the Map of Medicine care pathway for the management of neuropathic pain was led by the British Pain Society. Focusing on treatment by non-specialists, this pathway is based on new evidence, consensus, and the interests of service users. This paper presents the care pathway and accompanying evidence base, highlighting its salient features, and discussing important treatment points. After initial assessment, the pathway progresses through first-, second-, and third-line drug treatment, includes advice on topical treatment and opioids (in specific circumstances), and describes non-pharmacological approaches. Importantly, timely review of patients and referral to specialist secondary or tertiary care must be considered as vital components of the pathway. Although the emphasis was not on specialist treatment, advice is given on existing interventions, including neural stimulation and multi-disciplinary care. These, and other steps on the pathway, will be subject to further review as more evidence becomes available. In the meantime, the pathway represents a straightforward, valuable and accessible approach for healthcare professionals managing the distress and impact of neuropathic pain.

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“…In standard practice, the first-line treatment is carbamazepine, which can relieve most of the observed symptoms [ 22 , 64 – 66 ]. Other drugs, including oxcarbazepine [ 67 ], phenytoin [ 68 , 69 ], baclofen [ 70 , 71 ], lamotrigine [ 72 , 73 ], gabapentin [ 74 , 75 ], and sodium valproate [ 76 , 77 ], are also efficient in reducing the signs-symptoms of TN in most patients. Sometimes, some of the drugs are taken with carbamazepine as an adjuvant for the synergistic effects in relieving the TN symptoms [ 78 , 79 ].…”

Section: Trigeminal Neuralgiamentioning

confidence: 99%

Trigeminal Neuralgia, Glossopharyngeal Neuralgia, and Myofascial Pain Dysfunction Syndrome: An Update

Khan

Nishi

Hassan

et al. 2017

Pain Research and Management

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Neuropathic pain is a common phenomenon that affects millions of people worldwide. Maxillofacial structures consist of various tissues that receive frequent stimulation during food digestion. The unique functions (masticatory process and facial expression) of the maxillofacial structure require the exquisite organization of both the peripheral and central nervous systems. Neuralgia is painful paroxysmal disorder of the head-neck region characterized by some commonly shared features such as the unilateral pain, transience and recurrence of attacks, and superficial and shock-like pain at a trigger point. These types of pain can be experienced after nerve injury or as a part of diseases that affect peripheral and central nerve function, or they can be psychological. Since the trigeminal and glossopharyngeal nerves innervate the oral structure, trigeminal and glossopharyngeal neuralgia are the most common syndromes following myofascial pain dysfunction syndrome. Nevertheless, misdiagnoses are common. The aim of this review is to discuss the currently available diagnostic procedures and treatment options for trigeminal neuralgia, glossopharyngeal neuralgia, and myofascial pain dysfunction syndrome.

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Lamotrigine for trigeminal neuralgia: Efficacy and safety in comparison with carbamazepine☆, ☆☆

Abstract: LTG is generally an effective and safe treatment for management of TN, compared to CBZ.

Cited by 55 publications

References 16 publications

Pharmaceutical Management of Trigeminal Neuralgia in the Elderly

Pharmaceutical Management of Trigeminal Neuralgia in the Elderly

Neuropathic pain: a pathway for care developed by the British Pain Society

Trigeminal Neuralgia, Glossopharyngeal Neuralgia, and Myofascial Pain Dysfunction Syndrome: An Update

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