COMPARISON OF EFFECTIVENESS OF CARBAMAZEPINE VERSUS TOPIRAMATE FOR THE MANAGEMENT OF TRIGEMINAL NEURALGIA

Abstract

Objective: To compare the effectiveness of Carbamazepine versus Topiramate for the management of trigeminal neuralgia.

Study Design: Comparative prospective study.

Place and Duration of Study: Oral and Maxillofacial Surgery department, Allied Hospital, Faisalabad Pakistan, from Nov 2017 to Nov 2018.

Methodology: A total of 60 patients (30 in each group) were included. Group A was treated with Carbamazepine 100mg TDS and group B with Topiramate 25mg TDS. Visual analogue scale was used to access pain and was calculated at 1st visit (baseline), at 7th day, at 14th day and at 28th day.

Results: Out of 60 patients, mean of age was 54.78 ± 8.49 years. Right and left side of the face was involved in 41 (68.3%) and 19 (31.7%) patients respectively. Maxillary branch was involved in 24 (40%) and mandibular branch was involved in 36 (60%) patients. The mean of visual analogue scale after 7 days in group A was 4.53 ± 0.93 and in group B was 7.1 ± 1.07, after 14 days mean of visual analogue scale in group A was 3.7 ± 1.02 and in group B was 4.03 ± 1.27. Mean of visual analogue scale after 28 days in group A was 3.27 ± 1.01 3.93 ± 1.28. The results were statistically significant with p-value of 0.03.

Conclusion: Topiramate has comparable efficacy as that of Carbamazepine at dose of 75-100mg with lesser side effects. So Topiramate can be used as first line of treatment in trigeminal neuralgia.