Medicines for face pain treatment
Medicines for face pain treatment are generally those that are used to treat fits (convulsions, seizures). These come under the group called anti-convulsants (these numb the brain and prevent response to stimuli). Anti-convulsants are medicines used to control convulsions(or “fits”).
While there are many medicines that could be used, some are similar to the older versions, some are very different; and some medicines are not related at all. Acupressure, acupuncture, Ayurveda and Homeopathy have also been tried.
How do medicines act?
Basically, all act by numbing the brain (Central nervous system ). The intention is to reduce reactivity of the Trigeminal nerve, but no medicine can act on just one nerve. It therefore acts on the entire nervous system, numbing it. This is the primary reason for the major side-effects of medication.
So, for most people, medication is the first line of treatment. Most of them are off-label for the treatment of facial pain (Trigeminal Neuralgia). Most patients need to adjust the medication with varying combinations and dosages to get the best pain relief effect with minimal side-effects.
The following video describes the typical journey of a patient who has started having facial pain on one side of the face:
Which medicines are commonly used to treat face pain?
Among the medicines that are used for treatment of trigeminal neuralgia and face pain are
Carbamazepine/Oxcarbamazepine/Eslicarbamazepine,
Gabapentin/Pregabalin,
Phenytoin and other anti-convulsants,
Some anti-depressants,
Skeletal muscle relaxants,
Anaesthetics
Toxins.
These medicines have different formulations and trade names.
How are medicines to treat TN pain started?
Initially only one drug is generally started, at a small dose, then the dose is increased as necessary. If the pain continues to increase in intensity and frequency, a second or third drug may be added. Please be sure to talk to your doctor about the effect and side-effects that you experience. Please look out for rashes or itching or some other sign that you maybe allergic to the drug.
Are there any specific drugs for TN pain?
There is a new drug that is being developed specifically for trigeminal neuralgia pain. Research is still on, and it is in the planning stage.
Please be sure to talk to your doctor about the effect and side-effects that you experience.
What are the side-effects of medicines used to treat face pain?
Common side effects of Medicines used for treatment of facial pain:
Memory loss
Reduced co-ordination
Confusion
Weight gain
Loss of balance
Drowsiness
Difficulty in finding the right words
Fatigue
Irritability
Dry Mouth
Nausea etc
Can these drugs be stopped suddenly?
No. Stopping the medicines used to treat your TN pain is as challenging as starting you on them.
Because of the need to titrate your dosages, or shift to a different medication you need to know this.
We need to change dosage or type of medicine if you are not responding, nature of pain has changed. a nerve block injection has failed or pain has recurred.
Typically, the medicines in high doses are tapered off over few weeks before stopping completely. This is especially true after you have undergone a successful MVD surgery. Dr Jaydev Panchwagh and his team have a specific protocol for tapering these drugs.
So, what can be expected during withdrawal?
Typically, one notices dizziness, nausea, increased pain, agitation, confusion, disorientation, violent dreams, tremors, irritability etc
Where can I find more information on the medicines?
We have an entire website dedicated to treatment of Trigeminal neuralgia pain. You can find information here.
Is there any alternative to medicines?
Yes, people try naturopathy, Homeopathy, Ayurveda, or Acupuncture, Acupressure and others.
Some people believe exercises help them. Some make adjustments in food.
What if medicines for treating the pain of trigeminal neuralgia have stopped working?
Do not worry! There are alternative treatments available. Nerve injections and Gamma knife procedures are nerve destructive procedures. Their effect is generally temporary. The success rate for pain relief is also less as compared to surgery.
Surgery for TN is called Microvascular Decompression (MVD surgery). It is generally a nerve preserving procedure, offers the potential of permanent pain relief. You can learn more about this here and here.
Dr Jaydev Panchwagh is the chief Neurosurgeon and Director of the Centre of excellence for MVD surgery in Pune, India. He has been keenly focused on MVD surgery for nearly twenty years and has operated on patients from more than 22 states in India, and about 13 countries around the world. He has performed more than 1900 MVD surgeries as of this date.
You can find more information on his work here.