‘Triple drug therapy’ for the management of carbamezapine refractory trigeminal neuralgia

  • Armaghan Israr Mirza FFD RCSI, FCPS, BDS, BS. Assistant Professor, Department of Oral and Maxillofacial Surgery, de’Montmorency College of Dentistry/ Punjab Dental Hospital, Lahore.
  • Adnan Aslam FFD RCSI, FCPS, BDS. Associate Professor, Department of Oral and Maxillofacial Surgery, Margalla Institute of Health Sciences, Islamabad.
  • Ali Farooq FCPS, BDS. Assistant Professor, Department of Oral and Maxillofacial Surgery, Sharif Medical and Dental College, Lahore.
  • Sajeel Ahmad BDS, FCPS. Resident. Department of Oral and Maxillofacial Surgery, de’Montmorency College of Dentistry/ Punjab Dental Hospital, Lahore.
  • Muhammad Azeem BDS, FCPS. Resident. Department of Oral and Maxillofacial Surgery de’Montmorency College of Dentistry/ Punjab Dental Hospital, Lahore.
Keywords: Orofacial pain, gabapentin, amitriptyline, refractory pain

Abstract

Introduction: Trigeminal Neuralgia is encountered in practices of dentists and specialists quite often. Many therapeutic regimes are used for its treatment. Hence the purpose of the present research was to evaluate the efficacy of combination therapy using Oxcarbazepine, Gabapentin and Amitriptyline among patients presenting with Trigeminal Neuralgia refractory to Carbamazepine therapy.

Material and Methods: A self-administered questionnaire consisting of questions on the intensity of pain and the impact of patient’s pain on their quality of life was distributed among patients presenting with Trigeminal Neuralgia refractory to Carbamazepine therapy. The collected data was analyzed using SPSS software. The study was conducted at the Department of Oral & Maxillofacial Surgery, de’Montmorency College of Dentistry / Punjab Dental Hospital, Lahore, from January, 2017 to August, 2017.

Results: A total of 32 patients participated in the study out of which 6 were lost during follow-up. Of the remaining 26, 21 (80.76%) patients had pain relief while 5 (19.23%) reported no improvement in symptoms. Of the 21 patients with improvement in pain symptoms, 12 (57.14%) reported their pain as moderate after 3 months and 9 (42.85%) reported their pain level as mild. Furthermore, the mean score for quality of life in these patients also improved from a mean of (8797) to (7768) in a period of 3 months.

Conclusions: It was concluded from the present study that combination therapy using Oxcarbazepine, Gabapentin and Amitriptyline for intractable Trigeminal Neuralgia leads to significant reduction in pain levels as well as improvement in quality of life and should be explored further.

Published
2018-08-31
How to Cite
Mirza, A., Aslam, A., Farooq, A., Ahmad, S., & Azeem, M. (2018). ‘Triple drug therapy’ for the management of carbamezapine refractory trigeminal neuralgia. Pakistan Orthodontic Journal, 10(1), 51-55. Retrieved from https://poj.org.pk/index.php/poj/article/view/211
Section
Original Articles