What options have you found to be most effective?

There seems to be two different kinds. The classic kind with electrical type pain that comes in VERY horrible spurts and can be frequent, can be relieved with surgery...called an MVD. Not sure what meds work best. I have heard a variety of things...mostly anti-convulsants.

The other type of problem in this area, where the Trigeminal Nerve has been damaged in some way, is or what was recently called "atypical trigeminal neuralgia." I have heard some talk that the Trigeminal Society is considering renaming this. Doesn't really matter...it still is very, very painful and difficult.
This is the problem I have and I can get some relief with: direct heat (heating pad, hot wash cloth or little heat pads used when snow skiing) and capsaicin cream (not necessarily at the same time...could cause a burn/be careful!!!)

These days I take a tricyclic medication (RX/pill) and a compounded cream with: Gabapentin, Capsaicin and Lidocaine. I rub the cream on my damaged right side 4 to 5 times a day. I also went to acupuncture 3x a week for several months. Now, I only go once in awhile. I also take Percocet for breakthrough pain once in awhile. This routine isn't perfect, but it has helped me and I am very grateful!

I hope you get some relief...this pain can be very very tough!

Thank you for the feedback. My father in law suffers with it and e are trying to figure out best options for him to consider.

Dad is currently on meds for his TN. He has always been a very sharp high spirited energetic individual but as time goes on he seems to be becoming more and more "out of it" so to speak. He just does not seem himself anymore. Is this common?

I don't know. I have had more word finding and spelling issues. How old is he? Surely, the doctor should be told about this. The medications often taken for this illness (neuroleptics, pain meds) certainly can cause a person to be "out of it!" I have tightened up my eating habits (NO SUGAR or junk food of any kind) and I also take my vitamins. I have mentioned on these boards a supplement I take called PS 100 many times. I understand it is used in Europe to help with memory issues. Probably should check with his doctor first to see if he can take it. Anyway, it has helped me a little with the memory issues caused by my medications. I take two tablets a day. You can read reviews about it at: www.iherb.com. Generally, it seems very safe and I understand it is used in other countries for ADD or dementia. Anyway, I would double check dosages, consider tightening up on diet and consider that supplement (if the doc says it is ok). Also, make sure your father is getting enough rest and is not depressed. Bad pain can interrupt sleep and make one very depressed. My goodness, until my pain got more controlled, I was VERY depressed and could barely think. I still have my bad days, but less so at this time and I am very grateful. Hang in there!