Evaluation of the Efficacy of Carbamazepine and Oxcarbazepine in Trigeminal Neuralgia

Introduction: Trigeminal neuralgia is characterized by the presence of sudden, intense and repetitive orofacial pain generated in one or more branches of the trigeminal nerve; carbamazepine and oxcarbazepine are the first-line drugs for its treatment. Objectives: To analyze the most up-to-date evidence on the doses and efficacy of carbamazepine and oxcarbazepine in the treatment of trigeminal neuralgia. Methods: A narrative review based on a search of articles in PubMed, Scopus, Scielo and Google was conducted. SANRA guidance for narrative reviews was followed. Results: In the studies analyzed, it is proposed that for the treatment of trigeminal neuralgia, carbamazepine should be used at an initial dose between 200 and 400 mg per day, and a maintenance dose between 300 and 800 mg per day. On the other hand, the initial dose of oxcarbazepine is proposed at 300 mg per day and the maintenance dose between 600 and 1200 mg. Conclusions: Carbamazepine and oxcarbazepine are the most used firstline drugs to relieve pain in trigeminal neuralgia, and the doses must be individualized, which depends on the patient characteristics and the evolution of the disease to avoid adverse effects.