Trigeminal neuralgia

Chronic paroxysmal sharp pain in trigeminal nerve distribution. First-line pharmacotherapy is carbamazepine and oxcarbazepine.

ICD-10 G50.01 drug

Also known as: Tic douloureux

Drugs used for this condition

ACarbamazepineFirst line · Antiepileptics. Carboxamide derivativesCarbamazepine remains the first-line drug for trigeminal neuralgia per AAN 2017 and European guidelines. NNT for 50% pain reduction is approximately 1.7. Starting dose 100–200 mg twice daily, titrated to clinical response (usually 600–1200 mg/day). Oxcarbazepine is considered an alternative with better tolerability.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit