Dr. Anthony Kauffman is one of the leading neurosurgeons in Canada to deal with Trigeminal Neuralgia. He is part of the Univeristy of Manitoba and this drug information was taken from his web site.
Drug Information website

Some of the other popular drugs to treat TN are: Phenytoin (Dilantin), Oxycarbazepine (Trileptal), and Gabapentin (Neurontin). Phenytoin was first introduced in 1942, and in 1962 Carbamazepine (Tegretol) became the most commonly used drug. Baclofen (Lioresal) may add to the effectiveness of these drugs. Recently, Neurontin has been widely used because of reduced side effects, although is more expensive and somewhat less effective then Tegretol. The anti-convulsants are thought to reduce TN attacks by decreasing the hyperactivity of the trigeminal nerve nucleus in the brain stem.

Trileptal (Oxycarbazepine)

Trileptal, or oxycarbemazepine, is a form of Tegretol that is becoming more widely prescribed for a variety of conditions. It has recently been found to be effective for some patients with trigeminal neuralgia. Like Tegretol, it is an anti-seizure drug, but the side effects are less severe and less frequently experienced.

The dose usually begins at 300 mg twice a day and is gradually increased to achieve pain control. The maximum dose is 2400-3000 mg per day. Common side effects are nausea, vomiting, dizziness, fatigue and tremors. Less frequent symptoms are rash, respiratory infections, double vision, and changes in electrolytes in blood. If you have had an allergic reaction to Tegretol (carbemazepine), then you should not try Trileptal. As with other anti-seizure medications, increasing and decreasing the dose should be gradual.

Phenytoin (Dilantin)

Phenytoin relieves pain in over half of TN sufferers at doses of 300 to 500 mg, divided into three doses per day. Phenytoin may also be administered intravenously to treat severe exacerbations of TN. The maximum dose depends upon the severity of the side effects that are experienced with the drug. These dose-dependant side effects include nystagmus (rapid movements of the eye), ataxia (decreased coordination), dysarthria (speech difficulty), ophthalmoplegia (paralysis of eye movements) as well as drowsiness and mental confusion. Other effects of the medication may include gingival hyperplasia (enlargement of the gums in the mouth) and hypertrichosis (excessive hair growth). Rare but serious complications may occur, including allergic skin rashes, liver damage and blood disorders.

Baclofen (Lioresal)

Baclofen is not as effective as Tegretol or Dilantin for TN, but may be used in combination with these medications. The starting dose of baclophen is usually 5 mg two or three times a day, and may be gradually increased. The usual dosage taken for complete pain relief is between 50 and 60 mg per day. Baclofen has a short duration of function so sufferers with severe TN may need to take doses every 3 to 4 hours.

The most common side effects associated with baclofen include drowsiness, dizziness, nausea and leg weakness. The incidence of these side effects is reduced by starting with a low dose of baclophen that is gradually increased. However, approximately one tenth of sufferers cannot tolerate baclofen. A rare complication is a confusional state that appears shortly after baclofen is started, but this resolves quickly when therapy is stopped. Baclofen should not be discontinued abruptly after prolonged use because hallucinations or seizures may occur. If these withdrawal symptoms do occur, the previous dose of baclofen is usually re-instituted and then gradually reduced.

Gabapentin (Neurontin)

Gabapentin is an anti-epileptic drug that is structurally related to the neurotransmitter GABA. This drug is almost as effective as Tegretol but involves fewer side effects. The starting dose is usually 300mg three times a day and this is increased to a maximal dose. The most common adverse reactions include somnolence (sleepiness), ataxia (decreased coordination), fatigue, and nystagmus (rapid movements of the eye). There is no known interaction with Tegretol or Dilantin, permitting usage of these drugs in combination with Neurontin. As with all of these drugs, rapid discontinuation should be avoided as severe withdrawal reactions may occur.


So there you have it. A virtual smorgasbord of TN drugs...none to be taken lightly and none to be taken without the strict supervision of your physician. However this shows you that your options are not limited to the one drug your doctor may have subscribed. Like I mentioned in the previous post, it may take a while to experiment and find just the right therapeutic dose or combination to get you the relief you need.