جۆری توێژینهوه: Original Article
/ Dean of the College/ College of Pharmacy/ University of Mosul/ Mosul/Iraq
Department of Pharmacology/ College of Medicine/University of Mosul/ Iraq.
Department of Pharmacology and Toxicology/College of Pharmacy/ University of Mosul/ Mosul/Iraq.
Department of Pharmacology and Toxicology/College of Pharmacy/ University of Mosul/ Mosul/Iraq
Head of the Department of Pharmacology and Toxicology/College of Pharmacy/ University of Mosul/ Mosul/Iraq.
/ Department of Pharmacology and Toxicology/College of Pharmacy/ University of Mosul/ Mosul/Iraq
Background: Trigeminal neuralgia (TN) is a painful symptom that impact the trigeminal nerve, whose primary function is to provide sensory and motor innervation to the face. The standard therapy is with carbamazepine (CMZ). Aims: The aim of the present study is to compare published data for studies comparing newly introduced antiepileptic or non-antiepileptic agents versus CMZ. Results: Short-term use confirms that gabapentin is significantly more effective than CMZ, however, long-term use showed a non-significant difference between compared studies. Present clinical trials showed therapeutic effectiveness of topiramate not to differ from CMZ in the management of TN. However, a large-scale data analysis showed a favourable effect of topiramate compared with CMZ after a treatment of 8 weeks period. CMZ was useful for 90.5% of the patients with pain relief (p < 0.05), in comparison to 62% of patients using lamotrigine. Three studies have compared CMZ to tizanidine, tocainide and pimozide, and only pimozide was superior to CMZ. These studies have shown that CMZ is still the drug of choice for TN. Lamotrigine and pimozide are recommended as second line drugs indicated for refractory cases. Topiramate and tocainide had no sufficient analgesic effects. Conclusions: There is low-quality evidence that the effect of anti-epileptics or tizanidine is not significantly different than that of CMZ in treating TN. Pimozide is more effective than CMZ, although the evidence is insufficient, and the data did not allow comparison of adverse event rates.
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