Evidence-Based Pharmacologic Approaches for Chronic Orofacial Pain

For neuropathic pain, the three medications to use are gabapentinoids, tricyclic antidepressants and serotonin norepinephrine reuptake inhibitors plus topical anesthetics. Beta-blockers, tricyclic antidepressants and anti-epileptic drugs are effective preventive medications for daily migraine headaches. The three FDA-approved drugs for fibromyalgia, pregabalin, duloxetine and milnacipran, are not robust. For osteoarthritis, nonsteroidal anti-inflammatories have good efficacy, and when gastritis contraindicates them, corticosteroid injections are helpful.