Tag: depression and chronic pain

Trigeminal neuralgia medication-how to take them?

Posted on | by Dr. Jaydev Panchwagh | 45 Comments on Trigeminal neuralgia medication-how to take them?

Trigeminal neuralgia medication, at least the majority of them, are anti-convulsants.

“How to take them-Trigeminal neuralgia medication?”

Can I take TN medication when I feel the pain coming on?

Can I add more drugs during a Trigeminal neuralgia attack?

Do I have to continue taking the Trigeminal neuralgia medicines even if I have no or minimal pain?

These are all questions that frequently come to the patients’ minds.

What is essential to understand is that TN medicines are not straight-forward pain-killers. They are primarily anti-convulsants or brain numbing medications. Once the first pill is consumed, it takes a few hours to reach the blood. The liver simultaneously metabolizes the drug, while some of it also reaches the brain to act upon. So in effect, the blood level reduces. Over a period of the next few hours, the blood level will become zero. Before this happens, we need to consume another pill to increase and maintain the blood level. If this does not happen, there is no effect on the pain as well.

In short, regular medication is essential to maintain a particular blood level of the drug, so that it calms the brain/ nerve. This calming effect means that they do not respond to pain signals, and therefore have a neuralgic-pain-reducing effect.

Another key point to be noted is that the dosages need to be very gradually increased (and decreased also).

What happens if I take too many TN pills?

Well, you will certainly start manifesting all the side-effects of these anti-convulsants, like drowsiness, dizziness, imbalance, mental clouding, memory loss, depression etc. This is why, their dosages have to be adjusted by your doctor, who will determine what is right for you. One typically starts with the lowest dosage twice or thrice a day. This may be increased to maximum doses four times a day.

What happens if I miss a couple of doses of TN medication?

The blood level reduces, and you may experience break-through pain.

Allergic reactions to Trigeminal neuralgia medication

When starting off drugs to control TN pain for the first time, one has to be aware of and be on the lookout for allergic reactions. Though rare, it is not unheard of. I have come across a few patients in my practice. Typically they are in the form of skin rashes. These may be the harbinger of a very serious and potentially fatal Stevens-Johnson syndrome. If one notices skin rashes on consuming TN medication, please inform your doctor immediately and stop taking it.

What are the commonly used medication for trigeminal neuralgia?

What other drugs than anticonvulsants are useful for TN pain?

Is TN permanent?

What are some of the FAQs about TN?

Is there a cure for Trigeminal neuralgia?

Who is Dr Jaydev Panchwagh?

Youtube videos explaining in detail about Trigeminal neuralgia

Can I hear some patient testimonials? MicroVascular Decompression surgery to cure Trigeminal neuralgia.

How do I contact Dr Jaydev Panchwagh?

Trigeminal Neuralgia Patient Testimonial | Laxminarayan Gogineni

Posted on | by Dr. Jaydev Panchwagh | 31 Comments on Trigeminal Neuralgia Patient Testimonial | Laxminarayan Gogineni

I suffered from Trigeminal Neuralgia and this is my patient testimonial:

I suffered from Trigeminal Neuralgia for five years before my Microvascular decompression surgery. Symptoms of TN for me was a severe shock like pain along the lower jaw.

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Depression and chronic pain

Posted on | by Dr. Jaydev Panchwagh | 36 Comments on Depression and chronic pain
People who suffer from Trigeminal neuralgia, which is a chronic pain condition, often have depression. I have written this blog to help understand how the pain-anxiety-depression cycle kicks in.
I remember a story told to us in childhood.
Akbar asked Birbal, what is the worst punishment for a human being? (Akbar was a powerful Mughal emperor in India and Birbal was his wisest court- minister).
Birbal said, “Sire, before I give you the answer to this question, may I ask you what do you think is the worst punishment ?”
“Why, Birbal, of course it is death penalty ! …I just want to know if you have any different thoughts.”
“Sire, the worst punishment is not death; it is a “continuous, chronic mental terror that death or pain is about to come. I do not wish this punishment upon my worst enemy too.”
“Surely Birbal, you are joking. How can anything be worse than death itself? You have to prove your claim” said the Emperor in his usual style.
And in his usual style, Birbal too arranged the experiment.
He ordered a ferocious and hungry tiger to be brought in a cage. He ordered that the tiger should be kept half fed.
Five feet from the cage, he tied a well-fed sheep to a tree.
A heap of grass was kept by the sheep’s side so she could feed to her heart’s content.
Birbal told Akbar, “Sire, we will visit this site daily.”
On the tenth day. The sheep had lost all the weight, had not eaten any grass and there was a terrified look on her face that had become almost permanent. The fear of the tiger had taken away her appetite.
This story is more than just amusement.
A chronic pain, chronic terror, continuous foreboding that the next attack of pain in imminent is typical of trigeminal neuralgia pain….even in patients who are on medicines for months and years together.
This continuous terror and severe anxiety is worse than pain itself.
It has been proven with the help of functional MRI that the surface area of sensory pain mapped on brain surface is found to have increased many-fold in patients with trigeminal neuralgia and other types of chronic pain.
So, the brain actually changes for worse in these patients….literally and structurally.
This results in even small painful stimuli causing severe pain as the sensory interpretation of the pain has multiplied many fold.
Thus chronic pain can cause severe depression, and induce suicidal tendencies.
And this is the reason that procedures like MicroVascular Decompression should be used to CURE the disease (Trigeminal Neuralgia), rather than any temporary methods or medicines.
Dr Jaydev Panchwagh is a renowned neurosurgeon with special interest in Trigeminal neuralgia treatment, and has performed over a thousand Microvascular Decompression surgeries.