What medication is the treatment of choice for trigeminal neuralgia?

Carbamazepine is recognized as the first-line treatment for trigeminal neuralgia due to its effectiveness in managing the condition. This anticonvulsant works by stabilizing the neuronal membrane and reducing the excessive discharge of nerve impulses that characterize trigeminal neuralgia. It has been extensively studied and is the most commonly prescribed medication for this type of facial pain, often providing rapid relief from symptoms.

Gabapentin and pregabalin are also used in the management of neuropathic pain, but they tend to be considered second-line treatments for trigeminal neuralgia. These medications can be helpful in situations where patients do not respond adequately to carbamazepine or experience significant side effects. Topiramate is another anticonvulsant that may offer some benefit for neuropathic pain but has not been established as a primary treatment for trigeminal neuralgia.

The choice of carbamazepine is based on its strong evidence of efficacy, and it is often the first medication tried in clinical practice for this condition. Regular monitoring of blood levels and potential side effects is important while using carbamazepine, but its specific mechanism and history of use make it the treatment of choice in managing trigeminal neuralgia.