جۆری توێژینه‌وه‌: Original Article

نوسه‌ران

1 / Dean of the College/ College of Pharmacy/ University of Mosul/ Mosul/Iraq

2 Department of Pharmacology/ College of Medicine/University of Mosul/ Iraq.

3 Department of Pharmacology and Toxicology/College of Pharmacy/ University of Mosul/ Mosul/Iraq.

4 Department of Pharmacology and Toxicology/College of Pharmacy/ University of Mosul/ Mosul/Iraq

5 Head of the Department of Pharmacology and Toxicology/College of Pharmacy/ University of Mosul/ Mosul/Iraq.

6 / Department of Pharmacology and Toxicology/College of Pharmacy/ University of Mosul/ Mosul/Iraq

10.24271/garmian.scpas26

پوخته‌

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.

  • Besi, E. et al. (2015) ‘Comparison of tolerability and adverse symptoms in oxcarbazepine and carbamazepine in the treatment of trigeminal neuralgia and neuralgiform headaches using the Liverpool Adverse Events Profile ( AEP )’, The Journal of Headache and Pain. The Journal of Headache and Pain, pp. 1–7. doi: 10.1186/s10194-015-0563-z.
  • Campbell, F. G., Graham, J. G. and Zilkha, K. J. (1966) ‘Clinical trial of carbazepine ( Tegretol ) in trigeminal neuralgia’, pp. 265–267.
  • Chen, S. and Eisenach, J. C. (2000) ‘Synergistic Effect between Intratbecal Non-NMDA Antagonist and Gabapentin on Allodynia Induced by Spinal Nerve Ligation in’, 5(2), pp. 500–506.
  • Cheshire, W. P. (2002) ‘Defining the Role for Gabapentin in the Treatment of Trigeminal Neuralgia: A Retrospective Study’, 3(2), pp. 137–142. doi: 10.1054/jpai.2002.122944.
  • Devor, M. et al. (2002) ‘Pathophysiology of Trigeminal Neuralgia : The Ignition Hypothesis’, pp. 4–13.
  • Finnerup, N. B. and Svensson, P. (2016) ‘Trigeminal neuralgia New classification and diagnostic grading for practice and research’, 0.
  • George, M. (2011) ‘R eview Article’, 1(2), pp. 28–31.
  • James, M. (2015) ‘Carbamazepine in the Treatment of Neuralgia Use and Side Effects’, 70112.
  • Jensen, T. S. (2002) ‘Anticonvulsants in neuropathic pain : rationale and clinical evidence’, 6, pp. 61–68. doi: 10.1053/eujp.2001.0324.
  • Lemos, L. et al. (2008) ‘Gabapentin Supplemented With Ropivacain Block of Trigger Points Improves Pain Control and Quality of Life in Trigeminal Neuralgia Patients When Compared With Gabapentin Alone’, 24(1), pp. 64–75.
  • Maarbjerg, S. et al. (2017) ‘Trigeminal neuralgia – diagnosis and treatment’, 0(0), pp. 1–10. doi: 10.1177/0333102416687280.
  • Neuralgia, T. et al. (1990) ‘Incidence and Clinical Features Minnesota , 1945-1984’, pp. 89–95.
  • Nicol, C. F. (no date) ‘A four year double-blind study of tegretol ( r ) in facial pain’.
  • Prisco, L. et al. (2011) ‘Trigeminal neuralgia : successful antiepileptic drug combination therapy in three refractory cases’, pp. 43–45.
  • Rockliff, B. W., Davis, E. H. and Angeles, L. O. S. (2015) ‘Trigeminal Neuralgia Os /’.
  • Sato, J. et al. (2004) ‘Diagnostic significance of carbamazepine and trigger zones in trigeminal neuralgia’, pp. 18–22. doi: 10.1016/j.tripleo.2003.08.003.
  • Shaikh, S. et al. (2011) ‘Lamotrigine for trigeminal neuralgia : Efficacy and safety in comparison’, Journal of the Chinese Medical Association. Elsevier Taiwan LLC and the Chinese Medical Association, 74(6), pp. 243–249. doi: 10.1016/j.jcma.2011.04.002.
  • Silver, M. et al. (2007) ‘Double-Blind , Placebo-Controlled Trial of Lamotrigine in Combination with Other Medications for Neuropathic Pain’, 34(4), pp. 446–454. doi: 10.1016/j.jpainsymman.2006.12.015.
  • Sindrup, S. H. and Jensen, T. S. (2002) ‘Pharmacotherapy of Trigeminal Neuralgia Abstract ’:, pp. 22–27.
  • Siqueira, S. R. D. T. et al. (2009) ‘ABNORMAL EXPRESSION OF VOLTAGE-GATED SODIUM CHANNELS’. Elsevier Inc., 164, pp. 573–577. doi: 10.1016/j.neuroscience.2009.08.037.
  • Sistemática, R. (2004) ‘Tratamento Famacológico da Neuralgia do Trigêmeo ’:, 54, pp. 836–849.
  • Stefano, G. Di et al. (2014) ‘Natural history and outcome of 200 outpatients with classical trigeminal neuralgia treated with carbamazepine or oxcarbazepine in a tertiary centre for neuropathic pain’, 15(1), pp. 1–5. doi: 10.1186/1129-2377-15-34.
  • Stefano, G. Di et al. (2017) ‘ce pt ed cr t’, 7175(August). doi:10.1080/14737175.2017.1370375.
  • Wang, Q. and Bai, M. (2011) ‘Topiramate versus Carbamazepine for the Treatment of Classical Trigeminal Neuralgia’, 25(10), pp. 847–857.
  • Yuan, M. et al. (2016) ‘Efficacy and Safety of Gabapentin vs . Carbamazepine in the Treatment of Trigeminal Neuralgia : A Meta-Analysis’, (1), pp. 1–9.
  • Zakrzewska, J. M. et al. (1997) ‘Lamotrigine ( Lamictal ) in refractory trigeminal neuralgia : results from a double-blind placebo controlled crossover trial’, 73, pp. 223–230.
  • Zavoreo, I., Dubrovnik, G. H. and Govori, V. (2009) ‘Neuropathic pain’, (September).