Evaluation of Carbamazepine Pharmacotherapy In Patients With Trigeminal Neuralgia

Abstract

In this study we aimed to determine the adverse effects and pain outcome following carbamazepine pharmacotherapy to manage patients with classical trigeminal neuralgia. The study was carried out on patients diagnosed with classical trigeminal neuralgia at the Faculty of Dentistry, University of Malaya. Medical records of patients diagnosed with trigeminal neuralgia over a period of 11 years from April, 2003 to April, 2014 were reviewed. A total of 49 patients who fulfilled the inclusion criteria were included in the study. Demographic details, clinical features and blood test reports of the patients were recorded from the patient’s clinical files. Subjects included in the study were administered the Faces Pain Rating Scale (FPS) and Numeric Pain Rating scale (NRS) to measure the pain outcome retrospectively. Analysis and interpretation of results was carried out using SPSS. Hepatic adverse effects were more commonly seen in our patients (n=39) followed by haematological (n=27), renal (n=23) and non-specific adverse effects (n=22). However, there was no significant association between the observed side effects and carbamazepine pharmacotherapy. Analysis of our data using Pearson Chi Square test, showed no significant correlation between gender, ethnicity and age of the patients with adverse effects. 9 out of the 49 subjects included in the study were administered the FOS and the NRS. Pain perception after treatment was significantly decreased (p-0.007) in comparison to pain perception before commencement of therapy with carbamazepine in the selected group of patients. Even though pain perception decreased in the selected patients, the data is insufficient to state the efficacy of the treatment as none of the patients reported a complete relief from their pain. The results of our study showed that there were no significant haematological, hepatic, renal, and non-specific adverse effects associated with the use of carbamazepine. The efficacy of this drug in the treatment of trigeminal neuralgia was proven to be satisfactory. It may be concluded that carbamazepine could be considered as the drug of choice in the treatment of trigeminal neuralgia.