Tic Douloureux (cont.)
A number of medications are effective in helping control the pain of tic douloureux. The most commonly prescribed medications are anticonvulsants (seizure medications). Anticonvulsants help to stop the irritated trigeminal nerve from firing pain impulses.
- The most frequently prescribed anticonvulsant medication for tic douloureux is carbamazepine (Tegretol). Other anticonvulsants used include phenytoin (Dilantin) and gabapentin (Neurontin). These medications are generally started at a low dose and then increased until pain is controlled or side effects occur. Common side effects include drowsiness, dizziness, double vision, and nausea. Rarely, serious liver or bone marrow problems can occur.
- Baclofen (Lioresal), a muscle relaxant, is useful for some people who either do not respond to anticonvulsants or who suffer serious side effects.
- Opioid pain medications can be useful during episodes of severe pain.
- Medication is 80% effective. For the other 20%, drug therapy either fails to provide adequate pain control or adverse side effects are intolerable. Unfortunately, up to 50% of people who initially respond to anticonvulsants eventually develop resistance to the medications.
Francisco Talavera, PharmD, PhD