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Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
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An update on pharmacotherapy for trigeminal neuralgia
Joseph V Pergolizzi1, Jo Ann LeQuang1, Salah N El-Tallawy2,3
1NEMA Research, Pain management, Naples, FL, USA.
Expert Review of Neurotherapeutics
|June 13, 2024
Summary
Newer medications and combination therapy show promise for treating trigeminal neuralgia (TN) by potentially reducing side effects associated with older drugs like carbamazepine. Further research is needed to establish robust clinical evidence for these novel approaches.
Area of Science:
- Neurology
- Pharmacology
Background:
- Trigeminal neuralgia (TN) is a rare neuropathic pain condition.
- Current treatments like carbamazepine and oxcarbazepine have significant adverse effects.
- Novel therapeutic strategies are being explored for TN management.
Purpose of the Study:
- To review emerging pharmacological options for trigeminal neuralgia.
- To discuss the potential of third-generation anticonvulsants, CGRP blockers, ketamine, and cannabinoids.
- To evaluate the evidence for these agents as monotherapy or adjuncts.
Main Methods:
- Literature review of recent studies and clinical practice observations.
- Discussion of proposed mechanisms of action for new agents.
- Consideration of combination therapy approaches.
Main Results:
- Limited robust clinical evidence currently exists for novel TN treatments.
- Migraine-specific agents are being considered despite distinct pathologies.
- Combination therapy may allow for reduced doses of traditional medications.
Conclusions:
- Newer anticonvulsants, CGRP blockers, ketamine, and cannabinoids represent potential future treatments for TN.
- Combination therapy is a practical approach to mitigate side effects of established drugs.
- Further high-quality clinical trials are essential to validate efficacy and safety.
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