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Considerations When Using Gabapentinoids to Treat Trigeminal Neuralgia: A Review
Gianfranco De Stefano1, Giuseppe Di Pietro1, Andrea Truini1
1Department of Human Neuroscience, Sapienza University, Rome, Italy.
Neuropsychiatric Disease and Treatment
|September 25, 2023
Summary
Gabapentin and other alpha2-delta ligands show promise for treating trigeminal neuralgia, especially when first-line drugs cause side effects or fail. Further research is needed due to low-quality evidence.
Area of Science:
- Neurology
- Pharmacology
Background:
- Voltage-gated sodium channel blockers are first-line treatments for trigeminal neuralgia but cause side effects.
- Their efficacy may decrease in patients with continuous pain, necessitating alternative treatments.
Purpose of the Study:
- To review current evidence on gabapentin and other alpha2-delta ligands for trigeminal neuralgia.
- To assess the efficacy and tolerability of these agents.
Main Methods:
- Systematic search of PubMed, EMBASE, Cochrane Database, and ClinicalTrials.gov up to April 2023.
- Inclusion and data extraction by two independent authors.
- Analysis of seven controlled or open-label studies.
Main Results:
- Gabapentin and pregabalin (alpha2-delta ligands) were assessed in the included studies.
- Evidence quality is currently low.
- These agents have a favorable tolerability profile.
Conclusions:
- Alpha2-delta ligands are of interest for trigeminal neuralgia treatment, particularly for continuous pain.
- Their favorable tolerability profile warrants further investigation in clinical trials.
- Future research should focus on higher-quality studies to confirm efficacy.
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