Syed Ghazanfar Hassan, Abdul Qadir Dall, Muhammad Shahzad, Salman Shams, Mirza Arsalan Baig, Nadir Ali.
Comparison of Analgesic Effects of Oral Carbamezapine with Pregablin in Idiopathic Trigeminal Neuralgia.
Med Forum Jan ;2(4):66-9.

Introduction: Idiopathic trigeminal neuralgia, a form of neuropathic pain, caused by not well defined etiology, is a formidable therapeutic challenge to clinicians because it does not respond well to traditional drug therapies. Anticonvulsant drugs are regarded as useful treatment for neuropathic pain. Carbamazepine, the first anticonvulsant studied in clinical trials, probably alleviates pain by decreasing conductance in Na+ channels and inhibiting ectopic discharges. Pregabalin has the most clearly demonstrated analgesic effect for the treatment of neuropathic pain. . The role of anticonvulsant drugs in the treatment of Idiopathic trigeminal neuralgia is evolving and has been clearly demonstrated with Pregabalin and carbamazepine. Objective: The aim of this study was to investigate.comparison of analgesic effects of oral carbamezapine with pregablin in idiopathic trigeminal neuralgia. Study Design: interventional study. Place and Duration of Study: Oral & Maxillofacial surgery department, LUMHS. Jan 2012 to DEC 2012 . Materials and methods: 30 patients with well defined history and diagnostic clinical symptoms of idiopathic trigeminal neuralgia were selected, divided into two groups of 15 individuals with similar gender & age difference. Clinical trial were conducted with group 1 with carbamazepine and group 2 with Pregabalin for 4 weeks. Subjective pain level of both groups was recorded before intervention (pre treatment recording) and after intervention (1st, 2nd, 3rd and 4th) on weekly basis by using 0-10 visual analogue scale (zero represent no pain 10 represent pain that could not be worse). Results: Following intervention, both groups were evaluated for pain score in 1st and 2nd week, there was no significant difference observed between the two groups. (P value 0.44 and 0.456), but after 3RD and 4TH weeks it was observed that, there is significant difference, (p value 0.000 and 0.009) on visual analogue scale. It was observed that there was a significant difference between pretreatment and fourth week mean pain score in group 2, (8.9 and 1.07). Similarly marginally significant difference with (r = .640) was seen in 1st week of group 2 receiving Pregablin, the mean value was (2.53, 1.60) respectively. Conclusion: Based on these results that are in line with the recommendations made by other studies, the 1st line medical therapy is Carbamazepine but this should be changed to other drug therapy if there is no pain relief or adverse effect.

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